A grounded theory of families responding to mental illness

Despite decades of research documenting family burden related to mental illness of a relative, little is known about families' responses over time. A grounded theory study was designed to describe families' responses to these severe mental illnesses. Twenty-nine participants representing 17 families were interviewed 3 times over 2 years. Interviews were analyzed using constant comparison. Living with ambiguity of mental illness was the central concern. The basic social process was pursuing normalcy and included confronting the ambiguity of mental illness, seeking to control impact of the illness, and seeing possibilities for the future. Goals were managing crises, containing and controlling symptoms, and crafting a notion of "normal." Strategies were being vigilant, setting limits on patients, invoking logic, dealing with sense of loss, seeing patients' strengths, and taking on roles. The study revealed that families were profoundly affected by the social contexts of mental illnesses.