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Getting "to the Point": The Experience of Mothers Getting Assistance for Their Adult Children Who Are Violent and Mentally Ill

Copeland, Darcy Ann; Heilemann, MarySue V.

doi: 10.1097/01.NNR.0000319500.90240.d3
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Background: If individuals with mental illness become violent, mothers are most often victims, yet there is little available research addressing how, when, and from whom mothers seek help for themselves or their children when they become victims of this form of familial violence.

Objectives: To describe how mothers understood violence their adult children with mental illness exhibited toward them and to articulate the process mothers used to get assistance and access mental health treatment when this violence occurred.

Method: Grounded theory methods were used to explore and analyze mothers' experiences of violence perpetrated by their adult children with mental illness. Eight mothers of adult children who are violent with a diagnosed Diagnostic and Statistical Manual of Mental Disorders Axis I disorder participated in one to two open-ended interviews. Mothers were of diverse ethnic backgrounds.

Results: Getting immediate assistance involved a period of living on high alert, during which mothers waited in frustration for their children to meet criteria for involuntary hospitalization. This was a chaotic and fearful period. Fear and uncertainty eventually outweighed mothers' abilities to manage their children's behavior, at which time they called the police or psychiatric evaluation teams who served as gatekeepers to mental health treatment. Mothers accepted the consequences of being responsible for their children's involuntary hospitalization or of being left home with their children if the gatekeepers did not initiate involuntary hospitalization.

Discussion: Mothers can identify signs of decompensation in their children who are ill and recognize their need for hospitalization. They cannot, however, always access mental health treatment due to their children's refusal or failure to meet legal criteria for involuntary hospitalization. Mothers' inability to intervene early sometimes results in their own violent victimization.

Darcy Ann Copeland, PhD, RN, is Assistant Professor, School of Nursing, University of Portland, Oregon.

MarySue V. Heilemann, PhD, RN, is Associate Professor, School of Nursing, University of California Los Angeles.

Accepted for publication January 24, 2008.

Funding support for this dissertation research included a predoctoral fellowship through the National Institute of Nursing Research Grant 5 T32 NR 07077, Vulnerable Populations/Health Disparities Research at the UCLA School of Nursing and a Sigma Theta Tau, Gamma Tau Chapter research grant.

The first author would like to thank dissertation committee members Drs. Nancy Anderson, MarySue Heilemann, and Sally Maliski from the UCLA School of Nursing and Dr. Doug Hollan from the UCLA Department of Anthropology for their assistance in conceptualizing and completing this research.

Corresponding author: Darcy Ann Copeland, PhD, RN, University of Portland, School of Nursing, 5000 North Willamette Blvd, Portland, OR 97203 (e-mail: copeland@up.edu).

© 2008 Lippincott Williams & Wilkins, Inc.