Family Consultation: How We’re Supporting Family Members of Adults with SMI

Whether in the midst of an active crisis or figuring out day to day life, caring for an adult who has a severe mental illness can become all consuming. But so often, there’s another party that gets overlooked: the family members/caregivers.

From every day logistical details like making appointments, keeping track of medications, and so on, family members and caregivers are also making dozens of decisions per day, frequently with very little guidance. That’s where Family Consultation support comes in.

So what is Family Consultation and who is it for? Here are our most frequently asked questions about our Family Consultation services.

FAQ about Family Consultation

  1. What is Family Consultation and who is it for? Family Consultation is for the family member(s) of an adult who has a severe mental illness. This service is a collaborative and supportive relationship with the goal of developing a plan that will result in their loved one building a relationship with treatment providers. Any family member of an adult with a severe mental illness is eligible. 
  2. What relationship/dynamic can I expect between myself and HITH? The relationship between our team and your family  is a supportive one where we work together and discuss what has and has not worked in the past. We discuss what the family members have been wanting and what their loved one with a SMI wants and how to align the two.  It is also understood that this is a long term process with no guarantees.  OUR GOAL is to develop a plan that will result in their loved one building a relationship with treatment providers.  Families find it helpful to have someone with experience coming alongside them. We help families develop plans to manage a crisis if/when it occurs to help give them peace of mind that they have done everything within their control to protect their loved one.
  3. Are families with loved ones in crisis eligible? Yes. In an active crisis we are assisting families in creating a plan to keep their loved one safe. Sometimes their loved one is too acute to be eligible for our services and needs to go to a higher level of care prior to coming to Help in the Home for support. In these cases we are helping the family secure admission at a facility that is appropriate to support their loved one’s needs. There are so many variables that can impact a family’s choice in facility from cost, bed availability, coordinating transportation to the facility, vetting the credibility of a treatment center, etc. Sometimes families are in a fight against time, especially when they are trying to get their loved one from inpatient stabilization to the next level of care. Most stabilizations in an inpatient hospital setting are 5-7 days and sometimes this isn’t enough time to coordinate the next placement which is usually a residential treatment center. There are also a limited number of residential treatment centers that specialize in treating SMI so sometimes the most appropriate facility with bed availability can be halfway across the country.  Unfortunately COVID-19 has added an extra layer of complication to this process. With Family Consultation we are working alongside the family to help fill in all of the gaps. It is a very tedious and time consuming process that often needs to be done as quickly as possible when a family is in crisis.
  4. What does Family Consultation look like for family members with a loved one that is currently stable? Sometimes families come to us for support when their loved one with SMI is not in crisis. It is common for people with severe mental illness to be uninterested or not want to engage with traditional treatment. This is usually an indication that the person is on the precipice of a crisis. Very rarely is treatment a requirement unless it is court ordered or a client is hospitalized involuntarily. This puts the family members of adults with severe mental illness in a very tough situation when their loved one is not interested in engaging with the recommended treatment. Most family members of people with severe mental illness recognize that without ongoing maintenance, that can include but is not limited to medication, regular psychiatry visits, therapy sessions, physical exercise and proper nutrition, their loved one might end up in a crisis situation. The anticipation of this crisis without having outlined strategies and plans in place is extremely stressful. Crisis involving SMI can be really scary for everyone involved. They might include angry or violent outbursts, wandering off/going missing, police involvement, involuntary hospitalization and people getting physically hurt. It can be extremely traumatic but in a lot of cases it is preventable with the right treatment. However, unless someone finds treatment that works for them, crisis is almost inevitable.
  5. What are some of the services/help I can lean on HITH to help me with while working together? Some of the services HITH assists Family Consulting clients with includes but is not limited to: Program recommendations, support with application/admission to treatment program, the collaborative development of a plan to see crisis stabilized,  the collaborative development of a plan to support that stability long-term, recommendation of local treatment providers from our network of providers skilled in serving those with SMI, regular ongoing support.
  6. What’s the benefit of using Family Consultation services? An important piece of Family Consultation is the level of skill of our Family Consultants. They have a Master’s degree or significant experience working with families. For families in crisis trying to find higher levels of care, our Family Consultants are putting their critical clinical eye on the facility or facilities and thoroughly vetting their capability to do what they say they do. We have preexisting relationships with facilities across the country who we have already vetted. Sometimes families come to us with their own research and unfortunately there are some bad actors/facilities who’s only admission criteria is the family’s ability to pay for services. This can be very dangerous. Someone with SMI who is not properly understood by trained professionals can have violent outbursts which can put them and others at risk of harm. Additionally, there are symptoms of psychosis which can cause people to be very disconnected from reality and even normal situations or environments can become dangerous. Without proper supervision there is the possibility for a client to wander off and potentially get hurt. For families coming to us when their loved one is not engaged, our Family Consultants are working alongside the family to create a plan if crisis occurs. Crisis trickles down from the individual with an SMI to the entire family, making the support that is being put into place vital for them as well. Having support allows the family to manage the crisis instead of being in crisis themselves which in turn allows them to have a better sense of agency instead of being swept away by it. Families need to know they are not in this alone and our team is there to work alongside them while they are in crisis and after.
  7. How does COVID affect this service? Due to the safety protocol in place to prevent the spread of COVID, Family Consultation services are currently 100% virtual. However, our team connects with providers, companions, etc. who do the necessary in person contact with the loved one in crisis. In the near future, we look forward to being able to meet with families in person.
  8. What’s the investment for Family Consultation services? Family Consultation is billed hourly at $166 per hour.Typically, to create an initial crisis stabilization plan, a commitment of 10 – 20 hours are required. From there,  ongoing monthly support ranges around 10 hours. However, these are estimates and change as needed

For more information on our Family Consultation services and to schedule your free consult – please contact us at or (866) 967-9994

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