The Family and Mental Illness

Abstract

The story of the family in relation to mental illness has had a convoluted course, and one that is highly culturally determined. While the full scope of psychiatric debate on the aetiology and onset of various forms of major mental illness are outside the scope of this chapter, an understanding of the social and political antecedents of modern-day formal psychiatry, and the researched evidence of the physical causes of illness — ‘the virus, enzyme, hormone, toxic substance, gene, organic deficiency responsible for schizophrenia’, for example — still contribute to oppositional contemporary debates (Asen, 1986, p. 32). In a recent paper Cooklin et al. (1997) commented on the way in which British psychiatry has developed within a belief system that takes as its core the individual and the illness, independent of the social context or culture in which this occurs. Cottrell (1989) has demonstrated that the training of junior psychiatrists has led to little or no family history, and less cultural history, being taken from patients admitted to acute psychiatric wards other than that which emerges by default when ‘taking a past history’. Both Cooklin and Byng-Hall, in their role as training psychiatrists in family therapy, have described the impact that requiring all admitting doctors to ask about the children that a patient may have at home has had on the practice of the psychiatrists they have trained.¹