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2013 Toolkit


The 2014 Toolkit will be available in early summer.

Families and Caregivers of Young People

Download PDF version of "Families and Caregivers of Young People" (226 KB) Download PDF version of "Families and Caregivers of Young People" (226 KB)

Introduction...

Family members and caregivers often form the front lines in promoting prevention, treatment, and recovery from mental and/or substance use disorders.  Traditional and non-traditional families – including parents, grandparents, other relatives, life partners, and unrelated individuals who inherit or adopt caretaking responsibilities – often want to know how and when to help a young person in need.

To encourage families and caregivers to seek support and resources, the Substance Abuse and Mental Health Services Administration (SAMHSA), within the U.S. Department of Health and Human Services (HHS), sponsors National Recovery Month (Recovery Month).  Each September, this national observance increases awareness and understanding of mental and substance use disorders, and promotes that behavioral health is essential to health, prevention works, treatment is effective, and people recover.

The 2013 Recovery Month theme, “Join the Voices for Recovery:  Together on Pathways to Wellness,” represents the many ways that people can prevent behavioral health issues, seek treatment, and sustain recovery as part of a commitment to living a mentally, physically, emotionally, and spiritually healthy life.  The 24th annual Recovery Month celebrates the journey family members and caregivers take to help a young person on a pathway to wellness.

This document shares how to create an environment supportive of behavioral health and wellness.  It also outlines ways to treat current issues, as well as how to access critical prevention, treatment, and recovery support resources.

Prevent Mental and Substance Use Disorders…

Mental and substance use disorders occur throughout the United States, in people of all ages, races, ethnicities, and genders.  In light of how common these conditions are, many family members and caregivers find it challenging to raise a child or support a loved one in a constructive, safe environment.  This can be difficult as they strive to balance work, social lives, and their own wellness each day.

However, research shows that a caring adult can make a difference in a young person’s life. Adults who interact with young people in an open, warm manner can raise kids with higher self-esteem, better performance in school, and fewer negative outcomes such as depression or later substance use than those who do not.1  To do so, it’s important to make the young person feel loved or wanted, which increases feelings of connectedness.2  This, in turn, opens the lines of communication.

SAMHSA’s Building Blocks for a Healthy Future website provides tips to help children or loved ones make healthy decisions as they grow up.  It offers ideas for conversation starters, positive discipline, and family activities.  SAMHSA’s Too Smart to Start website helps youth, families, educators, and communities prevent underage alcohol use and its related problems.

While it’s important to start this conversation at a young age, youth attitudes may evolve about behavioral health issues as children get older,3 requiring family members and caregivers to adapt the way they communicate with an older child or teenager.  Despite their preferences for privacy and independence, youth and teenagers respond to prevention messages.  In 2011, youths aged 12 to 17 who believed their parents would strongly disapprove of their using a specific substance were less likely to use that substance than were youths who believed their parents would somewhat disapprove or neither approve nor disapprove.4

When establishing a connection with someone, it may help to acknowledge your own shared experiences if the young person brings it up, but keep the focus of the conversation primarily on the young person’s current challenges.  Consider the following tips when talking with a young person or teenager:5

  • Be a good listener and encourage young people to be open and willing to share.
  • Respect their privacy, as teenagers may become more inviting if you understand or respect their need for space.
  • Give them increased autonomy, to assist in building trust.
  • Accept their feelings.
  • Apologize when you are wrong.

There are other ways to make connections and promote wellness.  Since behavioral health is closely linked to physical health, take the opportunity to help young people eat nutritiously and stay healthy.  In addition to talking openly about behavioral health issues, stay active in a young person’s school activities by participating in parent-teacher conferences and other school events and extracurricular activities.

Recognize the Signs and Symptoms…

Prevention is essential, but what happens when a child or teenager starts to exhibit signs of unusual behavior or emotional distress?  Do you know how to recognize these signs? What if your child or loved one has developed a co-occurring disorder, one that involves both mental and substance use disorders – how would you know?

