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McCann TV, Lubman DI. Help-seeking barriers and facilitators for affected family members of a relative with alcohol and other drug misuse: A qualitative study. J Subst Abuse Treat 2018; 93:7-14. [DOI: 10.1016/j.jsat.2018.07.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 07/11/2018] [Accepted: 07/11/2018] [Indexed: 11/26/2022]
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Onwumere J, Amaral F, Valmaggia LR. Digital Technology for Caregivers of People With Psychosis: Systematic Review. JMIR Ment Health 2018; 5:e55. [PMID: 30185402 PMCID: PMC6231782 DOI: 10.2196/mental.9857] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 04/11/2018] [Accepted: 05/19/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Psychotic disorders are severe mental health conditions that adversely affect the quality of life and life expectancy. Schizophrenia, the most common and severe form of psychosis affects 21 million people globally. Informal caregivers (families) are known to play an important role in facilitating patient recovery outcomes, although their own health and well-being could be adversely affected by the illness. The application of novel digital interventions in mental health care for patient groups is rapidly expanding; interestingly, however, far less is known about their role with family caregivers. OBJECTIVE This study aimed to systematically identify the application of digital interventions that focus on informal caregivers of people with psychosis and describe their outcomes. METHODS We completed a search for relevant papers in four electronic databases (EMBASE, MEDLINE, PsycINFO, and Web of Science). The search also included the Cochrane database and manual search of reference lists of relevant papers. The search was undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. RESULTS The search identified 9 studies derived from 8 unique datasets. Most studies were assessments of feasibility and were undertaken in the United States. Interventions were predominately Web-based, with a focus on improving the caregivers' knowledge and understanding about psychosis. CONCLUSIONS This study offers preliminary support for the feasibility and acceptability of digital interventions for psychosis in informal caregiver populations. However, the findings underpin a clear need for greater development in the range of caregiver-focused digital approaches on offer and robust evaluation of their outcomes. The use of digital approaches with caregiver populations seemingly lags someway behind the significant developments observed in patient groups.
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Affiliation(s)
- Juliana Onwumere
- Institute of Psychology, Psychiatry and Neuroscience, Department of Psychology, King's College, London, London, United Kingdom.,Bethlem Royal Hospital, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Filipa Amaral
- Institute of Psychology, Psychiatry and Neuroscience, Department of Psychology, King's College, London, London, United Kingdom
| | - Lucia R Valmaggia
- Institute of Psychology, Psychiatry and Neuroscience, Department of Psychology, King's College, London, London, United Kingdom
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103
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Betts J, Pearce J, McKechnie B, McCutcheon L, Cotton SM, Jovev M, Rayner V, Seigerman M, Hulbert C, McNab C, Chanen AM. A psychoeducational group intervention for family and friends of youth with borderline personality disorder features: protocol for a randomised controlled trial. Borderline Personal Disord Emot Dysregul 2018; 5:13. [PMID: 30065842 PMCID: PMC6060555 DOI: 10.1186/s40479-018-0090-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/05/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Caring for a person with borderline personality disorder is associated with poor outcomes including elevated psychological distress and burden. This study will compare the effectiveness of two brief psychoeducational programs for carers of youth presenting for early intervention for borderline personality disorder features. The protocol for this study is presented here. METHODS The study is a single-centre parallel group, randomised controlled trial. As a family unit, relatives, partners and friends ('carers') are randomly allocated to one of two treatment arms to receive either an online borderline personality disorder psychoeducation program, or both the online psychoeducation group and a face-to-face group program, Making Sense of Borderline Personality Disorder. Carers are assessed at baseline and follow-up (4 weeks after the intervention). It is expected that participants who received the combined group and online programs will have better outcomes than those who received the online program alone. The primary outcome is carer burden, assessed using the negative appraisal subscales of the Experience of Caregiving Inventory. Secondary outcomes include positive experiences of caregiving, coping, self-rated personality disorder knowledge, psychological distress, expressed emotion and quality of life. DISCUSSION This will be the first published evaluation of a psychoeducational intervention for carers of youth with borderline personality disorder features using a randomised controlled trial design. The results have the potential to inform clinicians and carers about the effectiveness of brief interventions designed to support families and friends of young people with borderline personality disorder, and what medium those interventions should utilise. TRIAL REGISTRATION Prospectively registered with the Australian New Zealand Clinical Trial Registry ACTRN12616000304437 on 08 March 2016.
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Affiliation(s)
- Jennifer Betts
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, (Locked Bag 10), Parkville VIC, Melbourne, 3052 Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Jessie Pearce
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Ben McKechnie
- Orygen Youth Health, Northwestern Mental Health, Melbourne, Australia
| | - Louise McCutcheon
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, (Locked Bag 10), Parkville VIC, Melbourne, 3052 Australia
- Orygen Youth Health, Northwestern Mental Health, Melbourne, Australia
| | - Sue M. Cotton
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, (Locked Bag 10), Parkville VIC, Melbourne, 3052 Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Martina Jovev
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, (Locked Bag 10), Parkville VIC, Melbourne, 3052 Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Orygen Youth Health, Northwestern Mental Health, Melbourne, Australia
| | - Victoria Rayner
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, (Locked Bag 10), Parkville VIC, Melbourne, 3052 Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Mirra Seigerman
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Carol Hulbert
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia
| | - Catharine McNab
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, (Locked Bag 10), Parkville VIC, Melbourne, 3052 Australia
- Orygen Youth Health, Northwestern Mental Health, Melbourne, Australia
| | - Andrew M. Chanen
- Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Rd, (Locked Bag 10), Parkville VIC, Melbourne, 3052 Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
- Orygen Youth Health, Northwestern Mental Health, Melbourne, Australia
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Abstract
SUMMARYBurbach describes the content of a phased approach to delivering family work in psychosis. Clinicians would find it helpful to have guidance on how to address the challenges they face in clinical practice, such as engaging all family members in the process and how to deal with confidentiality conflicts. Implementation challenges are also likely to affect their ability to deliver this intervention. It may also be useful to consider the role that family members can play in co-production and training, and in delivering support to other families through a carer peer support model.DECLARATION OF INTERESTNone.
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105
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Zanetti ACG, Vedana KGG, Gherardi-Donato ECDS, Galera SAF, Martin IDS, Tressoldi LDS, Miasso AI. Emoção expressa de familiares e recaídas psiquiátricas de pacientes com diagnóstico de esquizofrenia. Rev Esc Enferm USP 2018; 52:e03330. [DOI: 10.1590/s1980-220x2016042703330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 12/31/2017] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: Avaliar a relação entre recaídas psiquiátricas de pacientes com diagnóstico de esquizofrenia, níveis de emoção expressa de seus familiares e fatores relacionados. Método: Estudo prospectivo, realizado em um serviço ambulatorial de saúde mental e em dois Centros de Atenção Psicossocial, com pacientes e familiares que responderam ao Family Questionnaire − Versão Português do Brasil, um formulário contendo as variáveis sociodemográficas e clínicas e um roteiro estruturado para avaliação de recaídas. Para a análise, utilizou-se do modelo de regressão logística. Resultados: Participaram do estudo 89 díades. Dos pacientes investigados, 31% apresentaram recaídas, e 68% dos familiares, elevada emoção expressa. A relação entre a emoção expressa e as recaídas não foi significativa. A análise de regressão logística mostrou que quanto maior o número de internação nos 2 anos precedentes ao estudo, a chance de o paciente apresentar recaídas no período de 24 meses é de 1,34. Conclusão: A emoção expressa foi insuficiente para predizer recaídas. Assim, as recaídas devem ser compreendidas como um fenômeno multifatorial. Esses resultados fornecem subsídios para intervenções e investigações sobre os múltiplos fatores envolvidos na evolução do paciente com esquizofrenia, acompanhado em serviços de saúde mental de base comunitária.
