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Tham SS, Solomon P. Family Involvement in Routine Services for Individuals With Severe Mental Illness: Scoping Review of Barriers and Strategies. Psychiatr Serv 2024:appips20230452. [PMID: 38938096 DOI: 10.1176/appi.ps.20230452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2024]
Abstract
OBJECTIVE The authors investigated barriers to practices that promote family involvement in mental health services, focusing on individuals with severe mental illness, their families, and mental health providers. Additionally, the authors sought to identify strategies to facilitate family involvement in mental health provision to highlight the engagement process in routine practice and propose future directions for organizations to establish a family-friendly environment. METHODS Systematic searches for literature published from January 1990 to March 2023 were conducted in PsycInfo, PubMed, CINAHL, Sociological Abstracts, and Scopus databases. Gray literature searches and backward and forward snowballing strategies were also used. RESULTS Forty-six articles were reviewed, revealing contextual backgrounds and engagement practices that hindered family involvement. Inconsistencies in family involvement stemmed from organizational culture, societal attitudes, and providers' negating of family expertise. Uncertainty regarding confidentiality policies and the absence of practice guidelines posed challenges for providers. Negative experiences of families within the mental health system along with variable commitment also hampered involvement. Some service users declined family involvement because of privacy concerns and differing expectations regarding the extent of involvement. Promoting a shared culture of family work, integrating practice standards, and engaging in professional development activities emerged as key strategies. CONCLUSIONS A gap exists between implementing policies and practices for family involvement in mental health treatment. Without cultural and organizational shifts in support of working with families, the uptake of family involvement practices will remain inadequate. Each stakeholder has different perceptions of the barriers to family involvement, and family involvement will remain elusive without a shared agreement on its importance.
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Affiliation(s)
- Suzanne S Tham
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia
| | - Phyllis Solomon
- School of Social Policy and Practice, University of Pennsylvania, Philadelphia
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Sambrook L, Balmer A, Roks H, Tait J, Ashley-Mudie P, McIntyre JC, Shetty A, Bu C, Nathan R, Saini P. The journey of service users with complex mental health needs: a qualitative study. Health Psychol Behav Med 2024; 12:2365226. [PMID: 38887740 PMCID: PMC11182059 DOI: 10.1080/21642850.2024.2365226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 05/29/2024] [Indexed: 06/20/2024] Open
Abstract
Background: This study aimed to provide a robust picture of the journey of service users with complex mental health needs by evaluating the perspectives of service users and carers with lived experience of services and gaining clinician views about decision making in relation to this cohort. Methods: A qualitative design was used. Service users (n = 11), carers (n = 10) and clinicians (n = 18) took part in semi-structured interviews, which were transcribed verbatim and analysed using thematic analysis. Results: The following themes were identified by participants: 'relationships with staff,' 'treatment options, pathways and availability,' 'the role of autonomy in recovery,' 'impact of out-of-area placements,' and 'specialist training for staff.' The findings demonstrated that the journey of serviceusers can be impacted by a wide range of factors, including relationships with staff, the nature of support offered, community response, financial constraints, and organisational goals around bed pressures. Conclusions: Recommendations include the need for staff to work in partnership with service users and carers, foster autonomy, access specialised suicide prevention training, and agree discharge and contingency plans with service users. Further work is needed to deliver the best possible experience for individuals with complex mental health needs and those who care for them.
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Affiliation(s)
- Laura Sambrook
- Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Anna Balmer
- Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Hana Roks
- Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Jackie Tait
- Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | | | | | - Amrith Shetty
- Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
| | - Christopher Bu
- Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
| | - Rajan Nathan
- Cheshire and Wirral Partnership NHS Foundation Trust, Chester, UK
| | - Pooja Saini
- Faculty of Health, Liverpool John Moores University, Liverpool, UK
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Weimand B, Johansson A, Sjöström N, Waern M, Ewertzon M. A Vicious Circle of Hope and Despair: Stigma Experienced by Relatives of Persons with Severe Mental Illness. Issues Ment Health Nurs 2024; 45:409-416. [PMID: 38364206 DOI: 10.1080/01612840.2024.2308551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
Not only people suffering from severe mental illness (SMI) but also their family members experience stigma. Relatives are met with negative attitudes from healthcare professionals, which adds to the problem. This Swedish study employed a qualitative inductive explorative design in the analysis of written free-text responses from 65 persons who completed a questionnaire for relatives of persons with SMI. The overarching theme, "A vicious circle of hope and despair", was elaborated by four categories which formed a vicious circle: "Wanting openness, understanding and acknowledgement"; "Facing a lack of understanding from others"; "Seeking understanding from mental healthcare professionals but experiencing the opposite"; and "Keeping family experiences private." If this vicious circle of family stigma is to be broken, measures are needed for both relatives and health care professionals.
