Living with psychiatric patients: implications for the mental health of family members.

Current treatment policy has resulted in large numbers of ex-hospitalized psychiatric patients residing with family members in the community. However, little is known about the emotional consequences for family members. This paper focusses on the relationship between level of chronic strain, as indexed by 'objective' and 'subjective' family burden, and extent of psychological distress among family members of ex-hospitalized psychiatric patients. This relationship is assessed within a multivariate model that also considers eventful experience as an additional source of stress and social support and mastery as potential stress mediators. We found the variable of mastery, or sense of personal control, to be by far the most powerful predictor of distress among family members. When mastery was considered in regression analyses the modest correlations between 'objective' and 'subjective' family burden and distress scores disappeared. However, assessment of interactions indicated that strain is independently associated with distress among those subjects who scored relatively low on the mastery scale. Our most general conclusion is that the presence of some patients tends to be associated with substantial psychological costs for some families.