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Giacco D, Mavromara L, Gamblen J, Conneely M, Priebe S. Shared decision-making with involuntary hospital patients: a qualitative study of barriers and facilitators. BJPsych Open 2018; 4:113-118. [PMID: 29971154 PMCID: PMC6020261 DOI: 10.1192/bjo.2018.6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 01/15/2018] [Accepted: 01/15/2018] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Last year, there were more than 63 622 involuntary admissions to psychiatric hospitals in England. One of the core principles stipulated in the code of practice for care under the Mental Health Act is involving involuntary patients in care decisions. AIMS Identifying barriers and facilitators to shared decision-making with involuntary patients. METHOD Focus groups and individual interviews with patients and clinicians who have experience with involuntary hospital treatment were carried out. Data were subjected to thematic analysis. RESULTS Twenty-two patients and 16 clinicians participated. Barriers identified included challenges in communication, and noisy and busy wards making one-to-one meetings difficult. Patient involvement was identified as easier if initiated early after admission and if the whole clinical team was on board. Carers' presence helped decision-making through providing additional information and comfort. CONCLUSIONS The barriers and facilitators identified can inform changes in the practice of involuntary care to increase patient involvement. DECLARATION OF INTEREST None.
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Affiliation(s)
- Domenico Giacco
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, UK
| | - Liza Mavromara
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, UK
| | - Jennifer Gamblen
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, UK
| | - Maev Conneely
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, UK
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Ebrahimi H, Seyedfatemi N, Namdar Areshtanab H, Ranjbar F, Thornicroft G, Whitehead B, Rahmani F. Barriers to Family Caregivers' Coping With Patients With Severe Mental Illness in Iran. QUALITATIVE HEALTH RESEARCH 2018; 28:987-1001. [PMID: 29478404 DOI: 10.1177/1049732318758644] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The broad spectrum of problems caused by caring for a patient with mental illness imposes a high burden on family caregivers. This can affect how they cope with their mentally ill family members. Identifying caregivers' experiences of barriers to coping is necessary to develop a program to help them overcome these challenges. This qualitative content analysis study explored barriers impeding family caregivers' ability to cope with their relatives diagnosed with severe mental illness (defined here as schizophrenia, schizoaffective disorders, and bipolar affective disorders). Sixteen family caregivers were recruited using purposive sampling and interviewed using a semi-structured in-depth interview method. Data were analyzed by a conventional content analytic approach. Findings consisted of four major categories: the patient's isolation from everyday life, incomplete recovery, lack of support by the mental health care system, and stigmatization. Findings highlight the necessity of providing support for caregivers by the mental health care delivery service system.
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Affiliation(s)
- Hossein Ebrahimi
- 1 Department of Psychiatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naeimeh Seyedfatemi
- 2 Nursing Care Research Center. Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Namdar Areshtanab
- 1 Department of Psychiatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Ranjbar
- 3 Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Farnaz Rahmani
- 1 Department of Psychiatric Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
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Mirsepassi Z, Tabatabaee M, Sharifi V, Mottaghipour Y. Patient and family psychoeducation: Service development and implementation in a center in Iran. Int J Soc Psychiatry 2018; 64:73-79. [PMID: 29334847 DOI: 10.1177/0020764017747910] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Family and patient psychoeducation have demonstrated significant improvement in clinical and social outcomes for patients suffering from severe mental disorders and their families. However, these evidence-based practices are not widely implemented at service delivery level and into routine clinical practice, especially in less developed countries. AIM The aim of this article is to report the processes of development and implementation of a psychoeducational service for patients with severe mental illnesses and their families in Iran. METHOD The program was developed at Roozbeh Hospital in Tehran, Iran. A group of clinicians worked on the development phase of the program and drafting the manuals. Then, a series of workshops and supervision sessions were held to train group leaders for implementation of the group psychoeducation for patients and families. In the pilot phase, the services were delivered to two groups of patients and families, and then the manual was revised based on the feedback from group leaders and participants. RESULTS The program consisted of eight 90-minute weekly patient group sessions and 6 weekly multiple family group sessions. Two manuals for patient education (schizophrenia and bipolar disorder) were developed. Several information sheets were developed and distributed during different sessions of family and patient psychoeducation related to the content of each session. Despite providing the hospital clinicians with the information regarding these new services, less than 10% of the admitted patients were referred by their clinicians. CONCLUSION Feasibility and sustainability of the program are affected by a number of factors. Low referral rate of clinicians, limited resources of the hospital, issues related to stigma and logistic issues are barriers in implementation of these services. Administrators' and clinicians' understanding of the importance of patient and family psychoeducation seems to be crucial in sustainability of such programs in routine service delivery.
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Affiliation(s)
- Zahra Mirsepassi
- 1 Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Tabatabaee
- 1 Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Vandad Sharifi
- 1 Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Mottaghipour
- 2 Department of Psychiatry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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109
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Reupert A, Ward B, McCormick F, Ward C, Waller S, Kidd S. Developing a model of family focused practice with consumers, families, practitioners and managers: a community based participatory research approach. BMC Health Serv Res 2018; 18:66. [PMID: 29382350 PMCID: PMC5791189 DOI: 10.1186/s12913-018-2844-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 01/16/2018] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND While governments are urging adult mental health services to support consumers in the context of their family, there is little information about what family focused practice is, nor how it might be enacted. METHODS Informed by the principles of Community Based Participatory Research, workshops were held in three rural Australian communities in 2015 to discuss the meaning of family focused practice and how such practices might be promoted. RESULTS Participants described the need to raise community awareness about mental illness and provide practical support to the family. Participants emphasized the importance of practitioners genuinely communicating with consumers and their families about mental illness and the need for collaborative care and treatment planning. They also highlighted the challenges of living in rural places and posed some solutions. CONCLUSION On the basis of the results and previous literature, we developed a model of family focused practice that outlined various stakeholders and their enactments. The model has the potential to inform policy, professional development and practice guidelines.
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Affiliation(s)
- Andrea Reupert
- Faculty of Education, Krongold, Monash University, Clayton, VIC 3800 Australia
| | - Bernadette Ward
- School of Rural Health, Monash University, PO Box 666, Bendigo, VIC 3552 Australia
| | - Francis McCormick
- Psychiatric Services, Bendigo Health, PO Box 126, Bendigo, VIC 3552 Australia
| | - Cathy Ward
- Murray City Coast Country GP Training, Bendigo, VIC 3550 Australia
| | - Susan Waller
- Monash Rural Health, Monash University, PO Box 397, Moe, VIC 3825 Australia
| | - Susan Kidd
- Psychiatric Services, Bendigo Health, PO Box 126, Bendigo, VIC 3552 Australia
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Predictors of length of stay in psychiatric inpatient units: Does their effect vary across countries? Eur Psychiatry 2018; 48:6-12. [PMID: 29331601 DOI: 10.1016/j.eurpsy.2017.11.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 11/10/2017] [Accepted: 11/10/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Previous studies in individual countries have identified inconsistent predictors of length of stay (LoS) in psychiatric inpatient units. This may reflect methodological inconsistencies across studies or true differences of predictors. In this study we assessed predictors of LoS in five European countries and explored whether their effect varies across countries. METHODS Prospective cohort study. All patients admitted over 14 months to 57 psychiatric inpatient units in Belgium, Germany, Italy, Poland and United Kingdom were screened. Putative predictors were collected from medical records and in face-to-face interviews and tested for their association with LoS. RESULTS Average LoS varied from 17.9days in Italy to 55.1days in Belgium. In the overall sample being homeless, receiving benefits, social isolation, diagnosis of psychosis, greater symptom severity, substance use, history of previous admission and being involuntarily admitted predicted longer LoS. Several predictors showed significant interaction effects with countries in predicting LoS. One variable, homelessness, predicted a different LoS even in opposite directions, whilst for other predictors the direction of the association was the same, but the strength of the association with LoS varied across countries. CONCLUSIONS The same patient characteristics have a different impact on LoS in different contexts. Thus, although some predictor variables related to clinical severity and social dysfunction appear of generalisable relevance, national studies on LoS are required to understand the complex influence of different patient characteristics on clinical practice in the given contexts.
