Perspective request: What would a healthy family do during serious physical/mental health events?
What would your family do? What would a normal, healthy, supportive family do? (If different)
Hypothetical situation 1:
Two family members have had a major accident. No threat to their lives, some internal organ damage, some broken bones, not much other info is know. One of them is awake and can call/text for info, the other is in/out of surgeries and in ICU for the first two days.
A) immediately family drops everything and fly to their destination right away?
B) extended family do so?
C) discuss and send one person to go right away. Then discuss to arrange for longer term recovery + rehab care after hospital discharge
D) nothing, combo, or other ?
Hypothetical situation 2:
Family member is "not doing well", eg, mental health. Probably"moderate" level of suicide risk: no immediate plans, some reservations about morality and how devastated their partner would be, but constant ideation and philosophically don't see why not. CPTSD with more recent triggers of job loss and moving from away from a socially unsafe situation. Has entirely dropped out of communication with family. Their partner is reachable by phone or email or text and says the family member is not doing well at all and has ceased all outside of home activities such as getting mail, buying groceries, filling up the car or anything that involves other human beings.
What would a normal family do?
My inclination would be either A or C for Situation 1, depending on life situation. I don't have kids, so it's easier to drop things and travel like that, so I'd be more A-ish. If there were kids or other people needing cared for, that would incline things more toward C. Extended family would be part of the discussion for C. This also assumes a fairly average family dynamic with no particular animosity/estrangement.
For Situation 2... damn, that's tough. The fact that their partner is there and they're not alone helps. I take it they're not in therapy? It really, really sounds like they need to be in therapy. I'd be talking to the partner about if there's any way to arrange that and if some kind of family intervention might help, but there's only so much you can do for someone who isn't willing to even allow others to help them, let alone help themselves. Also make sure that the partner is limiting access to means where possible (weapons/pharmaceuticals)
The partner is definitely not limiting access, and has been basically begging for family to please come visit and please call and please take an interest. The family member has been in therapy for a few years.
Not who you replied to, but quick clarification: it's good that the partner isn't limiting access to people, but the person mentioned limiting access to means (of self harm) which is an important step for them to take. Keeping weapons and pharmaceuticals out of immediate reach (but not necessarily removed completely, that can feel very infantilizing and could do more harm than good. Keep any guns locked up, put kitchen knives out of sight but accessible for normal use, leave out a couple of days worth of meds at a time and lock up the rest, things like that).
I think there's also a balance to be held re it being infantilizing as to how much of a real risk it is which is hard to judge. Also having an honest conversation with that person can sometimes work where they're able to give permission for that to happen for specific means. Particularly guns or other more instant reactive means that reduce the time to be able to think.
Oh, it's a delicate balance for sure. But IMO the only time you should really go hard on locking everything down is in the case of a sudden and seemingly inexplicable "rebound," because that usually means the person has a plan in place. Until then my experience has been that treating them like an adult is much more helpful.
Oh wow that didn't even occur to me, thank you for clarifying and that brings up not only good to know helpful strategies, but also nuances of balance re infantilizing of the person who requires care.
I am not representative of a normal family, but I am representative of a family that has been absolutely wrecked by two suicides. So speaking from that perspective, I would drop what I was doing and be on the next flight out if my family member's partner told me they were worried about that family member's suicidal ideation. I would do literally anything in this world to go back in time and make different decisions knowing what I know now. I think about it every day, it's been 7 years. So. If this is a real scenario my advice is that there is no upper limit on making yourself available and present in that person's life. Like call them as often as you can, make it a priority to make sure that they KNOW they are an important part of your life. Send them mail or little care packages of things that make you think of them. Suicide is traumatizing in a way it's hard to find words for.
That said, I think a normal family would probably schedule visits in scenario 2 with less urgency than scenario 1. Scenario 1 I would imagine that the immediate family would probably go with urgency, and one or two of them would do an extended stay while after care is planned.
I am also not a representative of a normal family; I guess that's why I'm asking folks here who have a more rounded experience.
It is also my opinion that if the person suffering can find it in themselves to hold on just one more day at a time....it is a big, big ask and if they don't manage to be able to do anything else that day, they've already done more than could be reasonably requested of them. So many people decide on going away because they mistakenly believe that it will ease the burden on their loved ones, when tragically the reverse is true.
Yes, I agree. I hope you have supportive people around you as you think about these challenging topics. Not having a normal family is hard sometimes.
So the difficulty here is one is acute and the other isn't. With people in an ICU, they will definitely need someone to drive them home, feed the pets, check on the fridge, pick up prescriptions, etc.
With mental health, it's unknown if the person wants help, if that help would actually help, etc.
On the first case, what my siblings have always done is huddle up, pick the best person to go scout it out, with the others to follow shortly as needed. This has weirdly happened enough that we have a general gameplan.
For the second, we invite the person to visit, coordinate a visit with their partner if they think it is a good idea, to give them support if nothing else. Since your scenario has the significant other asking for help, we would of course go.
Thank you for the insight. In real life, a game plan like that hasn't been developed but I feel it's important for those conversations to start, as our real life parents begin to age.