In some cases, family members and caregivers are often the first to see symptoms that may be caused by mental and/or substance use disorders, as well as signs of other physical illnesses.  However, the exact nature of the problem isn’t always obvious.  For example, people who experience mental illness may manage their illness by abusing substances, leading to misdiagnosis, or distorting the root cause of a person’s behavioral health disorder.6

Despite this complexity, being aware of behavioral cues can help you determine if a young person in your life needs help.  The following signs and symptoms could be attributable to a mental illness, but may also indicate other problems, such as a substance use disorder:7

  • Young children:  Changes in school performance, poor grades despite strong efforts, excessive worry or anxiety, hyperactivity, persistent nightmares, continual disobedience or aggression, and frequent temper tantrums.
  • Older children and pre-adolescents:  Substance use; inability to cope with problems and daily activities; changes in sleeping and/or eating habits; excessive complaints of physical ailments; defiance of authority; truancy, theft, and/or vandalism; intense fear of weight gain; prolonged negative mood, often accompanied by poor appetite or thoughts of death; and frequent outbursts of anger.
  • Adolescents:  Feelings of sadness, hopelessness, or worthlessness; prolonged grief after a loss or death; excessive feelings of anger or worry; alcohol or drug use; exercising, dieting, or binge-eating obsessively; hurting others or destroying property; doing reckless things that may result in self-harm or harm to others.

Other signs may be unique to substance abuse, including bloodshot eyes or dilated pupils, slurred speech, or disappearing money, valuables, or prescriptions from your home.8

Remember that not all signs and symptoms are obvious, and there are a host of reasons that a child, teenager, or young adult may be experiencing these symptoms other than mental and/or substance use disorders.

Take the Right Steps…

Family members and caregivers are critical to intervening to help a loved one with a mental and/or substance use disorder.

If you suspect a preteen or teen is using drugs or alcohol or may have a mental illness, it’s important to take action right away, just as you would seek treatment for any other illness or injury.  Casual substance use can quickly turn into a long-term problem, and it can also be indicative of a person trying to cope with a mental illness.  Following are ways you and other family members can intervene if you suspect someone has a mental and/or substance use disorder:

  • Discuss household rules, such as curfews, that may help prevent the occurrence of mental and/or substance use disorders;9
  • Express your concern and support;10
  • Ask what you can do to help;11
  • Seek outside help and support from a teacher, neighbor, or coach, if necessary;12
  • Have productive conversations by remaining calm, sharing your concerns, and listening;13
  • Reassure your loved one that you care about him/her;14
  • Find out if the person is getting the care that he or she needs and wants;15
  • Observe behavior and activities, such as helping out with homework or chores;16 and
  • Dispose of unwanted or unused prescription medications so there are no unnecessary medications in the home.

Monitoring activities are proven to work.  In 2011, past-month use of illicit drugs and cigarettes and binge alcohol use were lower among youths aged 12 to 17 who said that their parents were engaged in monitoring behaviors than among youths whose parents seldom or never engaged in such behaviors.17

Some people are more at risk for mental and/or substance use disorders than others, such as those who have experienced traumatic events.  It is important for family members and caregivers to learn techniques to help young people cope with tragedies such as a death in the family, physical or sexual abuse, or a natural disaster.  The SAMHSA-funded National Child Traumatic Stress Network provides resources for overcoming these challenges.

It is also important to remember that people may have different needs for care; those who exhibit signs that they may harm themselves or others may require more intensive treatment or immediate help.  If you think a young person is at risk of suicide, contact the National Suicide Prevention Lifeline – 1-800-273-TALK (8255).  More options for mental and substance use disorder prevention, treatment, and recovery support can be found in the “Treatment and Recovery” section of this toolkit.

If you are unsure of what to do, call SAMHSA’s National Helpline – 1-800-662-HELP (4357) – or visit SAMHSA’s Treatment Locator, which offers 24-hour, free, and confidential information and treatment referrals for both mental and substance use disorders.

Family members and caregivers can also seek help for mental and/or substance use disorders by contacting the following:18

  • A local health or state department’s mental health division or substance use disorder agency (refer to the “Single-State Agency” section of this toolkit for resources);
  • A family physician;
  • A clergyperson;
  • Family services agencies, such as Catholic Charities, Family Services, or Jewish Social Services;
  • Educational consultants or school counselors;
  • Marriage and family counselors; and
  • Child guidance counselors.

When trying to help a loved one, remember that you are not alone.  There are resources and trained professionals available to help guide you on finding the appropriate pathway to wellness.

Take Care of Yourself…

Dealing with the impact of a mental and/or substance use disorder can take a toll on a family member or caregiver.  Keep in mind that you also need time to heal and take care of your own wellness.  Consider taking the following steps:

  • Accept your feelings and know that behavioral health conditions are common.
  • Ask a physician or counselor questions about what to expect and whether certain behaviors that may seem foreign to you are normal for someone with a behavioral health problem.
  • Establish a social network.  If you feel uncomfortable talking to a friend about your situation, join a support group to share with others who are experiencing similar situations.
  • Seek the services of a counselor or trained professional with whom you feel comfortable.