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111
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Harvey C. Family psychoeducation for people living with schizophrenia and their families. BJPSYCH ADVANCES 2018. [DOI: 10.1192/bja.2017.4] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
SUMMARYMost people with schizophrenia have frequent contact with their families. Therefore, the family should be involved in their relative's treatment and care wherever possible, so that they can contribute to that person's recovery and the family's own needs for information, support and treatment can be addressed. Family psychoeducation refers to a group of structured psychotherapeutic interventions that involve the person with schizophrenia and their family as partners in care. Trained practitioners adopt a collaborative approach to information sharing and provide training in coping, communication and problem-solving skills. This article describes the common principles and techniques of family psychoeducation (FPE), along with the substantial evidence for its benefits for families, especially reduced relapse rates for the person with schizophrenia. Despite recommendations in clinical practice guidelines, FPE is not widely available throughout the world. The current challenge is to address this through systemic approaches to practice change and tiered approaches to family service delivery.LEARNING OBJECTIVES•Appreciate the needs of families and recognise how these may be addressed by family psychoeducation•Understand the evidence for family psychoeducation•Delineate the key elements of family psychoeducation and consider how it may be applied in practiceDECLARATION OF INTERESTNone.
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112
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Rugkåsa J, Canvin K. Mental health, coercion and family caregiving: issues from the international literature. BJPsych Int 2017; 14:56-58. [PMID: 29093945 PMCID: PMC5618899 DOI: 10.1192/s2056474000001902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This article summarises current knowledge about two aspects of family care for people with mental illness: potentially pressurising or coercive aspects of family life; and family carers’ experiences of being involved in coercive service interventions. There is a paucity of studies on these topics, especially outside Europe, North America and Australasia, and further research is recommended.
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Affiliation(s)
- Jorun Rugkåsa
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway; email
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113
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Keogh B, Skärsäter I, Doyle L, Ellilä H, Jormfeldt H, Lahti M, Higgins A, Meade O, Sitvast J, Stickley T, Kilkku N. Working with Families Affected by Mental Distress: Stakeholders' Perceptions of Mental Health Nurses Educational Needs. Issues Ment Health Nurs 2017; 38:822-828. [PMID: 28745973 DOI: 10.1080/01612840.2017.1341587] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Family and informal caregivers provide a substantial amount of care and support to people who experience mental health problems. The aim of this study was to explore mental health nurses', students' and service users' perceptions of the knowledge, skills and attitudes that are required by mental health nurses to work with families and carers using a qualitative methodology. Three themes emerged from the data: Knowledge of the family and how mental distress affects the family; working with the family - support and education; and valuing the role of the family. The three themes demonstrate the complexity of preparing mental health nurses to work with families and carers, and the article offers recommendations about how this might be achieved.
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Affiliation(s)
- Brian Keogh
- a School of Nursing and Midwifery , Trinity College Dublin , Dublin , Ireland
| | - Ingela Skärsäter
- b School of Health and Welfare , Halmstad University , Halmstad , Sweden
| | - Louise Doyle
- a School of Nursing and Midwifery , Trinity College Dublin , Dublin , Ireland
| | - Heikki Ellilä
- c School of Health and Wellbeing , University of Applied Science Turku , Turku , Finland
| | - Henrika Jormfeldt
- b School of Health and Welfare , Halmstad University , Halmstad , Sweden
| | - Mari Lahti
- d University of Applied Science Turku , Turku , Finland
| | - Agnes Higgins
- a School of Nursing and Midwifery , Trinity College Dublin , Dublin , Ireland
| | - Oonagh Meade
- e School of Health Sciences, Faculty of Medicine and Health Sciences, Institute of Mental Health Building , University of Nottingham , Innovation Park , UK
| | - Jan Sitvast
- f Master Program in Advanced Nursing Practice , University of Applied Sciences HU , Utrecht , The Netherlands
| | | | - Nina Kilkku
- g Tampere University of Applied Sciences , Tampere , Finland
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114
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Mulligan K, McBain H, Lamontagne‐Godwin F, Chapman J, Haddad M, Jones J, Flood C, Thomas D, Simpson A. Barriers and enablers of type 2 diabetes self-management in people with severe mental illness. Health Expect 2017; 20:1020-1030. [PMID: 28306182 PMCID: PMC5600230 DOI: 10.1111/hex.12543] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2017] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND People with diabetes and severe mental illness (SMI) experience poorer outcomes than those with diabetes alone. To improve outcomes, it is necessary to understand the difficulties that people with SMI experience in managing their diabetes. AIMS To identify barriers and enablers to effective diabetes self-management experienced by people with SMI and type 2 diabetes. METHOD Qualitative methodology using semi-structured interviews was employed. Development of the interview topic guide and analysis of the transcripts were informed by the Theoretical Domains Framework for behaviour change, which consists of fourteen theoretical domains that have been found to influence behaviour. RESULTS Fourteen people with SMI and type 2 diabetes took part in the study. Participants considered diabetes self-management to be important, were aware of the risks of poor diabetes control but struggled to follow recommended advice, particularly if their mental health was poor. Support from family and health professionals was considered an important enabler of diabetes self-management. CONCLUSIONS New approaches are required to support diabetes self-management in people with SMI. This study identified some of the important domains that may be targeted in new interventions.
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Affiliation(s)
- Kathleen Mulligan
- Centre for Health Services ResearchSchool of Health SciencesCity, University of LondonLondonUK
- East London NHS Foundation TrustLondonUK
| | - Hayley McBain
- Centre for Health Services ResearchSchool of Health SciencesCity, University of LondonLondonUK
- East London NHS Foundation TrustLondonUK
| | - Frederique Lamontagne‐Godwin
- Centre for Health Services ResearchSchool of Health SciencesCity, University of LondonLondonUK
- Centre for Mental Health ResearchSchool of Health SciencesCity, University of LondonLondonUK
| | | | - Mark Haddad
- East London NHS Foundation TrustLondonUK
- Centre for Mental Health ResearchSchool of Health SciencesCity, University of LondonLondonUK
| | - Julia Jones
- Centre for Research in Primary and Community Care (CRIPACC)School of Health and Social WorkUniversity of HertfordshireHatfieldUK
| | - Chris Flood
- East London NHS Foundation TrustLondonUK
- Centre for Mental Health ResearchSchool of Health SciencesCity, University of LondonLondonUK
| | - David Thomas
- East London NHS Foundation TrustLondonUK
- Centre for Mental Health ResearchSchool of Health SciencesCity, University of LondonLondonUK
| | - Alan Simpson
- East London NHS Foundation TrustLondonUK
- Centre for Mental Health ResearchSchool of Health SciencesCity, University of LondonLondonUK
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Selick A, Durbin J, Vu N, O'Connor K, Volpe T, Lin E. Barriers and facilitators to implementing family support and education in Early Psychosis Intervention programmes: A systematic review. Early Interv Psychiatry 2017; 11:365-374. [PMID: 28418227 DOI: 10.1111/eip.12400] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 09/20/2016] [Indexed: 11/28/2022]
Abstract
Family support is a core component of the Early Psychosis Intervention (EPI) model, yet it continues to have relatively low rates of implementation in practice. This paper reports results of a literature review on facilitators and barriers to delivering family interventions in EPI programmes. A search was conducted of 4 electronic databases, Medline, EMBASE, PsycINFO and Joanna Briggs, from 2000 to 2015 using terms related to early onset psychosis, family work and implementation. Four thousand four hundred and two unique studies were identified, 7 of which met inclusion criteria. Barriers and facilitators were coded and aggregated to higher-level themes using a consensus approach. Five of 7 studies examined structured multifamily psychoeducation. Uptake by families was affected by: family/client interest and readiness to participate; ability to access supports; and support needs/preferences. Implementation by programmes was affected by staff access to training and resources to provide family support. A key finding across the identified studies was that families have different needs and preferences regarding the timing, length, intensity and content of the intervention. One size does not fit all and many families do not require the intensive psychoeducational programmes typically provided. The reviewed literature suggests that flexible, tiered approaches to care may better meet family needs and increase rates of uptake of family support. However, more research is needed on the effectiveness of different models of family support in early psychosis and how they can be successfully implemented.
