Community Mental Health Journal

, Volume 44, Issue 4, pp 271–281

Patients’ Report of Help Provided by Relatives and Services to Meet Their Needs

  • Marie-Josée Fleury
  • Guy Grenier
  • Jean Caron
  • Alain Lesage
Original Paper

Abstract

This article analyzes help provided by relatives and/or services to the needs of individuals with severe mental illness who have, versus do not have, regular contact with family. Factors that influence help are also examined. Data collection is based on a random sample of 186 Quebec outpatients. Patients’ needs were assessed using the Camberwell Assessment of Need. Relatives provided adequate help for social and functioning needs, adequately complementing services in other needs categories. Six sociodemographic variables influence help from relatives, only one affects help from services. The role of relatives is identified as important in meeting patients’ needs, either solely or jointly with services.

Keywords

Needs Help Adequacy Relatives Services 

References

  1. Albert, M., Becker, T., McCrone, P., & Thornicroft, G. (1998). Social networks and mental health service utilization—a literature. International Journal of Social Psychiatry, 44(4), 248–266.PubMedCrossRefGoogle Scholar
  2. Andresen, R., Caputi, P., & Oades, L. G. (2000). Interrater reliability of the Camberwell Assessment of Need Short Appraisal schedule. Australian and New Zealand Journal of Psychiatry, 34(5), 856–861.PubMedCrossRefGoogle Scholar
  3. Angell, B., & Test, M. (2002). The relationship of clinical factors and environmental opportunities to social functioning in young adults with schizophrenia. Schizophrenia Bulletin, 28(2), 259–271.PubMedGoogle Scholar
  4. Arvidsson, H. (2003). Test-retest reliability of the Camberwell Assessment of Need (CAN). Nordic Journal of Psychiatry, 57(4), 279–283.PubMedCrossRefGoogle Scholar
  5. Becker, T., Thornicroft, G., Leese, M., McCrone, P., Johnson, S., Albert M., & Turner D. (1997). Social networks and service use among representative cases of psychosis in South London. British Journal of Psychiatry, 171, 15–19.PubMedCrossRefGoogle Scholar
  6. Bengtsson-Tops, A., & Hansson, L. (1999). Clinical and social needs of schizophrenic outpatients living in the community: the relationship between needs and subjective quality of life. Social Psychiatry and Psychiatric Epidemiology, 34(10), 514–518.CrossRefGoogle Scholar
  7. Boardman, A. P., Hodgson, R. E., Lewis, M., & Allen, K. (1999). North Staffordshire community beds study: Longitudinal evaluation of psychiatric in-patient units attached to community mental health centers. 1: Methods, outcome and patient satisfaction. British Journal of Psychiatry, 175, 70–78.PubMedCrossRefGoogle Scholar
  8. Bogart, T., & Solomon, P. (1999). Procedures to share treatment information among mental health providers, consumers, and families. Psychiatric Services, 50(10), 1321–1325.PubMedGoogle Scholar
  9. Bonsack, C, & Lesage, A. (1998). Deux instruments pour évaluer les besoins de soins de santé mentale: Une étude comparative chez des personnes longuement hospitalisées. Annales Médico-psychologiques, 156(4), 244–257.Google Scholar
  10. Browne, G., & Courtney, M. (2007). Schizophrenia housing and supportive relationship. International Journal of Mental Health Nursing, 16(2), 73–80.PubMedCrossRefGoogle Scholar
  11. Caron, J., Mercier, C., Martin, A., & Stip, E. (2005). Le rôle du soutien social, du fardeau familial et de la satisfaction des services dans la détresse psychologique et la qualité de vie des familles de personnes souffrant de schizophrénie. Santé mentale au Québec, 30(2), 165–191.PubMedGoogle Scholar
  12. Carpentier, N., Lesage, A., & White, D. (1999). Family influence on the first stages of the trajectory of patients diagnosed with severe psychiatric disorders. Family Relations, 48(4), 397–403.CrossRefGoogle Scholar
