Advertisement

Community Mental Health Journal

, Volume 55, Issue 2, pp 318–330 | Cite as

Family Inclusion in Mental Health Service Planning and Delivery: Consumers’ Perspectives

  • Lauren WondersEmail author
  • Anne Honey
  • Nicola Hancock
Original Paper
First Online:

Abstract

Family inclusion in treatment planning and delivery for people living with mental illness is advocated in government policy but is yet to be widely translated into practice. While external barriers have been identified, including concerns about consumers’ best interests, little is known about consumers’ own views. This study explores consumers’ experiences and perspectives of including family in treatment. Semi-structured interviews were conducted with 13 adult consumers who could identify supportive family members. Data were analysed using constant comparative analysis. The findings indicated that the outcomes reported from family inclusion depended on who, how, how much and when family were included, and the degree of choice consumers had regarding these features For consumers to have real choice around these features, family inclusion needed to be accessible, families needed to be willing, and all parties needed to agree upon a consumer-centred purpose. Findings can aid health professionals to facilitate consumer choice.

Keywords

Mental illness Adult Family inclusion Recovery 
This is a preview of subscription content, log in to check access.

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare no conflict of interest with respect to the authorship and/or publication of this article.

References

  1. Aldersey, H. M., & Whitley, R. (2015). Family influence in recovery from severe mental illness. Community Mental Health Journal, 51(4), 467–476.  https://doi.org/10.1007/s10597-014-9783-y.Google Scholar
  2. Anthony, W. A. (1993). Recovery from mental illness: The guiding vision of the mental health system in the 1990s. Psychosocial Rehabilitation Journal, 16(4), 11–23.  https://doi.org/10.1037/h0095655.Google Scholar
  3. Bee, P., Brooks, H., Fraser, C., & Lovell, K. (2015). Professional perspectives on service user and carer involvement in mental health care planning: A qualitative study. International Journal of Nursing Studies, 52(12), 1834–1845.  https://doi.org/10.1016/j.ijnurstu.2015.07.008.Google Scholar
  4. Boye, B., Bentsen, H., Ulstein, I., Notland, T. H., Lersbryggen, A., Lingiaerde, O., & Malt, U. F. (2001). Relatives’ distress and patients’ symptoms and behaviours: A prospective study of patients with schizophrenia and their relatives. Acta Psychiatrica Scandinavica, 104(1), 42–50.  https://doi.org/10.1034/j.1600-0447.2001.00190.x.Google Scholar
  5. Bryant, A., & Charmaz, K. (2007). Grounded theory in historical perspective: An epistemological account. In A. Bryant & K. Charmaz (Eds.), The SAGE handbook of grounded theory (pp. 31–57). Los Angeles: SAGE Publications.Google Scholar
  6. Charmaz, K. (2003). Grounded theory: Objectivist and constructivist methods. In N. K. Denzin & Y. S. Lincoln (Eds.), Strategies of qualitative inquiry (2nd edn., pp. 249–291). Thousand Oaks, CA: SAGE Publications.Google Scholar
  7. Charmaz, K. (2014). Constructing grounded theory (2nd edn.). London: SAGE Publications Ltd.Google Scholar
  8. Cleary, M., Freeman, A., Hunt, G. E., & Walter, G. (2005). What patients and carers want to know: An exploration of information and resource needs in adult mental health services. Australian and New Zealand Journal of Psychiatry, 39(6), 507–513.  https://doi.org/10.1080/j.1440-1614.2005.01611.x.Google Scholar
  9. Cleary, M., Freeman, A., & Walter, G. (2006). Carer participation in mental health service delivery. International Journal of Mental Health Nursing, 15(3), 189–194.  https://doi.org/10.1111/j.1447-0349.2006.00422.x.Google Scholar