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Affiliation(s)
- Avra Selick
- Provincial System Support Program Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Janet Durbin
- Provincial System Support Program Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Nhi Vu
- Provincial System Support Program Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Karen O'Connor
- Canadian Mental Health Association, Peel Dufferin Branch, Brampton, Ontario, Canada
| | - Tiziana Volpe
- Provincial System Support Program Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Elizabeth Lin
- Provincial System Support Program Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Dirik A, Sandhu S, Giacco D, Barrett K, Bennison G, Collinson S, Priebe S. Why involve families in acute mental healthcare? A collaborative conceptual review. BMJ Open 2017; 7:e017680. [PMID: 28963308 PMCID: PMC5623469 DOI: 10.1136/bmjopen-2017-017680] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 08/29/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Family involvement is strongly recommended in clinical guidelines but suffers from poor implementation. To explore this topic at a conceptual level, a multidisciplinary review team including academics, clinicians and individuals with lived experience undertook a review to explore the theoretical background of family involvement models in acute mental health treatment and how this relates to their delivery. DESIGN A conceptual review was undertaken, including a systematic search and narrative synthesis. Included family models were mapped onto the most commonly referenced underlying theories: the diathesis-stress model, systems theories and postmodern theories of mental health. Common components of the models were summarised and compared. Lastly, a thematic analysis was undertaken to explore the role of patients and families in the delivery of the approaches. SETTING General adult acute mental health treatment. RESULTS Six distinct family involvement models were identified: Calgary Family Assessment and Intervention Models, ERIC (Equipe Rapide d'Intervention de Crise), Family Psychoeducation Models, Family Systems Approach, Open Dialogue and the Somerset Model. Findings indicated that despite wide variation in the theoretical models underlying family involvement models, there were many commonalities in their components, such as a focus on communication, language use and joint decision-making. Thematic analysis of the role of patients and families identified several issues for implementation. This included potential harms that could emerge during delivery of the models, such as imposing linear 'patient-carer' relationships and the risk of perceived coercion. CONCLUSIONS We conclude that future staff training may benefit from discussing the chosen family involvement model within the context of other theories of mental health. This may help to clarify the underlying purpose of family involvement and address the diverse needs and world views of patients, families and professionals in acute settings.
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Affiliation(s)
- Aysegul Dirik
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Sima Sandhu
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Domenico Giacco
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
- East London NHS Foundation Trust, London, UK
| | - Katherine Barrett
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Gerry Bennison
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Sue Collinson
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, London, UK
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117
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Kortteisto T, Laitila M, Pitkänen A. Attitudes of mental health professionals towards service user involvement. Scand J Caring Sci 2017; 32:681-689. [PMID: 28833316 DOI: 10.1111/scs.12495] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/10/2017] [Indexed: 11/29/2022]
Abstract
Patient-centred care and user involvement in healthcare services are much emphasised globally. This study was the first step in a multicentre research project in Finland to improve service users' and carers' opportunities to be more involved in mental health services. The aim of the study was to assess attitudes of professionals towards service user involvement. The data were collected via an online questionnaire from 1069 mental health professionals in four hospital districts. Altogether, 351 professionals responded. Data were analysed using appropriate statistical methods. According to the results, attitudes of healthcare professionals were more positive towards service users' involvement in their own treatment than in other levels of services. There were also differences in gender, age groups, working places and experiences in the attitudes of professionals concerning service users' involvement in their own treatment. These should be taken into account in the future when planning education for mental health professionals. In spite of governmental guidance on service user involvement and the growing body of knowledge of the benefits associated with it, change in attitudes towards user involvement is slow. Special attention should be paid to the attitudes of professionals working in inpatient care and of those with less working experience.
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Affiliation(s)
- Tiina Kortteisto
- Department of Internal Medicine, Tampere University Hospital, Tampere, Finland
| | - Minna Laitila
- Hospital District of South Ostrobothnia, Seinäjoki, Finland
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118
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Saidel MGB, Campos CJG. Family of older adults with mental disorder: perception of mental health professionals. Rev Bras Enferm 2017; 70:753-760. [PMID: 28793105 DOI: 10.1590/0034-7167-2016-0646] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/02/2017] [Indexed: 11/21/2022] Open
Abstract
Objective to understand the perceptions of healthcare professionals of the Psychosocial Care Centers regarding the family of older adults with mental disorders. Method study of a Qualitative Case conducted with 12 healthcare professionals from a Psychosocial Care Center, with a convenient and exhaustive sample. Conducting semi-structured interviews to collect data, which were analyzed with the Content Analysis technique. Results the following categories stood out: "Family exhaustion and deterioration in the perception of the healthcare professional" and "The abandonment of older adults by family members and their distancing in the perception of the healthcare professional." Final considerations culpability of older adults and penalization of the family were verified by healthcare professionals. To bring awareness about the difficulties faced in the attempt to bring the family closer to the healthcare service, it is necessary to analyze the care given to the older adult and to overcome challenges in the effective construction of the bond between family, healthcare user and mental health service.
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Affiliation(s)
- Maria Giovana Borges Saidel
- Universidade Estadual de Campinas, School of Nursing, Center of Qualitative Research in Health. Campinas, São Paulo, Brazil
| | - Claudinei José Gomes Campos
- Universidade Estadual de Campinas, School of Nursing, Center of Qualitative Research in Health. Campinas, São Paulo, Brazil
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119
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Parker S, Dark F, Newman E, Korman N, Rasmussen Z, Meurk C. Reality of working in a community-based, recovery-oriented mental health rehabilitation unit: A pragmatic grounded theory analysis. Int J Ment Health Nurs 2017; 26:355-365. [PMID: 27589881 DOI: 10.1111/inm.12251] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/16/2016] [Indexed: 11/28/2022]
Abstract
In the present study, we explored the experiences of staff working at a recovery-oriented, community-based residential mental health rehabilitation unit in Brisbane, Australia, called a 'community care unit' (CCU). A pragmatic approach to grounded theory was taken in the analysis of the transcripts of semistructured interviews with eight staff. Convenience sampling was used, and there was representation of junior and senior staff across nursing, allied health, and non-clinical support roles. Four key themes emerged from the analysis: (i) rehabilitation is different to treatment; (ii) the CCU is a positive transitional space; (iii) they (consumers) have to be ready to engage; and (iv) recovery is central to rehabilitation practice. Staff understandings of recovery in rehabilitation work were complex and included consideration of both personal and clinical recovery concepts. Rehabilitation readiness was considered important to the ability to deliver recovery-oriented care; however, the shared role of staff in maintaining engagement was acknowledged. Threats to recovery-oriented rehabilitation practice included staff burnout and external pressure to accept consumers who are not ready. The reality of working at a community-based recovery-oriented rehabilitation unit is complex. Active vigilance is needed to maintain a focus on recovery and rehabilitation. Leadership needs to focus on reducing burnout and in adapting these services to emergent needs.
