Confronting Mental Illness

Q. I'd like some advice about a neighbor family and the mother, who is mentally ill.

She isn't dangerous to herself or others but she doesn't function as a mother; she's not getting treatment, and I don't think the family is seeing a counselor either.

There are five children between 10 and 19 years old and a dad who desperately tries to keep all the balls in the air while working full time. The house is a wreck, the family eats what the kids manage to cook and the whole scene is pretty chaotic. One child in particular seems to be losing his way. He's been getting in a lot of trouble, has been kicked out of school and had cops coming to his door with complaints about his behavior. This child has a good heart, but he is lost.

My teenage daughter is friends with two of his sisters, and I have a warm relationship with them all. I would like to offer some support and have invited the boy who's drifting to come cook with me and take a meal home to the family on a regular basis, which he may -- or may not -- do.

I'm wondering about giving them books about parents who are mentally ill, and whether I could sensitively offer such resources. And how?

A.There's no point in asking yourself if you should help these children because you really don't have an option. Their mother can't control her mental illness the way she might have controlled a physical illness, so you have to step in. That's what neighbors are for.

The kind of help you give should depend on your time, your resources, your temperament and your ability to know what you can and can't do. The mentally ill have many needs, from trivial to grave, and if you don't set limits, you'll either do too much and then resent it or you'll do too little and feel guilty.

Concentrate on the things you can do for the children, because that is where your heart is.

Invite them over for dinner, one by one or all together, and have them come early enough to make the salad or set the table. This will give you the chance to ask how their mom is feeling and if she had a good night -- just as you would if she had cancer or multiple sclerosis -- and if you can do anything for her. The more matter-of-factly you talk about her illness, the more they will dare to tell you their troubles, in the hopes you'll tell them they're doing a good job, that they're not to blame for their mother's behavior and that you'd be glad to tell their school counselors what's going on at home, if they somehow cannot. Certainly all of the counselors need to know the facts, especially the one who monitors the 13-year-old boy.

Getting the mother into treatment and on medication should be the key goal, however. If she can function even a little better, the family won't be so stressed and the home so chaotic.

The father will realize how important it is if you can get him to go to support meetings at one of the 1,100 chapters of the National Alliance on Mental Illness. There he'll learn why treatment and medication are so important and perhaps enroll himself and his older children in NAMI's Family to Family, a free, 12-week course for anyone over 13.

The course will help them see this wife and mother as the person she used to be and teach them how to communicate better with her, what approaches they should use with her and what to do when they don't work. They'll also learn how to get better services, treatment and care for her, how to keep up with the latest brain research and why any family should see a counselor if they live with someone who is mentally ill.

As for books, you might give the 10-year-old -- or even the 13-year-old -- a copy of "Sometimes My Mommy Gets Angry" by Bebe Moore Campbell (Putnam, $6). Written for younger children, it's still a good introduction to mental illness.

The teenagers and the father will profit by reading "When Someone You Love Has a Mental Illness" by Rebecca Woolis (Penguin, $15), which is considered the most helpful and practical book on the subject; "I Am Not Sick, I Don't Need Help" by Xavier Amador (Vida, $18); "How to Live With a Mentally Ill Person" by Christine Adamec (Wiley, $20); and "The Burden of Sympathy" by David A. Karp (Oxford, $20).

The more the father and the children read about mental illness, the more easily they can talk about it in a positive, constructive way and the better they can work as a team.

Questions? Send them toadvice@margueritekelly.comor to Box 15310, Washington, D.C. 20003.