Research by Beardslee and his colleagues in the 1980s, which formed the backbone of his prevention program, identified three characteristics of resilient youth:
- They are committed to accomplishing developmental tasks outside the home, such as doing well in school and taking part in sports and community activities.
- They are committed to relationships with siblings, friends, adults and parents.
- They understand that they are not to blame for their parent's illness(es) and are free to go on with their own lives.
Beardslee noted that the third characteristic is crucial for a child dealing with a parent's mental illness. It has three components: an understanding of the illness and its manifestations; a realistic sense by the child of what he or she can do for the parent; and a willingness to take action based on that understanding.
Knowing these characteristics allows the psychiatrist to teach parents with mental illness how to build resiliency in their children, he said. These strategies are especially important after a hospitalization, which disrupts the entire family's routine.
The System's Limits
The interventions that Beardslee's group developed in the '80s were designed to be compatible with managed care -- they were relatively short-term, manual-based programs. It has been very hard to get insurance companies to focus on mental illness prevention among family members, Beardslee explained. Health care costs continue to climb, and the orientation in the U.S. health care system is toward major interventions after trouble occurs.