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Affiliation(s)
- Stephen Parker
- Rehabilitation Academic Clinical Unit, Metro South Addiction and Mental Health Service, Brisbane, Queensland, Australia
| | - Frances Dark
- Rehabilitation Academic Clinical Unit, Metro South Addiction and Mental Health Service, Brisbane, Queensland, Australia
| | - Ellie Newman
- Rehabilitation Academic Clinical Unit, Metro South Addiction and Mental Health Service, Brisbane, Queensland, Australia
| | - Nicole Korman
- Rehabilitation Academic Clinical Unit, Metro South Addiction and Mental Health Service, Brisbane, Queensland, Australia
| | - Zoe Rasmussen
- Rehabilitation Academic Clinical Unit, Metro South Addiction and Mental Health Service, Brisbane, Queensland, Australia
| | - Carla Meurk
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
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120
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Doody O, Butler MP, Lyons R, Newman D. Families' experiences of involvement in care planning in mental health services: an integrative literature review. J Psychiatr Ment Health Nurs 2017; 24:412-430. [PMID: 28102020 DOI: 10.1111/jpm.12369] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2017] [Indexed: 11/29/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Current policy advocates for the participation of family carers in care planning. Caring for a person with a mental illness requires a significant commitment from families to support their relative's recovery. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The evidence of family involvement in care planning is generally fraught with conflicting experiences related to different requirements between mental health professionals, families and service users. Confidentiality remains contentious at a practice level in terms of information sharing and decision-making. There is a requirement and need for a shared understanding around care planning between families and mental health professionals. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The provision of written information pertaining to families regarding confidentiality is required at service level. Educational workshops concerning care planning and treatment options should be provided for service users, families and mental health professionals. Further research into effective service-wide strategies that explore with families how their engagement can be positively fostered in mental health services is warranted. ABSTRACT Introduction Mental health service policy stipulates that family carers be involved in care planning. Aim To identify families' experiences of care planning involvement in adult mental health services. Method An integrative review where electronic databases and grey literature were searched for papers published between 01 January 2005 and 10 February 2016. Results Fifteen papers met the inclusion criteria. Thematic analysis generated three themes: (1) families' experience of collaboration, (2) families' perceptions of professionals and (3) families' impressions of the care planning process. Collaborative decision-making is not regularly experienced by families with an 'us' and 'them' divide, perpetuated by a lack of communication, confidentiality constraints and a claim of 'insider knowledge' of service users. When involved, families perceive care planning to be uncoordinated and that their lived experiences are not always appreciated. Discussion Families need to be valued, empowered and engaged in care planning and the partnership distance be addressed. Accommodating the views of family, service user and professionals is preferable but not always possible. Our findings suggest that the key element for professionals is to value all 'insider knowledge' where possible. Implications for Practice Services should develop written information on confidentiality for families and facilitate open communication concerning their involvement in care planning.
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Affiliation(s)
- O Doody
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - M P Butler
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - R Lyons
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - D Newman
- Cork Intergrative Service, Health Service Executive, Cork, Ireland
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121
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Morrison P, Stomski NJ. Carers’ Perspectives on Mental Health Consumers’ Use of Antipsychotic Medication: A Multidimensional Scalogram Analysis. CONTEMPORARY FAMILY THERAPY 2017. [DOI: 10.1007/s10591-017-9423-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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122
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Hutchison J, Lang K, Anderson G, MacMahon K. Health professionals' experiences of behavioural family therapy for adults with intellectual disabilities: a thematic analysis. J Psychiatr Ment Health Nurs 2017; 24:272-281. [PMID: 28190288 DOI: 10.1111/jpm.12375] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2017] [Indexed: 12/01/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Behavioural Family Therapy (BFT) has been shown to help people with some severe mental health conditions, such as schizophrenia, by reducing relapse rates and stress within families. It can be difficult to put family interventions, like BFT, into clinical practice. Families where someone has an intellectual disability can experience more stress compared to those who do not, but we know very little about using BFT with families where a member has an intellectual disability. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We interviewed nine Community Learning Disability Nurses and Allied Health Professionals about their experiences delivering BFT to families where one member has an intellectual disability. We found that therapists' experiences of delivering BFT were broadly positive, although they found some aspects of their service frustrating. EXPLAIN THE IMPORTANCE OF THE PAPER'S FINDINGS FOR A NON-SPECIALIST AUDIENCE: The study identifies the perceived benefits of BFT as a model to work with families, where a member has an intellectual disability. The study highlights some of the challenges experienced by practitioners, notably issues with engagement and some issues specific to working with adults with an intellectual disability. The findings suggest that it needs to be clear which families would benefit most from BFT, that interventions need to be adapted for people with intellectual disabilities and that Community Learning Disability Nurses and Allied Health Professionals should have support from management to deliver these interventions. ABSTRACT Introduction Studies have found family interventions (FIs) to be effective in reducing stress and relapse rates for a variety of mental health conditions. However, implementing FIs into clinical practice is challenging. Studies have suggested that levels of stress within some families of people with intellectual disabilities can be high. However, there is little reported about the use and implementation of FIs, such as Behavioural Family Therapy (BFT), in adult intellectual disability services. Purpose of study To explore the experiences of practitioners delivering BFT to adults with intellectual disabilities. Method A qualitative methodology was employed, using semi-structured individual interviews with BFT therapists from a health professional background (n = 9). Data were analysed thematically. Results Two overarching themes were identified: positivity and frustration. Discussion Implementation of therapy was identified as being broadly successful but with some underlying challenges, notably wider organizational issues and some issues specific to working with adults with intellectual disabilities. Implications for practice The broadly positive experiences reported provide encouragement for the delivery of FIs, such as BFT, to adults with intellectual disabilities, by professions outwith psychology. However, there is a need to provide clarity on referral processes, adapt materials accordingly for this client group and ensure that supportive management and supervision is available to therapists.
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Affiliation(s)
- J Hutchison
- Psychological Services for Adults with a Learning Disability, NHS Lanarkshire, Bothwell, UK
| | - K Lang
- Psychological Services for Adults with a Learning Disability, NHS Lanarkshire, Bothwell, UK
| | - G Anderson
- Psychological Services for Adults with a Learning Disability, NHS Lanarkshire, Bothwell, UK
| | - K MacMahon
- Senior Lecturer in Clinical Psychology, University of Edinburgh, Edinburgh, UK
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123
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Landeweer E, Molewijk B, Hem MH, Pedersen R. Worlds apart? A scoping review addressing different stakeholder perspectives on barriers to family involvement in the care for persons with severe mental illness. BMC Health Serv Res 2017; 17:349. [PMID: 28506296 PMCID: PMC5433083 DOI: 10.1186/s12913-017-2213-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2016] [Accepted: 03/31/2017] [Indexed: 11/24/2022] Open
Abstract
Background Empirical evidence shows that family involvement (FI) can play a pivotal role in the coping and recovery of persons with severe mental illness (SMI). Nevertheless, various studies demonstrate that FI in mental healthcare services is often not (sufficiently) realized. In order to develop more insights, this scoping review gives an overview of how various stakeholders conceptualize, perceive and experience barriers to FI. Central questions are: 1) What are the main barriers to FI reported by the different key stakeholders (i.e. the persons with SMI, their families and the professionals, and 2) What are the differences and similarities between the various stakeholders’ perspectives on these barriers. Methods A systematic search into primary studies regarding FI was conducted in four databases: Medline/Pubmed, Cinahl, PsychInfo and Web of Knowledge with the use of a PICO scheme. Thematic analysis focused on stakeholder perspectives (i.e. which stakeholder group reports the barrier) and types of barriers (i.e. which types of barriers are addressed). Results Thirty three studies were included. The main barriers reported by the stakeholder groups reveal important similarities and differences between the stakeholder groups and were related to: 1) the person with SMI, 2) the family, 3) the professionals, 4) the organization of care and 5) the culture-paradigm. Discussion Our stakeholder approach elicits the different stakeholders’ concepts, presuppositions and experiences of barriers to FI, and gives fundamental insights on how to deal with barriers to FI. The stakeholders differing interpretations and perceptions of the barriers related to FI is closely related to the inherent complexity involved in FI in itself. In order to deal better with these barriers, openly discussing and reflecting upon each other’s normative understandings of barriers is needed. Conclusions Differences in perceptions of barriers to FI can itself be a barrier. To deal with barriers to FI, a dialogical approach on how the different stakeholders perceive and value FI and its barriers is required. Methods such as moral case deliberation or systematic ethics reflections can be useful. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2213-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Elleke Landeweer
- Center for Medical Ethics, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130, Blindern, Oslo, NO, 0318, Norway.
