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Services to support carers of people with mental health problems: overview report
- Authors:
- ARSKEY Hilary, et al
- Publisher:
- University of York. Social Policy Research Unit
- Publication year:
- 2002
- Pagination:
- 47p.
- Place of publication:
- York
The overall aim of the scoping study was to advise the NHS Service Delivery and Organisation (SDO) Research and Development Programme as to what further research should be commissioned in the area of services to support carers, including young carers, of working-age adults and older people with mental health problems. The five key objectives were: to define what was meant by ‘effectiveness’ and ‘cost-effectiveness’ in relation to services to support the target group, recognising that the major stakeholders will have different perspectives on, and interpretations of, these terms; to examine and summarise the evidence from published and grey literature (both UK and international) about effective and cost effective services to support the target group; to ensure that the views of key stakeholders were central to the scoping study and informed its findings and recommendations ; to draw on the evidence from the literature, and the consultation with relevant stakeholders, to identify the key gaps in existing knowledge and, where possible, to describe how these gaps are affecting development of services; and to advise SDO on which areas should be a priority for further research, taking particular note of the requirements of the two NSFs, and the concerns and issues raised by different groups of carers or their representatives.
Burden, interdependence, ethnicity, and mental health in caregivers of patients with schizophrenia
- Authors:
- SURO Giulia, WEISMAN de MAMANI Amy G.
- Journal article citation:
- Family Process, 52(2), 2013, pp.299-311.
- Publisher:
- Wiley
Caring for a patient with schizophrenia often results in high levels of perceived burden and poorer overall mental health. Using a sample of 176 caregivers of patients with schizophrenia, the present study examined how two components of burden (objective and subjective) interacted with interdependence and ethnicity to influence relatives' overall mental health. In line with study hypotheses, and with the stress-appraisal-coping model developed by Lazurus and Folkman (1984), we found that subjective burden mediated the relationship between objective burden and mental health. In other words, subjective appraisals of caregiving appeared to partially underlie the association between the concrete costs of caregiving and psychological outcomes in schizophrenia caregivers. Also as hypothesised, the authors found that interdependence, or the perceived interconnectedness of individuals within a group, moderated the relationship between objective burden and subjective burden. In other words, when levels of interdependence were high, the objective components of burden appeared to have a weaker relationship with subjective burden. When interdependence was low, on the other hand, objective burden was more likely to be associated with subjective burden. This finding suggests that helping caregivers to value harmony and connection with others over individual self-interests may reduce the likelihood that objective stressors (which are often inevitable in schizophrenia) will result in subjective distress. On the basis of prior research, the authors also tested several hypotheses regarding the role of ethnicity and its association with burden, interdependence, and mental health. However, contrary to expectations, no ethnic patterns were observed. (Edited publisher abstract)
Services to support carers of people with mental health problems: literature review report
- Authors:
- ARKSEY Hilary, et al
- Publisher:
- National Co-ordinating Centre for NHS Service Delivery and Organisation
- Publication year:
- 2002
- Pagination:
- 180p.
- Place of publication:
- London
This report provides a scoping review of evaluation studies of interventions and services to support carers of people with mental health problems. It discusses issues relating to the effectiveness and costeffectiveness of interventions and highlights where there are gaps in knowledge. The 204 studies included in the review were diverse and complex. Interventions were classified into 11 different groups: educational interventions of different types (36 per cent); breaks from caring (18 per cent); family interventions (10 per cent); mutual support and social activity groups (9 per cent); telephone and computer-based services (8 per cent); multidimensional approaches to caring interventions (7 per cent); counselling (4 per cent); domiciliary care services (2 per cent); physic al environment (1 per cent); services to support Carers of People with mental health problems; supporting carers through memory clinics (1 per cent); and miscellaneous (4 per cent).
A pilot randomized trial of two cognitive rehabilitation interventions for mild cognitive impairment: caregiver outcomes
- Authors:
- VUC Andrea V., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 32(12), 2017, pp.e180-e187.
- Publisher:
- Wiley
This study aims to provide effect size estimates of the impact of two cognitive rehabilitation interventions provided to patients with mild cognitive impairment: computerised brain fitness exercise and memory support system on support partners' outcomes of depression, anxiety, quality of life, and partner burden. Methods: A randomised controlled pilot trial was performed. Results: At 6 months, the partners from both treatment groups showed stable to improved depression scores, while partners in an untreated control group showed worsening depression over 6 months. There were no statistically significant differences on anxiety, quality of life, or burden outcomes in this small pilot trial; however, effect sizes were moderate, suggesting that the sample sizes in this pilot study were not adequate to detect statistical significance. Conclusion: Either form of cognitive rehabilitation may help partners' mood, compared with providing no treatment. However, effect size estimates related to other partner outcomes (i.e., burden, quality of life, and anxiety) suggest that follow-up efficacy trials will need sample sizes of at least 30–100 people per group to accurately determine significance. (Publisher abstract)
Involving carers and service users in the training of psychiatrists
- Authors:
- FADDEN Grainne, SHOOTER Mike, HOLSGROVE Gareth
- Journal article citation:
- Psychiatric Bulletin, 29(7), July 2005, pp.270-274.