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Affiliation(s)
- Bente Weimand
- Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Drammen, Norway
- Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Anita Johansson
- Research and Development Centre, Skaraborg hospital, Skövde, Sweden
| | - Nils Sjöström
- Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
- Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Margda Waern
- Department of Psychotic Disorders, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
| | - Mats Ewertzon
- Department of Health Care Sciences, Marie Cederschiöld University College, Stockholm, Sweden
- Swedish Family Care Competence Centre, Kalmar, Sweden
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Silaule O, Casteleijn D, Adams F, Nkosi NG. Strategies to Alleviate the Burden Experienced by Informal Caregivers of Persons With Severe Mental Disorders in Low- and Middle-Income Countries: Scoping Review. Interact J Med Res 2024; 13:e48587. [PMID: 38236636 PMCID: PMC10835589 DOI: 10.2196/48587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/20/2023] [Accepted: 10/04/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND There is considerable evidence of the burden of care encountered by informal caregivers of persons with severe and enduring mental health conditions in low- and middle-income countries. Previous studies have highlighted the need to support these informal caregivers as key players in the care of these patients. To date, limited evidence exists on the extent and types of strategies for supporting these informal caregivers in low- and middle-income countries. OBJECTIVE This scoping review aims to identify and describe the extent and type of evidence on the existing strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions in low- and middle-income countries. METHODS A systematic literature search was completed following the Joanna Briggs Institute methodology for scoping reviews. The participants, concept, and context framework was used to guide the search for literature sources across 5 databases: PubMed, MEDLINE, CINAHL, and PsycINFO for published literature and ProQuest for unpublished literature. This review included studies that reported on strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions, with a focus on studies that evaluated or recommended caregiver interventions and support strategies in low- and middle-income countries. The search was limited to studies conducted between 2001 and 2021, and only papers written in English were considered for inclusion. Using the Covidence software (Veritas Health Innovation), 2 reviewers independently screened the papers, applied the inclusion and exclusion criteria, and met biweekly to discuss and resolve conflicts. The relevant studies and reported outcomes were summarized, organized, and analyzed descriptively using numeric summary analysis and deductive content analysis. RESULTS Of the 18,342 studies identified, 44 (0.24%) met the inclusion criteria. The included studies were from 16 low- and middle-income countries in Asia, Africa, Europe, and South and North America. Most studies (21/44, 48%) were randomized controlled trials conducted in Asian countries. The identified strategies were grouped into 2 categories: implemented and recommended intervention strategies. Identified strategies included community-based interventions, psychoeducation interventions, support groups, cognitive behavioral therapy, spirituality-based interventions, and smartphone-based interventions. In addition, mindfulness and empowerment, collaborative interventions, standard care, financial and social support, counseling, occupation-based interventions, policy and legislature, and access to mental health care were identified. Psychoeducation and support group interventions were identified as common strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions. CONCLUSIONS This review provides evidence on the types of implemented and recommended strategies for alleviating the burden of care among informal caregivers in low- and middle-income countries. Although psychoeducational interventions were the most preferred strategy for alleviating burden, their benefits were short-lived when compared with peer-led support groups. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/44268.