  10. Commonwealth Department of Health and Ageing. (2008). National Mental Health Policy 2008. Canberra, ACT: Commonwealth of Australia.Google Scholar
  11. Crombie, I. K., Irvine, L., Elliott, L., & Wallace, H. (2007). Carers of people with mental health problems: Health policy in nine countries. Journal of Public Health Policy, 28(4), 465–481.  https://doi.org/10.1057/palgrave.jphp.3200146.Google Scholar
  12. Department of Health. (2010). Recognised, valued and supported: next steps for the carers strategy. London: HMSO.Google Scholar
  13. Department of Health. (2013). National Practice Standards for the Mental Health Workforce 2013. Melbourne: Victorian Government Department of Health.Google Scholar
  14. Eassom, E., Giacco, D., Dirik, A., & Priebe, S. (2014). Implementing family involvement in the treatment of patients with psychosis: A systematic review of facilitating and hindering factors. British Medical Journal Open, 4(10), 6108–6117.  https://doi.org/10.1136/bmjopen-2014-006108.Google Scholar
  15. Ellis, G. (2003). Prevention, promotion or just survival? A consumer’s perspective. Australasian Psychiatry, 11(s1), s65–s69.  https://doi.org/10.1046/j.1038-5282.2003.02003.x.Google Scholar
  16. Family Mental Health Alliance. (2006). Caring together: Families as partners in the mental health and addiction system. Retrieved from http://ontario.cmha.ca/public_policy/caring-together-families-as-partners-in-the-mental-health-and-addiction-system/#.WBMZJmR96RY.
  17. Farkas, M., Gagne, C., Anthony, W. A., & Chamberlin, J. (2005). Implementing recovery oriented evidence based programs: Identifying the critical dimensions. Community Mental Health Journal, 41(2), 141–158.  https://doi.org/10.1007/s10597-005-2649-6.Google Scholar
  18. Fontana, A., & Frey, J. H. (2003). The interview: From structured questions to negotiated text. In N. K. Denzin & Y. S. Lincoln (Eds.), Collecting and interpreting qualitative materials (2nd edn., pp. 61–106). Thousand Oaks: Sage Publications.Google Scholar
  19. Gillespie, A., Murphy, J., & Place, M. (2010). Divergences of perspective between people with aphasia and their family caregivers. Aphasiology, 24(12), 1559–1575.  https://doi.org/10.1080/02687038.2010.500810.Google Scholar
  20. Glick, I. D., Stekoll, A. H., & Hays, S. (2011). The role of the family and improvement in treatment maintenance, adherence, and outcome for schizophrenia. Journal of Clinical Psychopharmacology, 31(1), 82–85.  https://doi.org/10.1097/JCP.0b013e31820597fa.Google Scholar
  21. Goodwin, V., & Happell, B. (2007). Consumer and carer participation in mental health care: The carer’s perspective: Part 2—Barriers to effective and genuine participation. Issues in Mental Health Nursing, 28(6), 625–638.  https://doi.org/10.1080/01612840701354612.Google Scholar
  22. Greenberg, J. S., Greenley, J. R., & Brown, R. (1997). Do mental health services reduce distress in families of people with serious mental illness? Psychiatric Rehabilitation Journal, 21(1), 40–50.  https://doi.org/10.1037/h0095344.Google Scholar
  23. Hancock, N., Scanlan, J. N., Honey, A., Bundy, A., & O’Shea, K. (2015). Recovery assessment scale—domains and stages (RAS-DS): Its faesibility and outcome measurement capacity. The Australian and New Zealand Journal of Psychiatry, 49(7), 624–633.  https://doi.org/10.1177/0004867414564084.Google Scholar
  24. Hungerford, C., & Richardson, F. (2013). Operationalising recovery-oriented services: The challenges for carers. Advances in Mental Health, 12(1), 11–21.  https://doi.org/10.5172/jamh.2013.12.1.11.Google Scholar
