INTRODUCTION Unlike the West, in India, family is the key resource in the care of patients with mental illness. Families assume the role of primary caregivers for two reasons. First, it is because of the Indian tradition of interdependence and concern for near and dear ones in adversities. Due to this most Indian families prefer to be meaningfully involved in all aspects of care of their relatives despite it being time-consuming. Second, there is a paucity of trained mental health professionals required to cater to the vast majority of the population; hence, the clinicians depend on the family. Thus, having an adequate family support is the need of the patient, clinician and the healthcare administrators. The term family has its root in the Latin word ‘familia’ that denotes a household establishment, akin to ‘famulus’, which denoted a servant who came from that household establishment. In the ancient Roman law, the word denoted the group of producers, slaves and other servants as well as members connected by common descent or marriage. Family as we understand today has been defined in the Oxford dictionary as (i) The body of persons who live in one house or under one head, including parents, children, servants, (ii) The group consisting of parents and their children, whether living together or not; in wider sense, all those who are nearly connected by blood or affinity. (iii) A person’s children reared collectively. (iv) Those descended, or claiming descent from a common ancestor. From the point of view of psychiatry, family denotes a group of individuals who live together during important phases of their life time and are bound to each other by biological and /or social and psychological relationship. It is a group defined by a sexual relationship sufficiently precise and enduring to provide for the procreation and upbringing of children.[1] When we look at the family as a unit, the following features are common across the globe: it is universal, permanent, nucleus of all social relationships, has an emotional basis, has a formative influence over its members, teaches its members as to what is their social responsibility and the necessity for co-operation and follows a social regulation.[2] FEATURES OF TRADITIONAL INDIAN FAMILIES India is a secular and pluralistic society characterized by tremendous cultural and ethnic diversity. In India the family is the most important institution that has survived through the ages. India, like most other less industrialized, traditional, eastern societies is a collectivist (a sense of harmony, interdependence and concern for others) society that emphasizes family integrity, family loyalty, and family unity. More specifically, collectivism is reflected in greater readiness to cooperate with family members and extended kin on decisions affecting most aspects of life, including career choice, mate selection, and marriage.[3] Since ages, the Indian family has been a dominant institution in the life of individuals. It is considered strong, stable, close, resilient and enduring. In India, overwhelmingly, families adhere to a patriarchal ideology, follow the patrilineal rule of descent, are patrilocal, have familialistic value orientations, and endorse traditional gender role preferences. Historically, the traditional, ideal and desired family in India is the joint family. A joint family includes kinsmen, and generally includes three to four living generations, including uncles, aunts, nieces, nephews, and grandparents living together in the same household. Frequently, a large joint family divides after the demise of elderly parents, when there is no longer a single authority figure to hold the family together. After division, each new residential unit, in its turn, usually becomes a joint family when sons of the family marry and bring their wives to live in the family home. The lines of hierarchy and authority are clearly drawn, shaping structurally and psychologically complex family relationships. Ideals of conduct are aimed at creating and maintaining family harmony. Women are especially strongly socialized to accept a position subservient to males, to control their sexual impulses, and to subordinate their personal preferences to the needs of the family and kin group. Reciprocally, those in authority accept responsibility for meeting the needs of others in the family group. Psychologically, family members feel an intense emotional interdependence with each other and there is strong interpersonal empathy, closeness, loyalty, and interdependency.[3] INTEGRATION OF FAMILY IN MENTAL HEALTH DELIVERY :INDIAN SCENARIO Until the arrival of the Britishers, there were no organized modern mental healthcare services in India and the mentally ill were looked after by their families or in religious institutions or simply roamed free. The Britishers established ‘mental asylums’ – institutions which were popular in the European countries, where the community felt safe to keep the unwanted, dangerous mentally ill in closed institutions away from family and society. This was initially for their soldiers but the benefits were gradually extended to the Indian population as well. The first mental asylum was established in Bombay in 1745, the second in Calcutta (1781), the third in Madras (1794) and the fourth in Monghyr, Bihar (1795). Around the same time, Philippe Pinel (1745-1826) in France, William Tuke (1732-1822) in England and Benjamin Rush (1745-1813) in United States ushered in the era of ‘moral treatment’ in psychiatry, which included humane care, avoiding physical restraints, better staff patient interaction and an open door system. Adolf Meyer, in 1909, advocated management of mentally ill patients outside the institutions and proposed a comprehensive ‘community mental health approach’ in which psychiatrists, family physicians, police, teachers and social workers would work together to organize primary, secondary, and tertiary preventive measures in the community. All these changes, taking place in Europe and America did not make any impact on the Indian scene. Till 1946, the approach of the Government was to establish custodial and no therapeutic centers, for a small percentage of severely mentally ill and handicapped The community mental health in its and and a in to establish community mental health and care for mentally who would from mental A large of community mental health were over a of time, the community approach because severely ill patients who were did not to the community mental health were not by their which in were in and In India there has been a tradition of families in the of mentally ill In the of involved the family members of the mentally ill in the by to with their patients in open in the that the patients and were home. on this family were established in The benefits were and family members as in their community as other patients and their family members to approach for This of the family in the care of the patient the of the trained and from the and of that were not the most to It was that be included in the to make in the Indian on families of and their four that of the patients living in mental no with any family that the of care for a the work of the patient and the to mental were the for the that of the patients in the one or family members, of did not have a single from a in the two of the mental have that large of patients have no with the the were at Bombay and Calcutta in and and in and The a of over the mental – were patients with mental health and in the of the health system. from family point of the patient with the family and the family was involved in the care of mentally ill It is important to that over the with the in and and in of better and are in their family on and This is by of on the aspects of care in when one to these it becomes that the family the patient to a mental as a of The of the primary care approach in the of mental The a in and the for health The were in and near and of from the of mental health and health the first of and it was in the in with the of community in the of the MENTAL HEALTH The traditional joint family that in India is as a of social and support and is for its of and to in of have that traditional joint families for of in families for the mentally ill and be for the and of mental of the role of the family in to mental health have that the family is to be with the joint that patients from families when to families because of the joint family that patients who from families and a better to a three have that the the in of it being an extended or joint the it was to for a in of having A by patients living in and India and that patients were who by the on the of of and the of – that persons with did better in India and other countries, when to their and of this has been to family support these patients in and on a of Indian have the of therapeutic including family by that the of and in in the first two of the illness. 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