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Affiliation(s)
- Olindah Silaule
- Department of Occupational Therapy, University of the Witwatersrand, Johannesburg, South Africa
| | - Daleen Casteleijn
- Department of Occupational Therapy, University of Pretoria, Pretoria, South Africa
| | - Fasloen Adams
- Division of Occupational Therapy, Stellenbosch University, Cape Town, South Africa
| | - Nokuthula Gloria Nkosi
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
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Shimange ME, Shilubane HN. Perspectives of Hospitalized Mental Health Care Users Concerning the Involvement of Family Members in Their Care: A Qualitative Study. NURSING REPORTS 2023; 13:1684-1694. [PMID: 38133115 PMCID: PMC10871100 DOI: 10.3390/nursrep13040139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023] Open
Abstract
The value of families and professionals in mental health care is well understood. Patient perspectives appear to have gotten less attention to date. This study investigated the perspectives of hospitalized mental health care users on the involvement of family members in their care using a qualitative phenomenological design. The participants with lived experience of family members being involved in their care were chosen using non-probability, purposive sampling. Individual interviews were carried out with the assistance of a voice recorder and observation notes. Because of data saturation, only fifteen people were interviewed. The interviews were transcribed verbatim and analyzed using Colaizzi's method. It started with reading and reviewing the transcript to extract key statements about the phenomenon. The meaning was then determined by carefully studying the primary significant statements and phrases. The established meanings were then organized into themes and subthemes. The three themes that emerged from the data analysis are as follows: a wide variation in patients' perspectives when family members remind them of their medicine, unpredictable visitation by family members, and a lack of support from family members. There were also the following five sub-themes: not visiting mental health care users in the hospital causes uncertainty about their future, mental health care users were concerned by fewer visits from relatives, friends were perceived as a contributory factor to no or limited visitation by family members, disappointment by a lack of financial support, and perceived lack of emotional support from family members. There is a need for family members to visit mental health care users to remove uncertainty about their future. Healthcare providers should listen to mental health care users to identify the challenges they are faced with, and hospital policies tailored to enhancing the involvement of family members should be formulated.
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Affiliation(s)
| | - Hilda N. Shilubane
- Department of Advanced Nursing Science, Faculty of Health Sciences, University of Venda, Thohoyandou 0950, South Africa
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Eckardt JP. Family caregivers: never underestimate the power of hope. Nord J Psychiatry 2023; 77:624-626. [PMID: 36803377 DOI: 10.1080/08039488.2023.2178672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 01/06/2023] [Accepted: 02/06/2023] [Indexed: 02/22/2023]
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Moran E, Noonan M, Mohamad MM, O'Reilly P. Women's experiences of specialist perinatal mental health services: a qualitative evidence synthesis. Arch Womens Ment Health 2023:10.1007/s00737-023-01338-9. [PMID: 37351664 DOI: 10.1007/s00737-023-01338-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
PURPOSE Specialist perinatal mental health services identify and treat women experiencing mental health conditions during pregnancy and up to one year post birth. There is limited knowledge about women's experiences of care from specialist services. Evaluation and optimisation of service delivery requires knowledge of women's care experiences. This review aimed to systematically identify, appraise, and synthesise qualitative evidence exploring women's experiences of specialist perinatal mental health services. METHODS A systematic literature search of five databases: Medline (OVID), EMBASE (Elsevier), PsycINFO (EBSCO), CINAHL (EBSCO) and Scopus (Elsevier), grey literature searching, and backward citation, identified a total of 1035 papers of which sixteen met inclusion criteria. Methodological quality of the included studies was assessed using the Critical Appraisal Skills Program (CASP) tool. RESULTS Thematic synthesis identified three themes: connected relationships; new beginnings; and meaningful service delivery. Findings identified that relationships developed with clinicians were significant to women and their experience of care. Women valued continuity of care from dedicated non-judgemental clinicians. Peer support from other mothers was perceived as meaningful to women. Through service interventions women gained new insights into their infant's needs and grew in confidence as a mother. CONCLUSIONS Women require provision of flexible and accessible specialist services with clinicians who are sensitive to their individual psychosocial needs and preferences. Examining discharge practices and continuing care needs is essential to ensure the best outcomes for women and their families.
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Affiliation(s)
- Emma Moran
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland.
- The Department of Nursing and Healthcare, Technological University of the Shannon, Athlone, Co Westmeath, Ireland.
| | - Maria Noonan
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
| | - Mas Mahady Mohamad
- Specialist Perinatal Mental Health Services, University Maternity Hospital Limerick, Limerick, Ireland
| | - Pauline O'Reilly
- Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
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Deng Y, Xie L, Wang L, Chen Y. Psychoanalysis of COVID-19 Patient Narratives: A Descriptive Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59040712. [PMID: 37109670 PMCID: PMC10145710 DOI: 10.3390/medicina59040712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 04/29/2023]
Abstract
Background and Objectives: COVID-19 patients are a psychologically vulnerable patient group who suffer from both physical symptoms and psychological problems. The present study is a psychoanalytic investigation of COVID-19 patients utilizing Lacan's desire theory. We aimed to explore the manner in which patients' desire is presented in their lived experience narratives and sought to discover factors which directly impacted on this process. Materials and Methods: In-depth semi-structural interviews were conducted with 36 COVID-19 patients in China. During each interview, participants narrated their lived experiences of COVID-19 infection. Emotions, metaphors, and behaviors in patient narratives were collated as the main points for psychoanalysis. Results: Our findings demonstrated that the desire for being a healthy person made patients emotionally sensitive to the social environment. Anxiety and obsessive behaviors emerged in the process, which reveals their desire for that which they lack. Furthermore, public fear with respect to COVID-19 was somehow converted to psychological pressure on COVID-19 patients. Thus, these patients attempted to "de-identify" their identity as "patients". Positive responses of COVID-19 patients to the external world included admiring medical personnel, government, and country, while negative responses included interpersonal conflicts or complaints about discrimination. Following the rules of the Other, COVID-19 patients were influenced by the Other's desire in constructing their own image of a healthy person. Conclusions: This study revealed COVID-19 patients' psychological need to rid themselves of the identity of "patient" at the individual and social level. Our findings have clinical implications in helping COVID-19 patients to reshape their identity and to live a normal life.
