Over 6 million people provide informal care in the UK, and this will rise to 9 million by 2037. For schizophrenia alone, informal carers save the public purse £1.24bn per year. Research shows us that involving carers in mental health can help patients’ recovery in a number of ways. It may result in fewer hospital admissions, shorter hospital stays and better patient-reported quality of life. However, in everyday clinical practice, the involvement of carers is often not implemented. Acute inpatient treatment represents a crisis which may facilitate carers’ involvement and the establishment of a strong working alliance between mental health staff, patients and carers.
- What are the barriers to carer involvement?
- How can carer involvement be facilitated during NHS inpatient routine care?
- We reviewed the available evidence on barriers and facilitators for carers’ involvement in mental health care. We found that carers’ involvement can only be implemented if this is considered a shared goal of all members of a clinical team and/or mental health service, including the leaders of the organisation. Developing a clear structure for staff, carers and patients to follow can be beneficial. However, there should be flexibility to accommodate individual needs. Concerns regarding privacy, power relations, fear of negative outcomes and the need for an exclusive patient–professional relationship should be explored and acknowledged through open, yet non-judgemental communication with patients and carers.
- We carried out a focus group study in order to obtain the perspectives of patients, carers, frontline clinicians and senior service managers on how to facilitate carers’ involvement in inpatient care. The data obtained are currently being analysed.
We are developing an intervention to involve carers in inpatient treatment, in collaboration with academic experts, clinicians and carers and users representatives.
The aims of the intervention are to: 1) ensure an early involvement of carers in routine hospital treatment (starting immediately after hospital admission); 2) provide carers and patients with information on treatment and on procedures for confidentiality; 3) establish a shared treatment planning.
Dr Domenico Giacco
Prof. Stefan Priebe
Eassom E, Giacco D, Dirik A, Priebe S. Implementing family involvement in the treatment of patients with psychosis: a systematic review of facilitating and hindering factors. BMJ Open. 2014 Oct 3;4:e006108.
NIHR Collaboration for Leadership in Applied Health Research and Care North Thames