Families As Partners in Mental Health Care was written by family carers and professionals with an enormous commitment to those who have psychiatric illnesses. In a down-to-earth way, it describes how mental health professionals can work with families of their clients for better relationships and superior outcomes. The aim of the book is to inform and motivate mental health services to adopt and implement family work as a part of basic care for those they treat and care for.
The book is available electronically by chapter below.
Chapter 1
Overview
Dianne Froggatt
With the introduction of community-based care and the reduction in the number of beds in both psychiatric and general hospitals, there is no doubt that the responsibility for care falls mainly on the family and the person’s social network. We define the family as those in a close personal relationship with the patient whether or not they are blood relatives. The fact that many mental health professionals see patients who are estranged from, or distant from their families is likely to be an indicator of the difficulties families are having holding the family together and providing ongoing support to someone who is unwell and unable to function as previously.
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Chapter 2
Models of Family Intervention
Dale L. Johnson
Families of people with severe mental illness live with considerable stress, or as it is commonly called, burden. They are puzzled by strange behaviours in a person they know well, they are frightened by threats or outright hostile attacks, they have never encountered anything like this before, and none of their prior experience has prepared them to handle this new situation. Family members may develop feelings of depression or anxiety, and are certainly well-acquainted with feelings of disempowerment, low self-esteem and loss of confidence.
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Chapter 3
Meeting the Challenges
Margaret Leggatt
For those already working in modern comprehensive mental health services, it may come as a surprise that not all mental health programs include all stakeholders. While “patient centred care” has been promoted in general health care, in mental illness, patient-centred care often overlooks that the patient is part of a family and that a family has more than a peripheral interest in the well being of its members.
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Chapter 4
Involving & Training Professionals
Dr Gráinne Fadden
In chapter two, there is a description of those family interventions that have been found to be effective. Ensuring that these are delivered to and received by families depends on clinical staff having the willingness, correct attitude, training, skills and competence to do so. Whether or not this happens depends on a range of factors including overall health policy which is covered in Chapter eight and issues in health systems described in Chapter three. Any discussion of the involvement and training of clinicians in providing services to families must take account of these broader factors. For example, if there is an absence of policy relating to the needs of families and how these are to be addressed, it is unlikely that all clinicians will be motivated to deliver services to families.
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Chapter 5
Involving Carers
This chapter is in two parts. Part 1 is written from a service perspective, and describes how professionals can actively involve carers in different aspects of service development and training. Part 2 is written by a carer and describes the various roles that family members can take on at local levels and also more widely developing into national roles.
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Chapter 6
Examples of Effective Community Services and Training in Family Psychoeducation
Chapter two outlined the definition, character and models of evidence-based family work. In this chapter we bring you a number of examples of services and training that adhere to the principles of these models and that are up and running, working effectively in the community. This is a small sample of a large number of operating programmes. We have selected these examples as highly representative of services providing evidence-based programmes, as well as services together with their evidence-based training. These are placed in random order in the chapter.
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Chapter 7
Voluntary Initiatives in Low-Income Countries – The Potential for Partnerships
Anil Vartak, Gurudatt Kundapurkar, Mukhul Goswami, Radha Shankar
Low-income countries are characterized by depressingly similar scenarios of mental health services. Mental health policies and clearly enunciated mental health programs are absent in many developing countries. The low priority given to mental health translates into limited resource allocation. Hence, the mental health infrastructure is grossly inadequate, both in facilities and trained personnel. However in some countries there are a few custodial institutions that cater to people who are seriously unwell, albeit for brief periods. Uneven economic development also means that the limited services are concentrated in urban areas, leaving rural areas to deal with both poverty and absence of health facilities. In the absence of a robust public mental health delivery infrastructure, services are delivered in a variety of settings including primary health care facilities, custodial and teaching hospitals, and clinics of private practitioners.
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Chapter 8
Government and Non-Government Organisations
Chapter 8 is a two-part chapter in which we explore what governments and non- government carer organizations can do in order to promote best-practice care for the mentally ill. In Part 1, Antony Sheehan describes how policy issues can influence the course of family involvement in mental health care, and in Part 2, Margaret Springgay outlines how a non-profit charity can succeed in influencing government and societal thinking about mental health.
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Chapter 9
Final Words about Family Work
An issue that is significant to both families and mental health professionals is patient confidentiality—the moral and legal obligation of the clinician to keep personal details about the patient private. The difficulty arises when those who are caring for a severely ill patient are told by the clinician that s/he cannot discuss the patient. In most cases, the carers are not looking for personal details of the clinical relationship but only for information that will help them to carry out their responsibilities as caregivers. This is not privileged information unless the patient has specifically asked the clinician not to talk to his/her parents about anything, a circumstance that is very rare in the families who bring their relative to treatment. The issues that family are interested in are usually related to taking the medications and advice about their caring role.
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Appendix 1
World Fellowship For Schizophrenia And Allied Disorders – Principles for Working With Families In Comprehensive Mental Health Care
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Appendix 2
Families as Partners in Care –Guide to Professionals Doing Family Work in Developing Countries
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