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Affiliation(s)
- Yu Deng
- College of Language Intelligence, Sichuan International Studies University, Chongqing 400031, China
| | - Luxue Xie
- School of English Studies, Sichuan International Studies University, Chongqing 400031, China
| | - Li Wang
- Science and Education Department, Chongqing Public Health Medical Center, Chongqing 400036, China
| | - Yaokai Chen
- Department of Infection Diseases, Chongqing Public Health Medical Center, Chongqing 400036, China
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Wergeland NC, Fause Å, Weber AK, Fause ABO, Riley H. Capacity-based legislation in Norway has so far scarcely influenced the daily life and responsibilities of patients' carers: a qualitative study. BMC Psychiatry 2023; 23:111. [PMID: 36804005 PMCID: PMC9940676 DOI: 10.1186/s12888-023-04611-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND When capacity-based mental health legislation was introduced in Norway in 2017, there was concern about the consequences of change in the law for patients'carer whose community treatment order was revoked as a result of being assessed as having capacity to consent. The concern was that the lack of a community treatment order would increase carers' responsibilities in an already challenging life situation. The aim of this study is to explore carers' experiences of how their responsibility and daily life were affected after the patient's community treatment order was revoked based on capacity to consent. METHOD We conducted individual in-depth interviews from September 2019 to March 2020 with seven carers of patients whose community treatment order was revoked following assessment of capacity to consent, based on the change in the legislation. The transcripts were analysed with inspiration from reflexive thematic analysis. RESULTS The participants had little knowledge about the amended legislation, and three out of seven did not know about the change at the time of the interview. Their responsibility and daily life were as before, but they felt that the patient was more content, without relating this to the change in the law. They had found that coercion was necessary in certain situations, which made them worry whether the new legislation would make it more difficult to use coercion. CONCLUSION The participating carers had little or no knowledge of the change in the law. They were involved in the patient's everyday life as before. The concerns prior to the change about a worse situation for carers had not affected them. On the contrary, they found that their family member was more satisfied with life and the care and treatment provided. This may suggest that the intention of the legislation to reduce coercion and increase autonomy was fulfilled for these patients, without resulting in any significant change in carers' lives and responsibilities.
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Affiliation(s)
- Nina Camilla Wergeland
- Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway. .,Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
| | - Åshild Fause
- grid.10919.300000000122595234Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Astrid Karine Weber
- National Competence Center for Community Mental Health (NAPHA), Trondheim, Norway
| | | | - Henriette Riley
- grid.412244.50000 0004 4689 5540Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway ,grid.10919.300000000122595234Department of Health and Care Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
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The duty of confidentiality during family involvement: ethical challenges and possible solutions in the treatment of persons with psychotic disorders. BMC Psychiatry 2022; 22:812. [PMID: 36539741 PMCID: PMC9764492 DOI: 10.1186/s12888-022-04461-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Family involvement during severe mental illness is still poorly implemented, contrary to evidence-based recommendations. Confidentiality issues are among the most prominent barriers, with mental health professionals facing complex ethical, legal, and practical challenges. However, research focusing on this barrier is very sparse. Nested within a cluster-randomised trial to implement guidelines on family involvement for persons with psychotic disorders in community mental health centres, the aim of this sub-study was to explore ethical challenges related to the duty of confidentiality as experienced by mental health professionals, and to explore key measures that might contribute to improving the handling of such challenges. METHODS In total 75 participants participated in 21 semi-structured focus groups, including implementation team members at the initial and late phase of the intervention period and clinicians who were not on the implementation teams, at late phase of implementation. We used purposive sampling and manifest content analysis to explore participants' experiences and change processes. RESULTS Ethical challenges related to the duty of confidentiality included 1) Uncertainty in how to apply the legislation, 2) Patient autonomy versus a less strict interpretation of the duty of confidentiality, 3) Patient alliance and beneficence versus a less strict interpretation of the duty of confidentiality, 4) How to deal with uncertainty regarding what relatives know about the patients' illness, and 5) Relatives' interests versus the duty of confidentiality. Measures to facilitate better handling of the duty of confidentiality included 1) Training and practice in family involvement, and 2) Standardisation of family involvement practices. CONCLUSION When health professionals gained competence in and positive experiences with family involvement, this led to vital changes in how they interpreted and practiced the duty of confidentiality in their ethical reasoning and in clinical practice. Especially, the need to provide sufficient information to the patients about family involvement became evident during the study. To improve the handling of confidentiality issues, professionals should receive training in family involvement and confidentiality statutes followed by practice. Furthermore, family involvement should be standardised, and confidentiality guidelines should be implemented in the mental health services. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03869177. Registered 11.03.19.