Continue on Pathways to Wellness…

For many young people with mental and/or substance use disorders, their path to wellness can be traced back to the steps that were enacted by a family member or caregiver. Perhaps a family member or caregiver was instrumental in promoting healthy lifestyles and spreading the belief that behavioral health is essential to health.  They may have provided healthy meals, encouraged a good night’s sleep, ensured that the young person has health insurance coverage, and challenged a young person to stay active and physically fit.

These activities, combined with a family member or caregiver’s ability to form a connection with a young person and recognize the signs of mental and substance use disorders, can help lead young people to their path to wellness.

Refer to the “Join the Voices for Recovery” section of this toolkit for real-life examples of how family members and caregivers are making a difference in a loved one’s life and learning how to cope themselves.

Make a Difference During Recovery Month and Throughout the Year…

There are many ways to help a family member or loved one during Recovery Month.  Consider taking the following steps:

  • Foster a healthy environment.  Inspire your loved one to eat well, rest, exercise, and attend recovery appointments and meeting commitments.  Remind him or her that recovery is a top priority.
  • Offer encouragement.  Let your loved one know how much he or she means to you.  Share words of hope that life in recovery is possible, and that professionals can help to manage a mental and/or substance use disorder.
  • Recognize accomplishments.  Tell your family member or loved one that he or she is brave and that you are proud be a part of the recovery journey.

Additional Resources…

A variety of resources provide additional information on Recovery Month and mental and substance use disorders, as well as prevention, treatment, and recovery support services. The toll-free numbers and websites below are available for people to share their experiences, learn from others, and seek help from professionals.  Through these resources, individuals can interact with others and find support on an as-needed, confidential basis.

  • SAMHSA’s Website Leads efforts to reduce the impact of mental and substance use disorders on communities nationwide.
  • SAMHSA’s National Helpline, 1-800-662-HELP (4357) :  Provides 24-hour, free, and confidential treatment referral and information about mental and substance use disorders, prevention, treatment, and recovery in English and Spanish.

  • SAMHSA’s “Find Substance Abuse and Mental Health Treatment” Website: Contains information about treatment options and special services located in your area.
  • SAMHSA’s Family Centered Substance Abuse Treatment Grants:  Support the implementation of evidence-based procedures, and were developed to provide substance abuse resources to adolescents and their families, or other primary caregivers, in areas with unmet needs, such as substance abuse prevention and treatment services.
  • SAMHSA’s Children’s and Family’s Health Transitions :  Uses a coordinated approach to provide an easy transition to adulthood for youth and young adults with mental illness, as well as to support their families.
  • National Suicide Prevention Lifeline, 1-800-273-TALK (8255):  Provides a free, 24-hour helpline available to anyone in suicidal crisis or emotional distress.
  • Technical Assistance Centers:  SAMHSA supports technical assistance centers that promote peer-directed approaches for adults with behavioral health conditions. Such programs maximize self-determination and recovery and assist people on their path to recovery, ultimately decreasing their dependence on expensive social services and avoiding hospitalization. The five technical assistance centers include:
  • Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS):  Provides policy and practice analysis, as well as training and technical assistance, to states, providers, and systems to increase the adoption and implementation of recovery supports with behavioral health issues.
  • BHBusiness:  Offers targeted training and support for behavioral healthcare executives, CEOs, and directors, including health care insurance enrollment training information.
  • Building Blocks for a Healthy Future:  Educates parents and caregivers about the basics of prevention in order to promote a healthy lifestyle.
  • Center for Financing Reform and Innovation:  Supports the need for information, analysis, products, and technical assistance to address significant changes in the organization and financing of behavioral health care, as well as the need to guide and support governments and people on how to most effectively and efficiently use available resources to meet the prevention, treatment and recovery support needs of the public.
  • http://www.healthcare.gov:  Contains information on finding health insurance options, help using insurance, information on the Affordable Care Act, help comparing providers, and information on prevention and wellness resources.
  • SSI/SSDI Outreach, Access, and Recovery (SOAR):  Increases access to Supplemental Security Income and Social Security Disability Income for eligible adults who are homeless or at risk of homelessness and have a mental and/or substance use disorder.
  • Teen Challenge International:  Provides youth, adults, and families with effective and comprehensive faith-based solutions to life-controlling alcohol and drug problems.