| | - Bert Molewijk
- Center for Medical Ethics, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130, Blindern, Oslo, NO, 0318, Norway.,Department of Medical Humanities, VU University Medical Center, Amsterdam, The Netherlands
| | - Marit Helene Hem
- Center for Medical Ethics, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130, Blindern, Oslo, NO, 0318, Norway
| | - Reidar Pedersen
- Center for Medical Ethics, Institute of Health and Society, Faculty of Medicine, University of Oslo, P.O. Box 1130, Blindern, Oslo, NO, 0318, Norway
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124
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Martindale B. A Psychoanalytic Contribution to Understanding the Lack of Professional Involvement in Psychotherapeutic Work with Families where there is Psychosis. BRITISH JOURNAL OF PSYCHOTHERAPY 2017. [DOI: 10.1111/bjp.12290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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125
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Gleeson J, Lederman R, Koval P, Wadley G, Bendall S, Cotton S, Herrman H, Crisp K, Alvarez-Jimenez M. Moderated Online Social Therapy: A Model for Reducing Stress in Carers of Young People Diagnosed with Mental Health Disorders. Front Psychol 2017; 8:485. [PMID: 28421012 PMCID: PMC5378069 DOI: 10.3389/fpsyg.2017.00485] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/15/2017] [Indexed: 11/13/2022] Open
Abstract
Family members caring for a young person diagnosed with the onset of mental health problems face heightened stress, depression, and social isolation. Despite evidence for the effectiveness of family based interventions, sustaining access to specialist family interventions is a major challenge. The availability of the Internet provides possibilities to expand and sustain access to evidence-based psychoeducation and personal support for family members. In this paper we describe the therapeutic model and the components of our purpose-built moderated online social therapy (MOST) program for families. We outline the background to its development, beginning with our face-to-face EPISODE II family intervention, which informed our selection of therapeutic content, and the integration of recent developments in positive psychology. Our online interventions for carers integrate online therapy, online social networking, peer and expert support, and online social problem solving which has been designed to reduce stress in carers. The initial version of our application entitled Meridian was shown to be safe, acceptable, and feasible in a feasibility study of carers of youth diagnosed with depression and anxiety. There was a significant reduction in self-reported levels of stress in caregivers and change in stress was significantly correlated with use of the system. We have subsequently launched a cluster RCT for caregivers with a relative diagnosed with first-episode psychosis. Our intervention has the potential to improve access to effective specialist support for families facing the onset of serious mental health problems in their young relative.
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Affiliation(s)
- John Gleeson
- School of Psychology, Australian Catholic UniversityFitzroy, VIC, Australia
| | - Reeva Lederman
- Department of Computing and Information Systems, The University of MelbourneParkville, VIC, Australia
| | - Peter Koval
- School of Psychology, Australian Catholic UniversityFitzroy, VIC, Australia
| | - Greg Wadley
- Department of Computing and Information Systems, The University of MelbourneParkville, VIC, Australia
| | - Sarah Bendall
- Orygen, The National Centre of Excellence in Youth Mental HealthParkville, VIC, Australia.,Centre for Youth Mental Health, The University of MelbourneParkville, VIC, Australia
| | - Sue Cotton
- Orygen, The National Centre of Excellence in Youth Mental HealthParkville, VIC, Australia.,Centre for Youth Mental Health, The University of MelbourneParkville, VIC, Australia
| | - Helen Herrman
- Orygen, The National Centre of Excellence in Youth Mental HealthParkville, VIC, Australia.,Centre for Youth Mental Health, The University of MelbourneParkville, VIC, Australia
| | | | - Mario Alvarez-Jimenez
- Orygen, The National Centre of Excellence in Youth Mental HealthParkville, VIC, Australia.,Centre for Youth Mental Health, The University of MelbourneParkville, VIC, Australia
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126
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Giacco D, Dirik A, Kaselionyte J, Priebe S. How to make carer involvement in mental health inpatient units happen: a focus group study with patients, carers and clinicians. BMC Psychiatry 2017; 17:101. [PMID: 28320376 PMCID: PMC5359804 DOI: 10.1186/s12888-017-1259-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 03/09/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Carers are family members or friends who support people with a mental health problem without being paid. Carer involvement in mental health treatment has been consistently supported by research evidence and promoted by policies but its implementation rates are poor. Particularly when patients are treated in inpatient units, carers often report being left without information or being excluded from decisions about treatment. In this study we have explored, along with staff perspectives, views of patients and carers who had a recent experience of inpatient mental health care on how to improve the implementation of carer involvement in inpatient care. METHODS Sixteen focus groups were held with carers, patients and clinicians in London, United Kingdom. We included staff working in inpatient units and patients and carers who had experience of inpatient care in the last five years. Data from focus groups were analysed using thematic analysis. RESULTS Eighty six participants in total (31 service users, 22 carers and 33 clinicians) attended the focus groups. Participants identified that generally, carer involvement should happen as soon as possible after admission, although this may be challenging in some cases. Carer involvement should include receiving information, participating in decisions about care and discharge and receiving emotional support by staff. When carers are involved, their personal knowledge of the patient's condition should be utilised. Challenges to carer involvement may include problems with identifying carers during a mental health crisis, obtaining valid patient consent, sharing appropriate information, and contacting and engaging carers. Additionally, it was perceived that all the ward staff need to be actively engaged in order to make carer involvement happen and this cannot be left only to specifically trained clinicians. CONCLUSIONS These findings identify basic components that all family interventions in inpatient units should have. Further studies are needed to explore how and if purposively designed clinical interventions can improve carer involvement in inpatient treatment and, consequently, patient outcomes.
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Affiliation(s)
- Domenico Giacco
- Unit for Social and Community Psychiatry, (WHO Centre for Mental Health Service Development), Queen Mary University of London, E138SP, London, UK. .,Newham Centre for Mental Health, E13 8SP, London, UK.
| | - Aysegul Dirik
- 0000 0001 2171 1133grid.4868.2Unit for Social and Community Psychiatry, (WHO Centre for Mental Health Service Development), Queen Mary University of London, E138SP, London, UK ,0000 0001 2227 3745grid.416554.7Newham Centre for Mental Health, E13 8SP, London, UK
| | - Justina Kaselionyte
- 0000 0001 2171 1133grid.4868.2Unit for Social and Community Psychiatry, (WHO Centre for Mental Health Service Development), Queen Mary University of London, E138SP, London, UK ,0000 0001 2227 3745grid.416554.7Newham Centre for Mental Health, E13 8SP, London, UK
| | - Stefan Priebe
- 0000 0001 2171 1133grid.4868.2Unit for Social and Community Psychiatry, (WHO Centre for Mental Health Service Development), Queen Mary University of London, E138SP, London, UK ,0000 0001 2227 3745grid.416554.7Newham Centre for Mental Health, E13 8SP, London, UK
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Zegwaard MI, Aartsen MJ, Grypdonck MHF, Cuijpers P. Trust: an essential condition in the application of a caregiver support intervention in nursing practice. BMC Psychiatry 2017; 17:47. [PMID: 28148235 PMCID: PMC5288942 DOI: 10.1186/s12888-017-1209-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 01/18/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The recent policy of deinstitutionalization of health care in Western countries has resulted in a growing number of people - including elderly - with severe mental illness living in the community where they rely on families and others for support in daily living. Caregiving for partners, parents, children, and significant others can be a stressful experience and has been associated with psychosocial problems and poorer physical health. To support caregivers, a new, complex, nurse-led caregiver - centered intervention was developed. The intervention focuses on preventing deterioration in the wellbeing of caregivers. The objective of this study is to obtain a better understanding of the potentials of this new intervention. METHODS We applied an interpretative qualitative field study at two Dutch mental health care institutes. Thirteen caregivers participated in a one-time semi-structured interview. RESULTS From the caregivers' perspective, a trusting relationship between caregivers and the mental health nurse is an essential condition for the depth and hence the effectiveness of the caregiver-centered counseling intervention. In this trusting relationship three overlapping and mutually reinforcing phases were identified (1) phase of engagement, (2) recognition of personal needs and (3) hope and optimism. Each phase encompasses key experiences that enhanced trust in that phase. CONCLUSIONS Collaborative relationships between caregivers and mental health nurses provide a framework in which the mental health nurse can assess and help not only patients but also caregivers to gain insight into their situation and take on new roles and responsibilities in ways that promote their wellbeing.
