Abuse of Carers by Relatives with Severe Mental Illness

Background: Relatives often experience considerable problems looking after a family member with severe mental illness. The problems arising from verbal and physical abuse are not well researched or acknowledged. Aims: To examine the frequency with which family carers experienced verbal and physical abuse from relatives who were being looked after by a community mental health service and to identify the correlates and consequences of that abuse. Method: Interviews with all the clients of a community mental health service in suburban Melbourne who had regular contact with a family carer together with interviews with the carers. Results: One hundred and one clients and their family carers were interviewed. Supporting a previous study of patients on an acute admission ward, the experiences of verbal and physical abuse were positively correlated. Higher rates of abuse were associated with poor relationships between patients and their families and a history of poly-drug misuse and previous criminal offences on the part of the patient. Relatives experiencing higher levels of abuse were more likely to have symptoms of emotional distress and were rated as experiencing more burden. Conclusions: Verbal and physical abuse are not infrequent problems facing family members caring for a relative with severe mental illness. Some of the risk factors for such abuse can be identified. Care plans for family carers could usefully target risk reduction strategies to minimise the occurrence of abuse.