Lodge Programs Serving Family Functions for People with Psychiatric Disabilities.

Lodge Programs Serving Family Functions for People with Psychiatric Disabilities* People affiliated with lodges, a community program for people with psychiatric disabilities, were interviewed through small group faceto face and telephone interviews about their perceptions of promising practices. Responses from the interviews appeared to fit the theme of the lodge serving many of the functions of a family. Relevant excerpts from the interviews were used to supplement this broad theme and implications for practice are discussed in terms of competency-based outcomes: Key Words: community emplopment, family fiaocrioa, mental health, mental illness, psychiatric support, psychosocial programs. Families caring for members with severe and persistent mental illness face challenges (Bernheim, 1989; Torrey, 1997) and multiple sources of stressors in the process of caregiving (Greenberg, Seltzer, Krauss, & Kim, 1997; Lefley, 1996). While many caring families have extended their support for their family member with mental illness in extraordinary and innovative ways (Carver, Scheier, & Weintraub, 1989; Horowitz, Tessler, Fisher, & Gamache, 1992; Marsh, Appleby, Dickens, Owens, & Young, 1993), many biological families are faced with stresses and strains in meeting the needed supports of their family members (Cook, Cohler, Pickett, & Beeler, 1997). Aging parents worry about how their son or daughter with a mental illness will have their needs for support met after they have died (Greenberg et al., 1997; Lefley, 1987; Seltzer, Greenberg, Krauss, & Hong, 1997). Thus, while the importance of having continuity of family functions is recognized, how such functions will be sustained for people with mental illnesses is less clear. Additionally, having a severe and persistent mental illness is a cost to society, both emotionally and financially (Marsh, 1992; Torrey, 1997). The cost to the person with the mental illness is extreme, namely, profound stigma. Hatfield and Le$ey (1993) have lamented the ramifications of this stigma. Stigma is the most critical burden suffered by persons with major mental illnesses . The message that mental illnesses are undesirable and that their bearers should be feared and avoided is transmitted in multiple ways-by the mass media, by employers, by neighbors, by former friends, and even by some family members. (p, 100-101) People with severe and persistent mental illness are thus faced with the burden of obtaining housing and employment in a world where they are often perceived as undesirable and feared. This kind of stigma serves to marginalize people with a severe and persistent mental illness (Parker, Georgaca, Harper, McLaughlin, & Stowell-Smith, 1995). Stigmatized individuals with mental illness may try to correct their condition by symptom management techniques without having access to the elements that define our social status, such as ownership of property, employment, and a new respectable social identity. They continue to suffer the negative consequences of the label, mentally ill (Goffman, 1963). Given these realities, it is not difficult to see that this population is indeed oppressed. Many programs have been developed without the real needs of this oppressed population having been considered (Marsh, 1994). What are these needs? The answer to this question lies in the voices of two significant stakeholder groups who have often been overlooked by professionals in the decision-making process of establishing and operating mental health programs: consumers and family members: Frederick J. Frese (1994), psychologist and consumer (fulfilling the stakeholder roles of both consumer and professional) poignantly asserts that all three stakeholders, consumers, families, and providers/professionals, need to form a genuine partnership. In this partnership, the system needs to be consumer-driven so that blaming family members for the illness is replaced with an acknowledgment of the strengths and resources of consumers as well as the pathology of their illness. …