The term ACMI "Adult Child of the Mentally Ill" is one I found in the book, My Parent's Keeper" by Eva Marian Brown. Who are the people this term refers to? Do the members of the group truly have a shared experience? Do we have a "syndrome" which is derived from our experiences as children? How many of us are there?
There have been a few attempts at shedding light on this issue and population. One is a book called "Troubled Journey" by Diane Marsh and Rex Dickens. They look at the affects on people of having an mentally ill parent or sibling. They also refer to a syndrome connected to a shared experience of ACMIs and the siblings of mentally ill people. Another great book is the one cited above by Eva Marian Brown. Like Marsh and Dickens, she lays out a process for acknowledging the issues we ACMIs face as adults and what their sources are in our upbringing. She then offers specific suggestions on ways to heal ourselves.
A third resource is a website in Australia called the "National Network of Adult and Adolescent Children who have a Mentally Ill Parent" (nnaami.org). This is a place where ACMI can share experiences and create community in an online forum.
Other online chat rooms for ACMI can be found at
http://pub2.bravenet.com/forum/static/show.php?usernum=151263616&frmid=150&msgid=0
and another on the NAMI site:
www.nami.org//Template.cfm?Section=Daughters_and_Sons
It seems to me that the experience of ACMIs lies on a vast continuum. The trauma we experience, if any, of growing up in a household with mentally ill people is very difficult to determine. It is very hard to generalize. And because for many of us it involved the basic patterning of our personality and self image, the exact affects of the mental illness can be extremely challenging to tease out.
One statistic put out there about the prevalence of mental illness in the general population is 1 in 4. I don't know about you but to me that sounds a bit high. Here's a more nuanced description from the National Institute of Mental Health (NIMH) website:
"Mental disorders are common in the United States and internationally. An estimated 26.2 percent of Americans ages 18 and older — about one in four adults — suffer from a diagnosable mental disorder in a given year. When applied to the 2004 U.S. Census residential population estimate for ages 18 and older, this figure translates to 57.7 million people. Even though mental disorders are widespread in the population, the main burden of illness is concentrated in a much smaller proportion — about 6 percent, or 1 in 17 — who suffer from a serious mental illness. In addition, mental disorders are the leading cause of disability in the U.S. and Canada for ages 15-44. Many people suffer from more than one mental disorder at a given time. Nearly half (45 percent) of those with any mental disorder meet criteria for 2 or more disorders, with severity strongly related to comorbidity."
The serious mental illnesses Marsh and Dickens focus on in their book are schizophrenia (1.1% of the population over age 18 in a given year or 2.4 million people) , major depression (6.7% of the population over age 18 in a given year or 14.8 million people) and bipolar disorder (2.6% of the population over age 18 in a given year or 5.7 million people) . If you add all three of these together you get 10.4% of the population or 22.9 million people over the age of 18. (Statistics from NIMH)
There is a discrepancy between the 10.4% statistic for those three disorders and the "6% who suffer from serious mental illness" cited in the NIMH passage above. I am guessing it must mean that there are some cases of schizophrenia, major depression, and bipolar which are not classified as "serious mental illness".
Whether it is 6% or 10% of the population with "serious mental illness", how many of these people have children? How many have siblings? I have not been able to find data to answer that question. What is likely is that we're talking about tens of millions of people in the U.S. whose formative years have been massively affected by a family member's mental illness.
If there is any question about the impact of these diseases on society one need only look at the Global Burden of Disease Study conducted by the World Health Organization. Currently they list Major Depression as the third leading cause of disease burden world-wide. By the year 2030 the study predicts that it will be number one. The definition of disease burden is the burden that a particular disease process has in a particular area as measured by cost, morbidity, and mortality (wikipedia).
In addition, there are the families of the people with mental illnesses which make up the difference between the 6% (serious) and 26.2% (diagnosable mental disorder). Perhaps the trauma they've endured is less intense in many cases than families where serious mental illness is present. Nevertheless, disruptive affects are likely, as is the need for healing.
So here's an obvious question: if mental illness is having such a huge impact on the world, why is it still so hidden? Why are so many people who are mentally ill or have an MI relative afraid to speak about their experiences openly? What it is about mental illness that makes us all so afraid to talk about it?
My sense is that mental illness can cut right to the core of our basic sense of self and for that reason it is more terrifying than, say diabetes, another chronic disease. Someone who has diabetes can manage their condition with insulin and the disease might have relatively little affect on their fundamental sense of self. It is a burden they have carry but they still have the experience of being "themselves." Mental illness seems more frightening because it can change, sometimes very dramatically as in schizophrenia, the basic personality of an individual. In olden times it is very likely that such a change in a person would lead others to think that the person was possessed by an evil spirit or demon. Today we don't believe in such things but we also haven't found an easy "box" in which to place such a dramatic and frightening shift in someone's sense of self. So since we are not really able to find an easy explanation about what's going on, we are left with the shit being scared out of us and pushing the whole topic away from our awareness to the greatest degree possible.
I know that's what I did until only a few years ago. And the only reason I changed my stance is that the basic quality of my life depended on my delving into this frightening world and trying to make sense of it.
Diane Marsh and Rex Dickens describe the family burden of mental illness as having subjective and objectives facets. I understand "subjective burden" to mean our inner feeling response to what's happening around us; and "objective burden" as the facts of the illness that we have to deal with.
The subjective part includes:
--a sense of grief and loss for your relative, your family and yourself;
--chronic sorrow as the illness is woven into your life on a continuing basis;
--an emotional roller coaster in response to the course of the disorder; and
--empathic pain as you share in your relative's and family's suffering.
The objective burden includes:
--symptoms of the illness, such as bizarre or frightening behavior;
--caregiving responsibilities for your relative;
--limitations of the mental health system; and
--social stigma, which continues to surround serious mental illness.
Eva Marian Brown, in "My Parent's Keeper", speaks about some of the common affects of this disease burden for ACMIs:
"You feel unsafe in the world because your family hasn't taught you the necessary interpersonal skills. You have a deep feeling of aloneness and deprivation because your parent isn't providing reliable and loving contact. And you feel terrible about yourself because you consider it your fault you aren't being adequately taken care of. In the midst of this massive struggle there is little room to be a playful, light-hearted child. The result is a typical profile of the parentified child--serious, responsible, intense, unusually sensitive, and often readily hurt."
It seems to me there is a deafening silence in our culture in regards to the mentally ill and their families. This is slowly changing. The conversation is gradually opening up and the stigma is trending downward ever so slightly. It also seems to me that NAMI is a huge help in creating a positive trend for all of us. Still, the fact that a single mental illness (major depression) is predicted by the WHO to have the most significant disease burden on the planet within two decades tells me we had better make a lot faster progress in acknowledging mental illness, trying to understand it better, and meeting the needs of those it affects.
It also seems to me that ACMIs and other family members of mentally ill people are in an excellent position to raise awareness about the issue of mental illness. We can do this by honestly sharing our experience, by working to heal ourselves, and by communicating with others who share our experience. We can support each other and gradually work to change the cultural bias against mental illness which we all feel so acutely.
Your comments are welcome.
Warmly, Ben
Thanks for explaining it!
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