134 Chapter 7 and having meaningful contact could result in enabling someone taking a problem oriented role. The latter especially occurred when they experienced diverging perspectives on what is going on, see Box A for an illustrative quote. BOX A Respondent A (family member), who maintains a close relationship to his brother B (person with severe mental illness) drew a line when B had started to break furniture, after they had disagreed earlier that day, about the question if B was doing well. At 1 a.m. I heard a huge bang. And then I walked into the living room where I saw him and my television, which had been knocked over. He said he hadn’t done anything, but then I was like, now you’re going too far for me at my house, even if you don’t realize it. Then I said, “[Brother] sit down and I now want you to listen to me: take this emergency medication.” And he did take it right away. So fortunately, he somehow was aware that it was ok to follow my demand. Respondents from all parties described establishing meaningful contact based on (basic) human (emotional) needs would take time. Especially changes in professionals involved were dreaded, by persons with severe mental illness and their family. Professionals in turn reflected on what they were (not) allowed to do as a professional, in other words, on boundaries of their role (Box B). They noted this was influenced by the institutional context they were in. Similarly, some persons with severe mental illness and their family reflected on how their original relationship, for example, being siblings or being just a friend, influenced their role within the triad, referring both to a role directed at meaningful contact or at (mental health) problems. BOX B A nurse on establishing contact by addressing a need, while also stating she did not consider that part of her job. With some people you need to hang on. With this client it took me at least a year before I got the idea that we had a bit of a trusting relationship. And that was purely because I cut his hair and shaved his beard, whereas that is not my job at all. A role oriented at addressing problems The second part of attributing roles referred to problem oriented roles parties attributed to one another. It involved matters like: is someone a patient with a mental illness? Does someone have to accept certain difficult behavior because of the problem? Can this family member decide what is good for a person with severe mental illness? Is this a professional with valid expertise for the matter at hand? Referring to problem oriented roles, the three parties frequently touched on misalignment over the question: is there a problem to be addressed, and if so, what exactly is this problem? Specifically, they referred to persons with severe mental illness being
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