Do individuals with serious mental illness want their families involved in their care?

The short answer is “ask them” because there is considerable research showing that these patients can express their needs and are not regularly asked. There have been only four research reports in the last decade identifying patient preferences for family involvement in their psychiatric treatment. A sample of 179 Veterans with major or minor depression, being seen in primary care, were asked if they wanted their romantic partner involved in their treatment by providing medication reminders, accompanying them to an appointment, or speaking with their treatment provider. Over half of the sample (64%) reported their partner was already involved in one of these ways; and nearly all Veterans who did not already have the involvement of their partner wanted it (Hershenberg, Mavandadi, Klaus, Oslin, & Sayers, 2014). In a convenience sample of 110 Veterans with post-traumatic stress disorder (PTSD) who were engaged in outpatient treatment for the disorder were given a needs assessment for family involvement in their care. Almost everyone reported having family and 79% expressed interest in greater family involvement in their care. Services of greatest interest were education for the family on PTSD (85%) and other mental health issues (76%) and attending a family or couples therapy group (72%) (Batten et al., 2010). A sample of 69 Veterans with serious mental illness, including 52 with schizophrenia or schizoaffective disorder, were asked about their desire for family involvement in their psychiatric care. This sample was gathered from inpatient, partial hospitalization, and outpatient clinics, and over half the sample (64%) wanted family involvement, but a significant subsample was concerned their families were too busy (35%) or had no interest (29%). There was also concern about family conflict (33%) getting in the way. There was a preference for their family to receive information on their progress (81%) and education about their psychiatric illness (77%). Engagement in a family support group was lower (48%), but still a large subsample (Murray-Swank et al., 2007). A sample of 232 Veterans with serious mental illness, including 100 with schizophrenia or schizoaffective disorder, who were engaged in outpatient treatment were asked about family treatment preferences as part of a study aimed to engage families in care. There was some concern that involvement would lead to a loss of privacy (41%) or be burdensome (40%), but there was little concern it would lead to increased tension (16%). Despite these concerns, the vast majority of this sizable sample (78%) wanted family involvement; many (62%) wanted their family to received written education; or for their family to attend a general or educational support group (56%) (Cohen et al., 2013).

REFERENCES

Batten, Sonja V., Drapalski, Amy L., Decker, Melissa L., DeViva, Jason C., Morris, Lorie J., Mann, Mark A., & Dixon, Lisa B. (2010). “”Veteran interest in family involvement in PTSD treatment””: Correction to Batten et al (2009). Psychological Services, 7(3), 135-135. http://dx.doi.org/10.1037/a0020166

Cohen, A. N., Drapalski, A. L., Glynn, S. M., Medoff, D., Fang, L. J., & Dixon, L. B. (2013). Preferences for family involvement in care among consumers with serious mental illness. Psychiatric Services, 64(3), 257-263. http://dx.doi.org/10.1176/appi.ps.201200176

Hershenberg, R., Mavandadi, S., Klaus, J. R., Oslin, D. W., & Sayers, S. L. (2014). Veteran preferences for romantic partner involvement in depression treatment. General Hospital Psychiatry, 36(6), 757-759. http://dx.doi.org/10.1016/j.genhosppsych.2014.08.001

Murray-Swank, A., Glynn, S., Cohen, A. N., Sherman, M., Medoff, D. P., Fang, L. J., . . . Dixon, L. B. (2007). Family contact, experience of family relationships, and views about family involvement in treatment among VA consumers with serious mental illness. J Rehabil Res Dev, 44(6), 801-811.”