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Affiliation(s)
- Marian I. Zegwaard
- Altrecht Mental Health Care, Gedachtengang 1, 3705 WH Zeist, The Netherlands
| | - Marja J. Aartsen
- 0000 0000 9151 4445grid.412414.6NOVA Norwegain Social Research, Oslo and Akershus University College, Postbox 4, St. Olavs plass, Oslo, 0130 Norway
| | - Mieke HF Grypdonck
- 0000 0001 2069 7798grid.5342.0University Centre for Nursing and Midwifery, Ghent University, De Pintelaan 185, block 5K3, 9000 Ghent, Belgium
| | - Pim Cuijpers
- 0000 0004 1754 9227grid.12380.38Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, Van der Boechorststraat 1, Amsterdam, 1081, BT The Netherlands
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128
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Klages D, Usher K, Jackson D. 'Canaries in the mine'. Parents of adult children with schizophrenia: An integrative review of the literature. Int J Ment Health Nurs 2017; 26:5-19. [PMID: 27996189 DOI: 10.1111/inm.12290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/28/2016] [Indexed: 11/28/2022]
Abstract
The purpose of this integrative review was to evaluate the current state of knowledge of parents who have adult children diagnosed with schizophrenia and their relationship with mental health professionals. Findings indicated that parents (primarily mothers) believed they intuitively knew when their adult children were becoming unwell and that they doggedly pursued connections with mental health care providers. Five themes were evident in the literature: trusting your instincts, feeling dismissed and devalued, making connections and making concessions, living with distress and sorrow, and becoming your own health-care provider. The implications of the findings on mental health nursing practice indicate that professional family relationships were not ideal, and that parents wanted to improve these relationships. Parents wanted health-care professionals to respond to their requests for help for both their children and for themselves, and wanted to be able to help the mental health team to help their adult children.
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Affiliation(s)
- Debra Klages
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Kim Usher
- School of Health, University of New England, Armidale, New South Wales, Australia
| | - Debra Jackson
- Faculty of Health & Life Sciences, Oxford Brookes University, Oxford, Oxfordshire, UK
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129
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Hjärthag F, Persson K, Ingvarsdotter K, Östman M. Professional views of supporting relatives of mental health clients with severe mental illness. Int J Soc Psychiatry 2017; 63:63-69. [PMID: 28135999 DOI: 10.1177/0020764016682268] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Supporting families where one person suffers from long-term severe mental illness (SMI) is essential, but seems hard to reach. The aim of this study was to examine professionals' views of supporting relatives of persons with SMI. MATERIAL Individual interviews mirroring personal narratives and group interviews reflecting group-processed answers were conducted among 23 professionals and analyzed thematically. RESULTS Three themes emerged: (a) information and group interaction reduces stigma and increases well-being, (b) professionals need to feel secure and confident about how the support structure works and (c) collaboration is difficult but required on several levels. CONCLUSION Trusting relationships with families were considered important, although seldom achieved; professionals wished to feel secure in their role toward relatives of a person with SMI; and professionals wanted to feel confident when working together with other services to support families.
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Affiliation(s)
- Fredrik Hjärthag
- 1 Department of Psychology, Karlstad University, Karlstad, Sweden
| | - Karin Persson
- 2 Faculty of Health and Society, Malmö University, Malmö, Sweden
| | | | - Margareta Östman
- 2 Faculty of Health and Society, Malmö University, Malmö, Sweden
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130
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Caqueo-Urízar A, Rus-Calafell M, Craig TKJ, Irarrazaval M, Urzúa A, Boyer L, Williams DR. Schizophrenia: Impact on Family Dynamics. Curr Psychiatry Rep 2017; 19:2. [PMID: 28097634 DOI: 10.1007/s11920-017-0756-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
In many societies, family members are now the primary caregivers of mental health patients, taking on responsibilities traditionally under the purview of hospitals and medical professionals. The impact of this shift on the family is high, having both an emotional and economic toll. The aim of this paper is to review the main changes that occur in family dynamics for patients with schizophrenia. The article addresses three central themes: (i) changes in the family at the onset of the disorder, (ii) consequences for family members because of their caregiver role, and (iii) family interventions aimed at improving the complex dynamics within the family. After analyzing and discussing these themes, it is observed that despite advances in the field, the viability of taking care of a patient with schizophrenia by the family remains a challenge. Improving care will require commitments from the family, the mental health service system, and local and national governments for greater investments to improve the quality of life of society in general and individuals with schizophrenia in particular.
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Affiliation(s)
- Alejandra Caqueo-Urízar
- Escuela de Psicología y Filosofía, Universidad de Tarapacá, Avenida 18 de Septiembre 2222, Arica, Chile.
- Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115-6018, USA.
| | - Mar Rus-Calafell
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Thomas K J Craig
- Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matias Irarrazaval
- Departamento de Psiquiatría, Facultad de Medicina, Hospital Clínico Universidad de Chile, Santiago, Chile
- Instituto Milenio para la Investigación en Depresión y Personalidad, Santiago, Chile
| | - Alfonso Urzúa
- Universidad Católica del Norte, Avda. Angamos 0610, Antofagasta, Chile
| | - Laurent Boyer
- Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005, Marseille, France
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115-6018, USA
- Department of African and African American Studies, Harvard University, Cambridge, MA, USA
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131
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Førde R, Norvoll R, Hem MH, Pedersen R. Next of kin's experiences of involvement during involuntary hospitalisation and coercion. BMC Med Ethics 2016; 17:76. [PMID: 27881139 PMCID: PMC5121949 DOI: 10.1186/s12910-016-0159-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 11/10/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Norway has extensive and detailed legal requirements and guidelines concerning involvement of next of kin (NOK) during involuntary hospital treatment of seriously mentally ill patients. However, we have little knowledge about what happens in practice. This study explores NOK's views and experiences of involvement during involuntary hospitalisation in Norway. METHODS We performed qualitative interviews-focus groups and individual-with 36 adult NOK to adults and adolescents who had been involuntarily admitted once or several times. The semi-structured interview guide included questions on experiences with and views on involvement during serious mental illness and coercion. RESULTS Most of the NOK were heavily involved in the patient's life and illness. Their conceptions of involvement during mental illness and coercion, included many important aspects adding to the traditional focus on substitute decision-making. The overall impression was, with a few exceptions, that the NOK had experienced lack of involvement or had negative experiences as NOK in their encounters with the health services. Not being seen and acknowledged as important caregivers and co sufferers were experienced as offensive and could add to their feelings of guilt. Lack of involvement had as a consequence that vital patient information which the NOK possessed was not shared with the patient's therapists. CONCLUSIONS Despite public initiatives to improve the involvement of NOK, the NOK in our study felt neglected, unappreciated and dismissed. The paper discusses possible reasons for the gap between public policies and practice which deserve more attention: 1. A strong and not always correct focus on legal matters. 2. Little emphasis on the role of NOK in professional ethics. 3. The organisation of health services and resource constraints. 4. A conservative culture regarding the role of next of kin in mental health care. Acknowledging these reasons may be helpful to understand deficient involvement of the NOK in voluntary mental health services.
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Affiliation(s)
- Reidun Førde
- Centre for Medical Ethics, Institute for Health and Society, University of Oslo, Oslo, Norway
| | - Reidun Norvoll
- Centre for Medical Ethics, Institute for Health and Society, University of Oslo, Oslo, Norway
| | - Marit Helene Hem
- Centre for Medical Ethics, Institute for Health and Society, University of Oslo, Oslo, Norway
| | - Reidar Pedersen
- Centre for Medical Ethics, Institute for Health and Society, University of Oslo, Oslo, Norway
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132
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“Negotiating partnerships:” parents’ experiences of collaboration in community mental health and substance use services. ADVANCES IN DUAL DIAGNOSIS 2016. [DOI: 10.1108/add-04-2016-0010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The importance of collaboration in the mental health field is a well established theoretical principle, but there has so far been less attention to its practical implications from a parents’ perspective. The purpose of this paper is to describe parents’ experiences of collaboration with mental health practitioners.
