Keeping relationships
As a consequence of deinstitutionalization, the burden of care has increasingly fallen on the relatives of the mentally ill. Informal caregiving significantly contributes to health care and rehabilitation (45). Fifty to ninety per cent of disabled persons live with their relatives following acute psychiatric treatment (46). This is a task many families do not choose voluntarily. Caregiving imposes a significant burden on families. Those providing informal care face consider- able adverse health effects, including higher levels of stress and depression, and lower levels of subjective well be- ing, physical health and self-efficacy (47). Additionally, not all families are equally capable of giving full support for their disabled member and willing to re- place insufficient health care systems. Caregivers regularly experience higher levels of burden when they have poor coping resources and reduced social support (48). But families also represent support systems, which provide natural settings for context-dependent learning important for recovery of functioning (49). Therefore, there has been a grow- ing interest in helping affected families since the beginning of care reforms (50).