  25. Jakobsen, E. S., & Severinsson, E. (2006). Parents’ experiences of collaboration with community healthcare professionals. Journal of Psychiatric and Mental Health Nursing, 13(5), 498–505.  https://doi.org/10.1111/j.1365-2850.2006.00971.x.Google Scholar
  26. Kvale, S., & Brinkmann, S. (2009). Interviews: An introduction to qualitative research interviewing (2nd edn.). Thousand Oaks, CA: Sage Publications.Google Scholar
  27. Lakeman, R. (2008). Family and carer participation in mental health care: Perspectives of consumers and carers in hospital and home care settings. Journal of Psychiatric and Mental Health Nursing, 15(3), 203–211.  https://doi.org/10.1111/j.1365-2850.2007.01213.x.Google Scholar
  28. Leamy, M., Bird, V., Le Boutillier, C., Williams, J., & Slade, M. (2011). Conceptual framework for personal recovery in mental health: systematic review and narrative synthesis. The British Journal of Psychiatry, 199(6), 445–452.  https://doi.org/10.1192/bjp.bp.110.083733.Google Scholar
  29. Leggatt, M. (2011). Families as partners in mental health care. Retrieved from http://www.carersvoice.com.au/assets/files/E-Bulletins/Families_as_partners_-_Leggatt_-_Summer_2011.pdf.
  30. Lucksted, A., McFarlane, W. R., Downing, D., & Dixon, L. (2012). Recent developments in family psychoeducation as an evidence-based practice. Journal of Marital and Family Therapy, 38(1), 101–121.  https://doi.org/10.1111/j.1752-0606.2011.00256.x.Google Scholar
  31. Marshall, T., & Solomon, P. (2000). Releasing information to families of persons with severe mental illness: A survey of NAMI members. Psychiatric Services, 51(8), 1006–1011.  https://doi.org/10.1176/appi.ps.51.8.1006.Google Scholar
  32. Maxwell, J. A. (2005). Research questions: What do you want to understand. In J. A. Maxwell (Ed.), Qualitative research design: An interactive approach (2nd edn., pp. 65–78). Thousand Oaks, CA: Sage Publications.Google Scholar
  33. McFarlane, W. R., Dixon, L., Lukens, E., & Lucksted, A. (2003). Family psychoeducation and schizophrenia: A review of the literature. Journal of Marital and Family Therapy, 29(2), 223–245.  https://doi.org/10.1111/j.1752-0606.2003.tb01202.x.Google Scholar
  34. McMahon, J., Hardy, J., & Carson, R. (2010). Identifying the carer project: final report and recommendations. Canberra: Commonwealth of Australia.Google Scholar
  35. Mental Health Council of Australia. (2000). Enhancing relationships between health professionals and consumers and carers—final report. Canberra: Commonwealth Department of Health and Aged Care.Google Scholar
  36. Noble, L. M., & Douglas, B. C. (2004). What users and relatives want from mental health services. Current Opinion in Psychiatry, 17(4), 289–296.  https://doi.org/10.1097/01.yco.0000133832.42167.76.Google Scholar
  37. Office of Adolescent Health. (2018). Adolescent health: Think, act, grow, 2018 playbook. Washington, DC: US Departement of Health and Human Services.Google Scholar
  38. Oyebode, J. R. (2005). Carers as partners in mental health services for older people. Advances in psychiatric treatment, 11(4), 297–304.  https://doi.org/10.1192/apt.11.4.297.Google Scholar
  39. Patton, M. Q. (2002). Qualitative research and evaluation methods (3rd edn.). Thousand Oaks: Sage Publications.Google Scholar
  40. Pernice-Duca, F. (2010). Family network support and mental health recovery. Journal of Marital and Family Therapy, 36(1), 13–27.  https://doi.org/10.1111/j.1752-0606.2009.00182.x.Google Scholar
  41. Piippo, J., & Aaltonen, J. (2008). Mental health and creating safety: the participation of relatives in psychiatric treatment and its significance. Journal of Clinical Nursing.  https://doi.org/10.1111/j.1365-2702.2008.02650.x.Google Scholar
