'Who cares?': An exploratory study of carer needs in adult mental health

Abstract

Overall, health professionals have been slow to recognise the needs of families and carers, and have tended to marginalise their input in aiding consumer recovery. Despite the rhetoric of carer inclusion in mental health policy, the continued lack of systematic involvement of carers in mental health systems ensures that they remain outside the realm of core business in mental health treatment.

Based on dialogues with 31 participants in a series of focus groups who are directly engaged in caring for an adult with a serious mental illness, this study reinforces the need for carer inclusion and legitimacy, and highlights necessary changes to service delivery that acknowledge carer isolation and secondary stigma. The importance of psychoeducation programs, consistency in case management roles, and better information about the interface with legal systems were seen as particularly critical.

Authors

Donna McAuliffe
School of Human Services and Social Work, Griffith University, Logan Campus, Meadowbrook, QLD

Laurie Andriske
Division of Mental Health, Princess Alexandra Hospital, Brisbane, QLD

Elva Moller
Division of Mental Health, Princess Alexandra Hospital, Brisbane, QLD

Mary O'Brien
Division of Mental Health, Princess Alexandra Hospital, Brisbane, QLD

Pam Breslin
Division of Mental Health, Princess Alexandra Hospital, Brisbane, QLD

Paul Hickey
Division of Mental Health, Princess Alexandra Hospital, Brisbane, QLD

References

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Keywords

carers, caregiving, consumers, mental health services, psychoeducation, policy, qualitative

Meta

PP: 057 - 068

Introduction

Mental health workers are often confronted with a complexity of issues and a fragmented practice knowledge base for working with families of people with mental health problems (Walsh, 2000). The research upon which this article is based took place within a context of service restructuring where the needs of carers, and carer inclusiveness, were seen as critically important. There had been many changes over previous years in service delivery structures and processes within the service, and these were perceived by staff to have been quite difficult for consumers and their families. Service delivery in the adult mental health area includes specialist assessment and provision of diagnostic and care coordination services to consumers aged between 18 and 65 years with a serious mental illness, and their families. Integral to carer interventions in this study was an ongoing family group psychoeducation program (developed by Bland, 1987) that promotes practice and research based carer support groups.

This study, developed by a small team of mental health workers from the disciplines of social work and nursing, was an essential part of the overall evaluative framework of family group interventions, albeit with a specified set of research questions. The primary aim and purpose of the study was to assist mental health clinicians, program administrators, and policy makers to better understand the experiences, concerns and needs of family carers during times of acute and post-discharge care. The rationale for the study was the hope that better understanding of needs and experiences of carers would assist the planning of carer support interventions and therefore have more positive implications for consumer outcomes....

The current research project recognises this commitment by focusing exclusively on the experiences of carers. In doing so, it has partially replicated the Carers of People with Mental Illness Project (MHCA & CAA, 2000). This national study was largely based on the use of focus groups (composed of carers and mental health service providers/stakeholders respect-ively) to identify priority actions to better support and recognise the role of carers of people with mental illness. In designing this local study of carer needs, the mental health practitioners involved agreed that the focus group methodology employed in the national study would also be the most appropriate method of discussing issues and concerns with carers from the participating service.

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