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Leclair MC, Charette Y, Seto M, Nicholls TL, Roy L, Dufour M, Crocker AG. Barriers and facilitators of access and utilization of mental health services among forensic service users along the care pathway. BMC Health Serv Res 2022; 22:1495. [PMID: 36476220 PMCID: PMC9730649 DOI: 10.1186/s12913-022-08848-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The verdict of Not Criminally Responsible on account of a Mental Disorder (NCRMD) is increasingly used to access specialized mental health services in Canada and elsewhere. This situation highlights the importance of ensuring timely access to services in the community to prevent violence and justice involvement. The objective of the present study is to identify individual and contextual barriers and facilitators of access to mental health services during the period preceding an offense leading to a verdict of NCRMD. METHODS The sample includes 753 people found NCRMD in Québec, Canada. All episodes of mental health hospitalizations and service use before the index offense were identified using provincial administrative health data, for an average period of 4.5 years. Access was conceptualized as a function of the possibility of seeking, reaching and receiving appropriate health care services, based on Lévesque and colleagues patient-centred model of access to care. Generalized linear models were computed to identify the individual and contextual predictors of: (1) seeking mental healthcare (at least one contact with any type of services for mental health reasons); (2) reaching psychiatric care (at least one contact with a psychiatrist); (3) receiving psychiatric care, operationalized as (3a) continuity and (3b) intensity. Factors associated with volume of emergency mental health services were examined as exploratory analysis. RESULTS Geographical considerations were highly important in determining who reached, and who received specialized mental health care - above and beyond individual factors related to need. Those who lived outside of major urban centres were 2.6 times as likely to reach psychiatric services as those who lived in major urban centres, and made greater use of emergency mental health services by 2.1 times. Living with family decreased the odds of seeking mental healthcare by half and the intensity of psychiatric care received, even when adjusting for level of need. CONCLUSIONS Findings support efforts to engage with the family of service users and highlights the importance of providing resources to make family-centred services sustainable for health practitioners. Health policies should also focus on the implementation of outreach programs, such as Forensic Assertive Community Treatment teams as part of prevention initiatives.
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Affiliation(s)
- Marichelle C. Leclair
- grid.14848.310000 0001 2292 3357Department of Psychology & School of Public Health, Université de Montréal, Montréal, Canada ,Institut national de psychiatrie légale Philippe-Pinel, Montréal, Canada
| | - Yanick Charette
- Institut national de psychiatrie légale Philippe-Pinel, Montréal, Canada ,grid.23856.3a0000 0004 1936 8390School of Social Work and Criminology, Université Laval, Québec City, Canada
| | - Michael Seto
- Forensic Research Unit, Royal Ottawa Health Care Group, Ottawa, Canada
| | - Tonia L. Nicholls
- grid.498716.50000 0000 8794 2105Department of Psychiatry, University of British Columbia & British Columbia (BC) Mental Health & Substance Use Services, Vancouver, Canada
| | - Laurence Roy
- Institut national de psychiatrie légale Philippe-Pinel, Montréal, Canada ,grid.14709.3b0000 0004 1936 8649School of Occupational Therapy, McGill University, Montréal, Canada
| | - Mathieu Dufour
- Institut national de psychiatrie légale Philippe-Pinel, Montréal, Canada
| | - Anne G. Crocker
- Institut national de psychiatrie légale Philippe-Pinel, Montréal, Canada ,grid.14848.310000 0001 2292 3357Department of Psychiatry and Addictology & School of Criminology, Université de Montréal, Montréal, Canada
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Maybery D, Reupert A, Casey Jaffe I, Cuff R, Duncan Z, Dunkley-Smith A, Grant A, Kennelly M, Eva Skogøy B, Weimand B, Ruud T. Getting the FACS: A Protocol for Developing a Survey Instrument to Measure Carer and Family Engagement with Mental Health Services. