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Many barriers interfere with family care in psychiatric settings

An estimated one-third to two-thirds of all mentally ill patients live with family members, who bear substantial levels of stress and a large burden in caring for these individuals. Yet, a large gap exists between what families feel they need from mental health professionals and what they receive, according to a study supported by the Agency for Healthcare Research and Quality (HS10378).

Many health professionals say they don't have the training and resources to deal with complex family issues. Yet families believe that lengthy and intensive interventions are neither necessary nor desired to address their concerns. Linda Rose, Ph.D., of Johns Hopkins University, and colleagues conducted 11 focus groups (78 people) with families, patients, and mental health professionals to examine what they believed constituted effective family care in psychiatric settings.

Families identified poor quality of care, conflict with health professionals about treatment, and lack of a role for families in the treatment. Patients wanted their families to be better educated about mental illness. Black families also identified isolation of their communities from the mental health care system. Adolescents emphasized the burden they sometimes felt as caregivers and their need for support. Providers said that the health care system hampered effective care through inadequate staffing and poor coordination of services. Providers also felt that they lacked skill and experience in family care.

Based on the focus groups, the researchers make several recommendations for mental health professionals to help families. These include general recommendations appropriate for all patients and families, as well as more focused recommendations for targeted groups, including blacks and adolescents.

See "Barriers to family care in psychiatric settings," by Dr. Rose, R. Kevin Mallinson, R.N., Ph.D., A.C.R.N., and Benita Walton-Moss, R.N., D.N.S., C.S., F.N.P., in the Journal of Nursing Scholarship 36(1), pp. 39-47, 2004.

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