Expert Commentary

Working With Families of Mentally Ill Patients

Igor Galynker, MD, PhD

Associate Chairman of Psychiatry
Director, The Family Center for Bipolar Disorder
Beth Israel Medical Center
New York, NY

When clinicians report a diagnosed mental illness to a patient’s family members, they may experience a wide range of responses, including guilt, blame, anger, and denial. Here, Igor Galynker, MD, PhD, explains that family members’ overt expressions of emotion can create problems for the patient and interfere with his/her ongoing treatment. He discusses optimal approaches to helping families accept the diagnosis so they can provide support for the patient in collaboration with the treating physician. The emotional burden for family members who are caregivers of patients with bipolar disorder, for example, has been associated with increased depression, anxiety and mental health service use by the family caregiver—and importantly, psychiatric symptoms in the caretaker are also associated with poor patient outcome. As discussed further in Dr. Galynker’s book, interventions that address the psychiatric needs of caregivers can result in improved outcomes for both patient and family. Essential to this process is cautioning the family to avoid stigmatizing the patient and the disease. It may be helpful, Dr. Galynker notes, for the clinician to explain that mental illnesses are biological diseases and that a referral to a psychiatrist is not unlike a referral to any other specialist. Dr. Galynker emphasizes the importance of family members forming a team with caretakers, primary care or other healthcare providers, and the psychiatric physician and staff, a strategy explored in detail in his book.



1. Galynker, Igor. Talking to Families About Mental Illness, What Clinicians Need to Know. WW Norton; New York, NY; 2012.

2. Steele A, Maruyama N, Galynker I. Psychiatric symptoms in caregivers of patients with bipolar disorder: a review. J Affect Disord. 2010;121:10-21.
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