  42. Pilgrim, D. (2005). Key concepts in mental health. London: Sage Publications.Google Scholar
  43. Pitschel-Walz, G., Leucht, S., Bauml, J., Kissling, W., & Engel, R. (2001). The effect of family interventions on relapse and rehospitalisation in schizophrenia: A meta-analysis. Schizophrenia Bulletin, 27(1), 1209–1222.  https://doi.org/10.1176/appi.ajp.160.7.1209.Google Scholar
  44. Polgar, S., & Thomas, S. A. (2008). Introduction to research in the health sciences (5th edn.). Edinburgh: Elsevier.Google Scholar
  45. QSR International (2014). NVivo10 [Computer software].Google Scholar
  46. Rapaport, J., Bellringer, S., Pinfold, V., & Huxley, P. (2006). Carers and confidentiality in mental health care: considering the role of the carer’s assessment: A study of service users’, carers’ and practitioners’ views. Health and Social Care in the Community, 14(4), 357–365.  https://doi.org/10.1111/j.1365-2524.2006.00631.x.Google Scholar
  47. Repper, J., & Perkins, R. (2003). Social inclusion and recovery. Edinburgh: Balliere Tindall.Google Scholar
  48. Ridley, J., Hunter, S., & Rosengard, A. (2010). Partners in care?: Views and experiences of carers from a cohort study of the early implementation of the mental health (Care & Treatment) (Scotland) Act 2003. Health and Social Care in the Community, 18(5), 474–482.  https://doi.org/10.1111/j.1365-2524.2010.00920.x.Google Scholar
  49. Rose, L. E., Mallinson, R. K., & Walton-Moss, B. (2004). Barriers to family care in psychiatric settings. Journal of Nursing Scholarship, 36(1), 39–47.  https://doi.org/10.1111/j.1547-5069.2004.04009.x.Google Scholar
  50. Sane Australia. (2016). Families, friends and carers. Retrieved October 25, 2016, from https://www.sane.org/mental-health-and-illness/facts-and-guides/292-families-friends-carers.
  51. Shepherd, G., Boardman, J., & Slade, M. (2008). Making recovery a reality. Retrieved from https://www.centreformentalhealth.org.uk/making-recovery-a-reality.
  52. Slade, M., Adams, N., & O’Hagan, M. (2012). Recovery: Past progress and future challenges. International Review of Psychiatry, 24(1), 1–4.  https://doi.org/10.3109/09540261.2011.644847.Google Scholar
  53. Standing Council on Health. (2012). Mental health statement of rights and responsibilities 2012. Canberra, ACT: Commonwealth of Australia.Google Scholar
  54. Substance Abuse and Mental Health Services Administration (SAMHSA). (2009). Family Psychoeducation: How to use the evidence-based practice KITs. Rockville, MD: US Department of Health and Human Services.Google Scholar
  55. Thornberg, R., & Charmaz, K. (2014). Grounded theory and theoretical analysis. In K. Metzler (Eds.), The SAGE handbook of qualitative data analysis. Thousand Oaks: Sage Publications.Google Scholar
  56. Tooth, B., Kalyanasundaram, V., Glover, H., & Momenzadah, S. (2003). Factors consumers identify as important to recovery from schizophrenia. Australasian Psychiatry, 11(s1), s70–s77.  https://doi.org/10.1046/j.1440-1665.11.s1.1.x.Google Scholar
  57. Tracey, S. J. (2013). Qualitative research methods: Collecting evidence, crafting analysis, communicating impact. West Sussex: Wiley-Blackwell.Google Scholar
  58. Walker, E., & Dewar, B. J. (2001). How do we facilitate carers’ involvement in decision making? Issues and Innovations in Nursing Practice, 34(3), 329–337.Google Scholar
  59. Wright, E. R. (1997). The impact of organizational factors on mental health professionals’ involvement with families. Psychiatric Services, 48(7), 921–927.  https://doi.org/10.1176/ps.48.7.921.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Discipline of Occupational Therapy, Faculty of Health SciencesUniversity of SydneySydneyAustralia

Personalised recommendations

Cite article

Buy options