Design/methodology/approach
This was a qualitative study based on thematic analysis of multi-stage focus group discussions with ten parents of young adults with co-occurring mental health and substance use problems.
Findings
The authors identified three major themes related to family member’s experiences of collaborative practices: negotiating partnerships, incomprehensible services and being the young adult’s advocate.
Research limitations/implications
A potential limitation of this study is that the parents who agreed to take part in this study were all part of the population who really want to be involved in their relative’s care; other family members who did not take part may have different feelings. It would be interesting to interview the siblings and partners of young adults with mental health and substance abuse problems. A last limitation is that only family parents participated in these focus group discussions; it would be interesting to invite service users and practitioners to elicit information about similarities and differences in their experiences of collaborative practices.
Practical implications
This study emphasises that parents should be seen as unique individuals as well as families. Parents are persons in different contexts. This creates different needs in their collaboration with the professionals. Parents want to be invited to contribute with their experiences and knowledge, being a collaborative partner in the service provision, and not a burden for their young adults, or to the professionals.
Social implications
This study emphasises that it may be important to understand the complex situations of each family parent, supporting their loved ones and at the same time living lives of their own. Families are in demanding and stressful situations often over many years. They want to be invited to contribute with their experiences and knowledge, being a collaborative partner in the service provision, and not a burden for their young adults, or to the professionals.
Originality/value
The importance of collaboration is well established in in the mental health field. However, there has been less attention to what collaboration with parents might involve in practice. This paper describes the collaborative experiences of parents of young adults (18-28 years) with co-occurring mental health and substance use problems.
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133
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Palonen M, Kaunonen M, Åstedt-Kurki P. Family involvement in emergency department discharge education for older people. J Clin Nurs 2016; 25:3333-3344. [PMID: 27218600 DOI: 10.1111/jocn.13399] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2016] [Indexed: 01/10/2023]
Abstract
AIMS AND OBJECTIVES To report findings concerning family involvement in emergency department discharge education for older people. BACKGROUND The current trend of population ageing in Western countries has caused an increase in emergency department visits. Due to the continuing improvement in the mental and physical status of older people, they are frequently discharged home. Proper discharge education enables older people and their families to better understand how they can cope with the medical issue at home. Given the lack of research, we know relatively little about the significance of family involvement in older people's emergency department discharge education. DESIGN A descriptive qualitative design was used. METHODS Qualitative thematic interviews of seven older patients, five family members and fifteen nurses were conducted. Data were analysed using content analysis. RESULTS Family involvement in discharge education was seen as turbulent. The experiences were twofold: family involvement was acknowledged, but there was also a feeling that family members were ostracised. Families were seen as a resource for nurses, but as obliged initiators of their own involvement. CONCLUSIONS Our findings suggest that family members are not considered participants in emergency department care. For a family-friendly approach, actions should be taken on both individual and organisational levels. RELEVANCE TO CLINICAL PRACTICE The findings support healthcare providers and organisation leaders in promoting family involvement in discharge education for older people. Families can be encouraged to be involved without feeling responsible for the interaction.
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Affiliation(s)
- Mira Palonen
- School of Health Sciences, University of Tampere, Tampere, Finland.
| | - Marja Kaunonen
- School of Health Sciences, University of Tampere, Tampere, Finland.,Pirkanmaa Hospital District, General Administration, Tampere, Finland
| | - Päivi Åstedt-Kurki
- School of Health Sciences, University of Tampere, Tampere, Finland.,Pirkanmaa Hospital District, General Administration, Tampere, Finland
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134
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Kaselionyte J, Dirik A, Tulloch S, Priebe S, Giacco D. Psychosis seminars: an open forum for service users, carers and professionals. BJPsych Open 2016; 2:330-334. [PMID: 27822382 PMCID: PMC5091616 DOI: 10.1192/bjpo.bp.116.003269] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/02/2016] [Accepted: 09/27/2016] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Psychosis seminars enable service users, their carers and mental health professionals to meet outside of a formal care setting, increase understanding of mental illness and help establish a dialogue. AIMS To explore feasibility of psychosis seminars in the UK and the experiences of participants. METHOD Seven meetings attended by 25 people were held over a 3-month period. An open-ended questionnaire was returned by ten participants. Responses were subjected to content analysis. RESULTS Benefits experienced were having an open forum for talking freely about mental health issues in a neutral space, learning from others about psychosis and hearing different views. Suggested adjustments were clarifying expectations of participants at the beginning, strengthening facilitation and increasing attendance. CONCLUSIONS Psychosis seminars may help to establish a dialogue among users, carers and professionals and seem feasible in the UK, although adjustment to delivery can help their implementation. DECLARATION OF INTEREST None. COPYRIGHT AND USAGE © The Royal College of Psychiatrists 2016. This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) license.
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Affiliation(s)
- Justina Kaselionyte
- , MSc, Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Newham Centre for Mental Health, Queen Mary University of London, London, UK
| | - Aysegul Dirik
- , MSc, Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Newham Centre for Mental Health, Queen Mary University of London, London, UK
| | - Simon Tulloch
- , MSc, Quality Outcomes and Experience, East London NHS Foundation Trust, London, UK
| | - Stefan Priebe
- , FRCP, Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Newham Centre for Mental Health, Queen Mary University of London, Newham Centre for Mental Health, London, UK
| | - Domenico Giacco
- , PhD, Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Newham Centre for Mental Health, Queen Mary University of London, London, UK
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135
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McCann TV, Bamberg J. Carers of older adults' satisfaction with public mental health service clinicians: a qualitative study. J Clin Nurs 2016; 25:1634-43. [DOI: 10.1111/jocn.13165] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Terence V McCann
- Centre for Chronic Disease; College of Health and Biomedicine (Discipline of Nursing); Victoria University; Melbourne Victoria Australia
| | - John Bamberg
- Centre for Chronic Disease; College of Health and Biomedicine (Discipline of Nursing); Victoria University; Melbourne Victoria Australia
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136
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Siette J, Gulea C, Priebe S. Assessing Social Networks in Patients with Psychotic Disorders: A Systematic Review of Instruments. PLoS One 2015; 10:e0145250. [PMID: 26709513 PMCID: PMC4692496 DOI: 10.1371/journal.pone.0145250] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 11/30/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Evidence suggests that social networks of patients with psychotic disorders influence symptoms, quality of life and treatment outcomes. It is therefore important to assess social networks for which appropriate and preferably established instruments should be used. AIMS To identify instruments assessing social networks in studies of patients with psychotic disorders and explore their properties. METHOD A systematic search of electronic databases was conducted to identify studies that used a measure of social networks in patients with psychotic disorders. RESULTS Eight instruments were identified, all of which had been developed before 1991. They have been used in 65 studies (total N of patients = 8,522). They assess one or more aspects of social networks such as their size, structure, dimensionality and quality. Most instruments have various shortcomings, including questionable inter-rater and test-retest reliability. CONCLUSIONS The assessment of social networks in patients with psychotic disorders is characterized by a variety of approaches which may reflect the complexity of the construct. Further research on social networks in patients with psychotic disorders would benefit from advanced and more precise instruments using comparable definitions of and timescales for social networks across studies.
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Affiliation(s)
- Joyce Siette
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, Newham Centre for Mental Health, London, E3 8SP, United Kingdom
| | - Claudia Gulea
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, Newham Centre for Mental Health, London, E3 8SP, United Kingdom
| | - Stefan Priebe
- Unit for Social and Community Psychiatry (WHO Collaborating Centre for Mental Health Service Development), Queen Mary University of London, Newham Centre for Mental Health, London, E3 8SP, United Kingdom
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137
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Seeman MV. Sexual Minority Women in Treatment for Serious Mental Illness: A Literature Review. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2015. [DOI: 10.1080/19359705.2015.1026016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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