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16279. [PMID: 36498364 PMCID: PMC9741005 DOI: 10.3390/ijerph192316279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/25/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Government policies recommend, and all stakeholders benefit, when mental health services meaningfully engage with carers and family. However, health service engagement with carers is inadequate, and often non-existent with children whose parents are service users. There are seven fundamental ways that carers and families want to be integrated with and engaged by health services but current survey instruments do not capture these seven engagement practices. This protocol describes the development of two closely aligned Family and Carer Surveys (FACS) to measure engagement of service users in mental health services. The new measures are based on the seven engagement themes and a conceptual distinction between the carer and family, with particular focus on where the service user is a parent. The instruments will be developed in five stages; (1) item generation (2) Cognitive pretesting of survey (3) preliminary item content quantitative assessment (4) psychometric analysis of a large data collection and (5) selection of items for short form instruments. These steps will operationalise the seven fundamental ways that families and carers want to be engaged with mental health services, thereby providing valid and reliable measures for use in research and benchmarking of carer and family engagement.
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Affiliation(s)
- Darryl Maybery
- Department of Rural Health & Indigenous Health, Monash University, Warragul 3820, Australia
| | - Andrea Reupert
- School of Educational Psychology & Counselling, Monash University, Melbourne 3800, Australia
| | - Irene Casey Jaffe
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
| | - Rose Cuff
- Satellite Foundation, Melbourne Central, Melbourne 3000, Australia
| | - Zoe Duncan
- Department of Rural Health & Indigenous Health, Monash University, Warragul 3820, Australia
| | - Addy Dunkley-Smith
- Department of Rural Health & Indigenous Health, Monash University, Warragul 3820, Australia
| | - Anne Grant
- School of Nursing and Midwifery, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, UK
| | - Melissa Kennelly
- Department of Rural Health & Indigenous Health, Monash University, FaPMI Strategy, Mildura 3500, Australia
| | | | - Bente Weimand
- Center for Mental Health and Substance Abuse, University of South-Eastern Norway, 3004 Drammen, Norway
- Division Mental Health Services, Akershus University Hospital, 1478 Lørenskog, Norway
| | - Torleif Ruud
- Division Mental Health Services, Akershus University Hospital, 1478 Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, 0450 Oslo, Norway
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Cameron SLA, Tchernegovski P, Maybery D. Mental health service users' experiences and perspectives of family involvement in their care: a systematic literature review. J Ment Health 2022; 32:699-715. [PMID: 35808821 DOI: 10.1080/09638237.2022.2091760] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background: The importance of engaging families in mental health care is recognised and endorsed by governments worldwide, however service users' perspectives of family involvement are not well understood.Aims: This study sought to summarise the literature regarding how service users view the involvement of family in their engagement with services and care.Methods: A search was conducted within the following databases for manuscripts published in the last 10 years: PsycINFO, CINAHLPlus, PubMed and Scopus. Of the 4251 eligible papers 17 met the inclusion criteria for review and were subjected to quality appraisal using the RATS (relevance, appropriateness, transparency, soundness) qualitative research review guidelines.Results: Thematic analysis identified four primary themes: family involvement can be positive and negative; barriers to family involvement; family involvement is variable; and communication and collaboration among stakeholders.Conclusions: Identifying the barriers to family involvement and heterogeneity among service users' views were key findings of this review. Despite the widely reported benefits of including families in mental health care it does not always occur. A clearer and more nuanced understanding of service users' needs and preferences for family involvement is required.
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Affiliation(s)
- Sarah L A Cameron
- School of Educational Psychology and Counselling, Monash University, Clayton, Australia
| | - Phillip Tchernegovski
- School of Educational Psychology and Counselling, Monash University, Clayton, Australia
| | - Darryl Maybery
- School of Rural Health, Monash University, Warragul, Australia
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Eckardt JP. Barriers to WHO Mental Health Action Plan updates to expand family and caregiver involvement in mental healthcare. Gen Psychiatr 2022; 35:e100784. [PMID: 35372788 PMCID: PMC8921906 DOI: 10.1136/gpsych-2022-100784] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
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