I guess I'm trying to process the mentality behind why acute health events might spur action, and mental health seems to be ignored. Although I understand "chronic" issues don't get the same response, I also am struggling to gauge how normal it is for immediate family to ignore requests for help and pretend nothing at all is different over spans of years. In hypothetical situation 2 there might even be expressions of hurt coming from the family about how much Person 2 being difficult is making them suffer. Maybe if the requests aren't clear?
I think there's a few things. First, there can be a stigma around mental health that makes people shy away from helping. And in fairness, many people who need help do turn down offers, which presents the problem of what to do when the person says they don't want help?
Beyond that, the acute vs chronic terms you used are a good way to frame it. If you had a family member with a chronic disease, you can only really help them if they work with you. You can't really live their life for them. So in an acute situation, you can step in for a definite period, and be done. For a chronic issue, you can help address specific things, but can't really just wait in the wings forever.
For example, if you have an aging parent who is losing the ability to self-care, you can offer to let them move in with you. But if they turn you down, what do you do? You could visit and help rearrange their living space, etc. but that doesn't solve the problem, it just punts it. At a certain point you get alarm fatigue and just let them be, until they realize they need to make bigger changes themselves.
Mental health is like that. You can step in and help with specific things when asked. But you can't make them want to make changes, and you can get alarm fatigue, support burnout, etc.
That said, if the person is asking for help, I think it weird not to help them. In my family it would be weird not to go help. But the ask would need to be clear, I think.
C always, and most importantly: healthy families communicate. Not talk. Communicate. Convey information between each other.
The one person sent to head up all the initial interactions is presumably a healthy individual that knows how to handle situations and de-escalate stuff. You don't send your sociopath mother in law to take lead at the hospital to deal with the medical staff, and you don't send your Trumper uncle to deal with your cousins depressive episode by pulling themselves up by the bootstraps
Sounds very reasonable.
I've been having thoughts of worry for our younger generations, when there are no such things as cousins or uncles/aunts within a day's travel distance, and in which friendships aren't stable enough to replace family
Scenario 1 happened when my dad went to the ER for stomach pain, and they found a tumor the size of a grapefruit that they wanted to operate on him immediately. My mom was there and able to make immediate decisions. I got on the first flight in and was there a few hours after he came out of surgery.
Even if it sounds like things are "under control", you never know when something can take an unexpected turn, so I would always try to go if I could. Also, people get better care when someone is with them in the hospital, so me being there during the day meant my mom could go home and rest and come stay overnight.
If work made trouble about me leaving, I would probably tell them to pound sand unless there was truly something mission critical I could not hand off – that is rarely truly the case in my experience. If I had difficulty with childcare that my spouse could not cover, I would reach out to my local network to get support that would enable me to go.
Having supportive work or the option to quit on the spot, plus a supportive spouse and a supportive local community are not privileges everyone enjoys. In the absence of those, I think a more strategic approach taking turns with other family members to get coverage k, or just taking more time to get your ducks in a row, are reasonable responses.
For extended family, I would expect to be "second string" unless there was no one from their immediate branch could go. For close friends who are local, I would similarly go immediately to help if needed, or help ASAP with childcare, meals, etc. depending on what they needed most.
I have somewhat been in situation 2 where a close family member in my generation was uncovering some past trauma and abuse. In that situation, I did immediately go for a few days just to be helpful and supportive, but just like one would not practice medicine on their family member in the hospital, one should understand their role is to be supportive while the person in crisis gets connected with experienced professional help. Offering a listening ear, a supportive attitude, a reminder that they are not alone in going through this are all appropriate responses (IMO). But it is therapy, psychiatric evaluation, and time that will do the healing.
Many of these things that can help can be done remotely, but there is also something about being with someone with less obvious time constraints that cannot replace being there in person.
I've been the suicidal person in situation 2.
Immediately they need therapy. In my experience, therapists will drop everything once suicide is mentioned. I was able to get a same day appointment when I was at my worst.
Any help with meals and chores is a big mental health relief. Can you do some dishes or laundry? Make some freezer meals and casseroles? Even just a DoorDash gift card.
Any mess and the struggle to decide what to eat exacerbates the downward spiral.
Thank you for the insight: yes person in situation 2 does seem to be in a very serious condition, even though we can't observe broken bones and we can't perform surgery.
Thankfully in this hypothetical scenario, Person 2 is currently in therapy because they are careful to mention "ideation" but stress that there are no plans etc.
I think it makes a lot of sense for family to step up and at least offer to remove some life stressors such as laundry and meals. Far away members could perhaps offer money or meal gift cards. "What do you need and how can we help" - if the person suffering finds it difficult to verbalize, and having to verbalize exacerbates the spiral, help could be offered via the partner actively providing care. That makes sense to me as signs of a caring family.
I will say, personally, I don't like to be asked how someone can help. Either I'm so bad off that I don't know or I feel like a burden answering. So it's always, "No no, I'm totally fine!" Most recently, my friend came over to hang out and she just started cleaning. She did my dishes and put away laundry. I cried for a good hour after she left. The love I felt and a bit of weight lifted was such a great feeling!
