A new study helps Learn what prevents and facilitates family involvement in the care of people with severe mental disorders.
“We know what the best treatment for serious mental disorders is. Families are advised to be involved in the treatment of people with serious mental disorders throughout the guidelines in the Western world. Not always done so anyway, with serious negative consequences for patients, relatives, the healthcare system and society,” said Christian McLane-Hansen.
She is a doctor. Researcher at the Centre for Medical Ethics at the University of Oslo.
“Family involvement in psychiatry is often the result of work done by individuals interested in it. Sometimes the family is also included , other times they are not. Personal interest cannot dictate what treatment is offered to patients,” she said.
Need to know what prevents families from participating
Myckland Hansson and colleagues studied the prevention and promotion of family factors of participation. Systematic family involvement is central to being able to provide appropriate treatment. One of the research’s most important contributions is helping to close the gap between what we know about work and what’s actually happening in the clinic.
“To achieve better family engagement, we need to know what doesn’t work. A lot of previous research has focused on this A little bit, but our main focus is to make it work,” said Myckland Hansson.
This study is part of the ‘Family Involvement in Serious Mental Health Problems’ research project. The main purpose of the project is to increase patient and family involvement in the healthcare system, thereby improving the psychosocial well-being and quality of services for patients and their relatives.
Reduced chance of relapse with family involvement
Studies show that family involvement has a positive impact on patients and their families. For patients, it could lead to a reduced chance of relapse, better medication, fewer hospitalizations, and stress on the healthcare system. Families can provide patients with better care and support.
“In the case of severe mental illness, society, the health care system, the patient and their relatives suffer. Here’s why We should do everything we can to provide patients with the best possible treatment,” said Myckland Hansson.
She explained that in the past, it was common to blame family members for a patient’s illness. Fortunately, we know more today. The family is critical to the patient’s recovery process.
“We depend on relatives. They must contribute through help and care outside of medical services. Otherwise, health care The system will not be sustainable. Relatives can be an important resource for clinicians and health services and understand how patients function in different situations and settings.
Having a family member who is struggling can be a huge stressor for the family. It is important to start working with the family early in the treatment process to build trust between everyone involved And good conversations. That’s how to prevent conflict, optimize patient resources, and ensure relatives are supported.
” Relatives often receive little attention and are sometimes ignored and rejected by health services. At the same time, psychiatry has fewer beds and shorter follow-up, and it is necessary for them to contribute. Why is family involvement so lacking and when is it so important? Asked by Myckland Hansson.
What hinders and promotes family participation Factors
This study revealed several different degrees of Factors, family participation in the treatment of patients with severe mental disorders.
Central factors are the lack of family participation capacity and experience in the treatment unit Staff, lack of awareness of measures that can involve families, negative attitudes towards family engagement, limited access to training and mentoring, lack of priorities, routines and practices for family engagement, lack of managerial support and lack of unit resources.
“Appropriate family involvement must be established at multiple levels simultaneously over time. If the organization or treatment unit they work for is not conducive to systematic family participation. This makes it difficult to implement practical solutions for family engagement,” says Myckland Hansson.
Facilitating families at the organizational level of treatment units The factor of participation is the department’s holistic approach, with clear roles and responsibilities for facilitating participation, standardization of routines, and simple tools and knowledge to address the core factors that hinder participation. For example, this might be dealing with confidentiality and patient refusal to allow family members Participation.
For clinicians in the unit, training and mentoring of family involvement is important. This leads to higher competencies, increased awareness and better attitudes towards family involvement in treatment units.
Researchers introduce measures to promote better family engagement
In the study, family engagement was implemented in accordance with national guidelines and guidelines for family engagement. The research team took steps to increase engagement and support throughout the treatment unit. The key is to provide all staff Provide training on how to involve families and help the department establish a workable routine that provides a basic level of family involvement for all patients.
Health care workers receive Psychoeducational Family Engagement (PEF) training and instruction from TIPS Sør-East. Here clinicians teach families to work together, develop communication skills, problem-solving and gain insight into symptoms and stressors.
“Our goal is for all employees to have the same competencies, common culture, goals and practices in family engagement. We do this by standardizing routines at the organizational level, including with managers, and by working with each clinician to standardize their routines,” said Myckland Hansson. The study team followed the treatment units for 18 months as they worked to introduce these measures. The units appointed a family engagement coordinator and an improvement team to improveparticipation. Myckland Hansson explained that it was exciting to see changes on a group and individual level.
“We see therapists often focus on a lack of time and resources. Some people have never worked with their families and don’t know what that means. After training, gaining personal experience with family involvement is an important facilitator. “
Family involvement affects both family and patient
“Systemic family involvement is a This is a complex intervention that requires effort, expertise and resources to implement, but we have seen health services be very successful in doing so. Participation makes a difference for patients and relatives. This is one of the most effective treatments we have for psychosis,” said Myckland Hansson.
She believes that PEF and more basic Family involvement, in the form of separate and together conversations with relatives and patients, is something that can and should be achieved in all units of care for people with severe mental disorders.
“Systematic conversations about family engagement should be offered as a default approach and the process should begin early in the treatment process,” she said.
This study was published in
BMC Health Services Research .
More information: Kristiane Myckland Hansson et al, Barriers Implementing Family Engagement and Facilitators in Community Mental Health Centers for People with Mental Disorders – Nested Qualitative Study, BMC Health Services Research (2022). DOI: 10.1186/s12913-022-08489-y
Citation : People with severe mental disorders are better treated with family involvement (Oct. 7, 2022), Retrieved Oct. 23, 2022 from https://medicalxpress.com/news/ 2022-10-patients-severe-mental-disorders-treatment .html
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