Caring for a mentally ill family members can cause many burdens, but are these burdens for the caregiver, the patient, or both? The deinstitutionalization of mental asylums left many mentally ill patients to fend for themselves. They were forced to live independently, in a group home, or under the wing of family members willing to help them. Many ‘healthy’ family members became caregivers, someone who cares for a vulnerable sick or disabled person, of these mentally ill family members. Mental illness is any disorders in which a person's thoughts, emotions, or behavior are so abnormal as to cause suffering to themselves or other people. Serious mental illnesses include clinical depression, schizophrenia, bipolar disorder, and anxiety disorder. Firstly, Phyllis Soloman gives us some history from her journal article, “The Cultural Context Of Interventions For Family Members with A Seriously Mentally Ill Relative.” Before the deinstitutionalization of asylums, “families were considered passive contributors to the onset of mental illness for not having protected the relative from societal disorganization, which was believed to be the causal agent” (Soloman 68). Because of this family was separated from their mentally ill family members, because they were seen as contributors to their illness. Families were left to be ignored, uniformed, and blamed for their family member’s illness. Overtime, there was a shift, and instead of being completely ignored parents and relatives were confronted in family therapy in regards to their responsibility in that person’s illness. Eventually there was another shift in thought that the parents and family members of the mentally ill were not the primary causal agent due to lack of evidence, but only one cause. This shift caused the belief that biological factors, as well as environmental factors were responsible for the onset of mental illnesses (Soloman 68). When the deinstitutionalization of asylums came about, families were left to care for their ill family members. They had no experience or knowledge, which led to families who were “highly critical, over-involved, and hostile.” This was known as being high in expressed emotion (EE). Families that were high in expressed emotion who took care of their mentally ill family member “were more likely to relapse than those who returned to low EE families” (Soloman 68). Families came together to from NAMI ( National Alliance for Mentally Ill) due to lack of communication between mental health providers and their families and families who were not happy with their relative’s treatment and the stigma associated with mental illness. This led to family interventions between the families of the mentally ill and their health care providers and helped family members understand their relative’s disorder, also leading to better care for their ill relative’s because they were better able to express their needs due to improving relationships with their family. NAMI also helped to educate the public about the real cause of mental illnesses and caused an increase in empathy for families (Soloman 69). Another aspect to be considered is covered by the authors of “Caregiving as Reciprocal Exchange in Families with Seriously Mentally Ill Members” who discuss the burdens caregiving can pose for both the patient and caregiver in terms of reciprocity. They conducted a research study to test the hypothesis that how much support a mentally ill family member receives depends on how much support they provide to other family members. The results “indicate the amount of support patients give parents and siblings is very strongly associated with how much support they receive from family members” (Horowitz, Reinhard, Howell-White 149). Reciprocity cannot be too one-sided to work effectively. If one side gives a lot more than the other over an extended period of time than the other side, then the person giving more may give up or cut back on the amount of support they a