Inclusion of websites and resources in this document and on the Recovery Month website does not constitute official endorsement by the U.S. Department of Health and Human Services or the Substance Abuse and Mental Health Services Administration.


Sources:

  1. American Psychological Association.  (n.d.).  Parents and Caregivers are Essential to Children’s Healthy Development.  Retrieved September 28, 2012, from http://www.apa.org/pi/families/resources/parents-caregivers.aspx.
  2. U.S. Department of Health and Human Services (HHS) Office of the Surgeon General and National Action  Alliance for Suicide Prevention.  2012 National Strategy for Suicide Prevention: Goals and Objectives for Action.  Washington, DC: HHS, September 2012, http://www.surgeongeneral.gov/library/reports/national-strategy-suicide-prevention/full_report-rev.pdf, p.139.
  3. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.  (n.d.).  Too Smart to Start.  Tips on Talking to Teens and Tweens. Retrieved September 28, 2012, from http://www.toosmarttostart.samhsa.gov/families/talking/default.aspx.
  4. Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-44, HHS Publication No. (SMA) 12-4713. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012, p. 68.
  5. Purcell, M.  (2006).  How to Talk With Your Teenagers, Not at Them.  Psych Central. Retrieved September 28, 2012, from http://www.psychcentral.com/lib/2006/how-to-talk-with-your-teenagers-not-at-them.
  6. National Alliance on Mental Health.  (n.d.).  Substance Abuse and Co-Occurring Disorders. Retrieved October 8, 2012, from http://www.nami.org/Content/NavigationMenu/Hearts_and_Minds/Smoking_Cessation/Substance_Abuse_and_Co-occurring_Disorders.htm
  7. Mental Health America.  (n.d.).  Mental Illness and the Family:  Recognizing Warning Signs and How to Cope.  Retrieved September 28, 2012, from http://www.nmha.org/go/information/get-info/mi-and-the-family/recognizing-warning-signs-and-how-to-cope.
  8. HelpGuide:  A Trusted Non-Profit Resource.  (n.d.).  Drug Abuse and Addiction: Signs, Symptoms, and Help for Drug Problems and Substance Abuse.  Retrieved September 28, 2012, from http://helpguide.org/mental/drug_substance_abuse_addiction_signs_effects_treatment.htm.
  9. The Partnership at Drugfree.org.  (n.d.).  Intervene. Don’t panic.  You can do this.  Retrieved September 28, 2012, from http://www.drugfree.org/intervene.
  10. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.  (2006).  What a Difference a Friend Makes.  Retrieved September 28, 2012, from http://www.whatadifference.samhsa.gov/docs/NASC.pdf, p. 6.
  11. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.  (2006).  What a Difference a Friend Makes. Retrieved September 28, 2012, from http://www.whatadifference.samhsa.gov/docs/NASC.pdf, p. 6.
  12. The Partnership at Drugfree.org.  (n.d.).  Intervene.  Don’t panic.  You can do this. Retrieved September 28, 2012, from http://www.drugfree.org/intervene.
  13. The Partnership at Drugfree.org.  (n.d.).  Intervene.  Don’t panic. You can do this. Retrieved September 28, 2012, from http://www.drugfree.org/intervene.
  14. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.  (2006).  What a Difference a Friend Makes.  Retrieved September 28, 2012, from http://www.whatadifference.samhsa.gov/docs/NASC.pdf, p. 6.
  15. U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration.  (2006).  What a Difference a Friend Makes.  Retrieved September 28, 2012, from http://www.whatadifference.samhsa.gov/docs/NASC.pdf, p. 6.
  16. The Partnership at Drugfree.org.  (n.d.).  Intervene. Don’t panic. You can do this.  Retrieved September 28, 2012, from http://www.drugfree.org/intervene.
  17. Substance Abuse and Mental Health Services Administration, Results from the 2011 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-44, HHS Publication No. (SMA) 12-4713. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2012, p. 71.
  18. Mental Health America.  (n.d.).  Mental Illness and the Family:  Finding the Right Mental Health Care for You.   Retrieved September 28, 2012, from http://www.nmha.org/go/information/get-info/mi-and-the-family/finding-the-right-mental-health-care-for-you. 

Call-out box: Mental Health America.  (n.d.).  Mental Illness and the Family: Recognizing Warning Signs and How to Cope.  Retrieved September 28, 2012, from http://www.nmha.org/go/information/get-info/mi-and-the-family/recognizing-warning-signs-and-how-to-cope.




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