That's very lovely. Your friend does love you and it is a very nice thing to have in life :) I hope to be that kind of prescense for the people I love
This would require a bit more information to answer in my opinion. If the socially unsafe situation they moved away from is family then the partner actively inviting family over could actually be harmful to them. But then again we probably wouldn't be talking about a normal family to begin with.
I just wanted to mention this as for a lot of people family is a "must" and the idea of having no contact with family is a very difficult concept. But in the context of dysfunctional families, in my opinion, it should be more normalized to be able to cut off ties with them.
However, if that person also doesn't have a safety net in the form of friends they can become isolated which does make it an really difficult situation to be in. But just to stress the point, this is still not a reason to force family in the mix if the family is (a) root cause for some of the issues to begin with.
Having said that, if we assume a normal functional family, I would expect them to at least make an attempt to keep in touch and be involved in the well-being that person.
Yeah, sometimes situations involving human beings are made more difficult to heal from, since isolation is terrible for human beings. It's like being allergic to water
Good point about inviting family over may not be the best move. And kinda tragic if the family, being a source of at least part of the problem, can't understand why their efforts are rebuffed, and in their own insecurity and dysfunction, don't respond well to requests of "could you please instead do X".
OP, are you suggesting that both scenarios typically get different responses, when they should receive similar responses? If so, I mostly agree, but am also aware of how that is rarely the case.
In addition to life situation, I think age will have a lot to do with it. If "not doing well" family member in your second scenario is 40 years old, their parents may not know how to respond. At 30, maybe a little more responsive depending on their experiences, but likely similar. 25 or younger, their parents are more likely to have learned more about mental health with the additional awareness it has received in popular internet circles, and may be able to gauge the severity better.
Yeah, I guess I'm trying to figure out what the typical social thing to do is in either case, and why there might be a difference, and how justified it would be.
It's also very interesting that you mentioned age, because yes I guess maybe older parents of middle aged children simply have no context for what one could possibly even do for someone suffering a mental health crisis. And perhaps hypothetically, simply not even mentioning it at all and pretending everything is fine was the standard of care back then.
I'm general I think you're right about the age of parents having an impact but I wouldn't feel comfortable relying on people's internet awareness helping with how individual people's internet can be with regards to what shows up and what doesn't.
Well, its one way for me to gather opinions from those outside of my immediate circles. Probably not healthy to rely on as only source but a valuable one nevertheless
I guess I mean it more in the sense of more recent social media sites bringing up mental health more often. Anyone around 60 or older (without personal experience handling it properly) might view mental health disorders as a mental construct that's caused by weakness or laziness.
While I dislike a lot of social media, it's clear how much it's helping young people explore and share and understand themselves when it comes to mental health and sense of self. (There are huge negatives too, of course. But I at least wanted to highlight this positive I've noticed.)
I'm completely with you on that in a general sense. I'm not sure I worded it right (or have done any better in this comment) but I've seen a fair few people in my wider circles who seem to have a much smaller slice of the mental health discourse on their timeline. I think I was trying to say whilst most younger people have been exposed to more mental health discourse and some of the help that can come from that we've all got our own slice of algorithm pie and it doesn't have to have included mental health discourse and therefore the generational generalisations can't be relied upon for younger folks to be more aware of mental health stuff.
Yeah, very fair point. I try to avoid sites that make their users "a victim of the algorithm" as I like to say. But that certainly does drive content that's viewed.
I suppose it depends on what your definition of "family" is, and what you'd consider "normal"?
I'm considering my wife, kids, parents and siblings as my "family" in either scenario. I've lived through something like scenario 1 a couple of times with my kids. Each time the answer was A, even when I was on the other side of the planet. If my wife found herself in a similar situation, my pick would be A each time. If it happened to a parent or sibling, it would depend on the severity and if someone else is there immediately to support (we don't live in the same country). The most likely option would be C, as they are not my "dependents".
In scenario 2, it would likely be about the same, A for dependents, C for others. Realistically, if picking option C, I'd try talk to them directly and make sure they're not in immediate danger, then get there as soon as possible (either when I can take time off from work or on the weekend).
I'm also lucky in that my boss and the place I work are quite flexible and understanding, so when I've had to deal with emergencies they've been very accommodating.
That's a good point: do we include cousins, best friends, uncles etc. let's go with immediate family: parents or children or adult children or siblings.
Thank you for the insight. May I ask a bit more - when folks visit an immediate family in physical or mental distress, when is it then time to leave and go back to normal life? What does it look like relationship-wise going towards after that point?
Sorry I didn't reply sooner! I've not been in this situation before so it's hard to tell to be honest. If it were a sibling or one of my parents, I imagine I'd stay as long as I could, which may not be very long as I have a job to get back to and a family back home. Hopefully during the trip there's enough time to put in place a game plan to figure out longer term support, and after returning I'd still personally check back in regularly. All of this would be dependent on a number of things though, such as the family member's willingness to receive help, how dire their situation is and if I'm capable of doing much to help, and so on. It's definitely a tough situation.
Thank you for your insight, yes i guess there are a lot of factors at play :/