- Publisher:
- Royal College of Psychiatrists
In June 2005 it became mandatory for psychiatric trainees to receive training directly from people who experience mental health problems and their carers. This will be checked on approval visits to all training schemes, and accreditation may be withheld until this aspect of training is in place. For many of those who are responsible for training, this may be a new undertaking. The authors outline some of the issues that trainers need to consider when involving service users and carers in their training programmes, including background issues, how to prepare both those delivering and those receiving training, and logistical considerations. It is hoped that this paper will alert trainers to issues that need to be considered if such training is to be successful.
Service innovations: developing a parent/carer support group in an in-patient adolescent setting
- Authors:
- SLOWIK Michael, et al
- Journal article citation:
- Psychiatric Bulletin, 28(5), May 2004, pp.177-179.
- Publisher:
- Royal College of Psychiatrists
It is a stressful experience for parents and/or carers when their child is admitted to an in-patient unit because of severe mental illness. Parent support groups have the potential to provide a psychosocial network, offering the opportunity for problem sharing and containment of anxiety. Compared with other types of parent groups within community adolescent mental health services, e.g. parent training groups for specific disorders such as conduct disorder and attention-deficit hyperactivity disorder little has been published about the process of setting up and running support groups for parents and carers in tertiary settings. The importance of considering the views of carers in clinical management was endorsed in the National Service Frameworks (Department of Health, 2003). The concept of a parent support group at the Regional Adolescent Unit in Birmingham was developed in Spring 2001 by two of the authors, driven by recognition of unmet needs of parents whose children were in-patients, coupled with the specialist registrars’ need for training experience in group work. The authors therefore aimed to: reflect on the process of setting up and running a parent support group in a tertiary setting; elucidate and describe themes brought up in the group meetings; and identify any therapeutic elements, and whether the group was useful.
Care needs of elderly people with schizophrenia: assessment of an epidemiologically defined cohort in Scotland
- Authors:
- McNULTY Seamus V., et al
- Journal article citation:
- British Journal of Psychiatry, 182(3), March 2003, pp.241-247.
- Publisher:
- Cambridge University Press
Little is known of the needs of elderly patients with psychotic illnesses. The aim of this artilce was to measure the care needs of an epidemiologically based group of patients over the age of 65 years suffering from psychotic illness, using a standardised assessment. All patients aged 65 years and over with a diagnosis of schizophrenia and related disorders from a defined catchment area were identified. Their health and social care needs were investigated using the Cardinal Needs Schedule. The 1-year prevalence of schizophrenia and related disorders was 4.44 per 1000 of the population at risk. There were high levels of unmet need for many patients, including those in National Health Service (NHS) continuing-care beds. Many needs were identified, all of which could be addressed using the existing skills of local health and social care professionals. The investigation raises serious concerns about standards of hospital and community care for elderly patients with schizophrenia. The findings may be unique, reflecting long-standing problems within a particularly hard-pressed part of the NHS. However, it is not known whether a similar situation exists in other parts of the UK.
The differences in perceived burdens between forensic and non-forensic caregivers of individuals suffering from schizophrenia
- Authors:
- McINNES Doug L., WATSON Jim P.
- Journal article citation:
- Journal of Mental Health, 11(4), August 2002, pp.375-388.
- Publisher:
- Taylor and Francis
- Place of publication:
- London
This article examines the burdens experienced by caregivers of people with schizophrenia. In-depth interviews were undertaken with 107 caregivers (79 caregivers of clients with a forensic history and 28 caring for non-offenders) and categorised into burden dimensions using content analysis. The severity of the burdens faced was also recorded. The types of burden experienced by the two groups were examined. Results indicated that the two groups described a similar number of burdens. However, the forensic caregivers were more likely to describe burdens relating to violent incidents and annoyance, particularly towards services. In addition, they were more likely to document more severe burdens.
Evaluating the quality of educational materials about schizophrenia
- Authors:
- CURRIE C., et al
- Journal article citation:
- Psychiatric Bulletin, 26(3), March 2002, pp.96-98.
- Publisher:
- Royal College of Psychiatrists
This study aimed to identify and evaluate the reliability and quality of educational materials provided to individuals with schizophrenia and their carers. Materials used by mental health professionals working in community and in-patient settings were collated. Two independent raters used the ‘Discern’ questionnaire to assess the publications. No educational package scored maximum marks, but four scored in the good quality range. About a fifth of the materials in widespread use were assessed as of poor quality.
Appraisals of strain and of gain: effects on psychological wellbeing of caregivers of dementia patients
- Authors:
- RAPP S.R., CHAO D.
- Journal article citation:
- Aging and Mental Health, 4(2), May 2000, pp.142-147.
- Publisher:
- Taylor and Francis
While much attention has been given to the negative impact of providing day-to-day care to an older, dependent family member, little is known about the benefits caregivers perceive and possible positive impact it may produce. This study examines the contributions of caregivers' appraisals of role strain and of role gain in predicting both positive and negative aspects of caregiver wellbeing. Results indicated that while care recipients' memory and behaviour problems correlated with negative affect they did not predict positive affect. These results suggest one pathway by which the stresses of caregiving affect wellbeing. They further suggest that positive appraisals play an important and under-recognized role in buffering stress and that they are independent of negative appraisals. Implications for caregiver research and interventions are discussed.