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A descriptive study of 62 family members with an outpatient adult son with a long-term physical (8 families) or mental (3 families) illness using multiple methods and multiple family members' perspectives. Family members completed FILE, FIRM, FAM-III. FACESIII, the Progress Evaluation Scale, and the Nottingham Health Profile. Single-item indicators were based on Rolland's (1988) psychosocial typology of illness, Mishel's (1988) components of uncertainty of illness, and selected demographics. On most of the instruments and their subscales, there were few statistical differences. Family members often did not report the same diagnosis. Based on the qualitative data, families coped by "just working with it" or "trying to step back."

Within this "Decade of the Brain," an accusatory veil lingers about the family's role in the genesis of mental illness. Health professionals need a framework to deal with chronic mental illness and caregiving.

Given the dynamics of the multidisciplinary team and the infancy of nursing diagnoses specific to psychiatric nursing, most nurses prefer using the DSM-III-R to document practice or do not see nursing diagnoses as relevant. The DSM-III-R, first published as the Diagnostic and Statistical Manual in 1952, is specific to the medical care of individuals and oriented toward "cure"; nursing diagnoses, initiated in 1973, are applicable to individuals, families, and groups and address human response to actual or potential health problems. The similarities of these two diagnostic systems include being a guide to practice, evolving as works of political compromise with international import, and serving as communication systems. However, without understanding the differences or similarities between these linguistic systems, nurses opting to use only the DSM-III-R do not contribute to understanding phenomena germane to psychiatric nursing, perpetuate the invisibility of nursing to patient care, and invite turf battles with other professions.