  13. Cedereke, M., & Öjehagen, A. (2002). Patients’ needs during the year after a suicide attempt. A secondary analysis of a randomized controlled intervention study. Social Psychiatry and Psychiatric Epidemiology, 37(8), 357–363.PubMedCrossRefGoogle Scholar
  14. Clare, L., & Birchwood, M. (1998). Social adjustment of patients living at home. In K. Mueser & N. Tarrier (Eds.), Handbook of social functioning in schizophrenia (pp. 39–51). Boston: Allyn and Bacon.Google Scholar
  15. Clark, R. E. (2001). Family support and substance use outcomes for persons with mental illness and substance use disorders. Schizophrenia Bulletin, 27(1), 93–101.PubMedGoogle Scholar
  16. Clark, R. E., Xie, H., Adachi-Meija, A. M., & Sengupta, A. (2001). Substitution between formal and informal care for persons with severe mental illness and substance use disorders. Journal of Health Policy and Economics, 4(3), 123–132.Google Scholar
  17. D’Avanzo, B. A. (2000). Family interventions in schizophrenia and related disorders: A critical review of clinical trials. Acta Psychiatrica Scandinavica, 102(2), 81–97.PubMedCrossRefGoogle Scholar
  18. Dixon, L., McFarlane, W. R., Lefley, H., Lucksted, A., Cohen, M., Falloon, I., Mueser, K., Miklowitz, D., Solomon, P., & Sondheimer, D. (2001). Evidence-based practices for services to families of people with psychiatric disabilities. Psychiatric Services, 52(7), 903–910.PubMedCrossRefGoogle Scholar
  19. Doornbos, M. M. (2002). Family caregivers and the mental health care system: Reality and dreams. Archives of Psychiatric Nursing, 16(1), 39–46.PubMedCrossRefGoogle Scholar
  20. Drake, R. E., Goldman, H. H., Leff, H. S., Lehman, F., Dixon, L., Mueser, K. T., & Torrey, W. C. (2001). Implementing evidence-based practices in routine mental health service settings. Psychiatric Services, 52, 179–182.PubMedCrossRefGoogle Scholar
  21. Fleury, M.-J., Grenier, G., & Lesage, A. (2006). Agreement between staff and service patients concerning the clientele’s mental health needs: A Quebec study. Canadian Journal of Psychiatry, 51(5), 131–136.Google Scholar
  22. Fleury, M.-J., Mercier, C., Lesage, A., Ouadahi, Y., Grenier, G., Aubé, D., Perreault, M., & Poirier, L.-R. (2004). Réseaux intégrés de services et réponse aux besoins des personnes avec des troubles graves de santé mentale. Ottawa: Fondation canadienne de recherche sur les services de santé.Google Scholar
  23. Gigantesco, A., Picardi, A., Chiaia, E., Balbi, A., & Morisini, P. (2002). Patients’ and relatives’ satisfaction with psychiatric services in a large catchment area in Rome. European Psychiatry, 17(3), 139–147.PubMedCrossRefGoogle Scholar
  24. Hansson, L., Björkman, T., & Svensson, B. (1995). The assessment of needs in psychiatric patients. Interrater reliability of the Swedish version of the Camberwell Assessment of needs instrument and results from a cross-sectional study. Acta Psychiatrica Scandinavica, 9, 285–293.CrossRefGoogle Scholar
  25. Hansson, L., Middelboe, T., Soorgaard, K. W., Bengtsson-Tops, A., Bjarnason, O., Merinder, L., Nilsson, L., Sandlund, M., Korkeila, J., & Vinding, H. R. (2002). Living situation, subjective quality of life and social network among individuals with schizophrenia living in community settings. Acta Psychiatrica Scandinavica, 106(5), 343–350.PubMedCrossRefGoogle Scholar
  26. Holley, H. L., Hodges, P., & Jeffers, B. (1998). Moving psychiatric patients from hospital to community, views of patients, providers, and families. Psychiatric Services, 49(4), 513–517.PubMedGoogle Scholar
  27. Holmes, A. M., & Deb, P. (1998). Factors influencing informal care-giving. Journal of Health Policy and Economics, 1(2), 77–87.CrossRefGoogle Scholar
  28. Horwitz, A. V. (1993). Adult siblings as sources of social support for the seriously mentally ill: A test of the serial model. Journal of Marriage and the Family, 55(3), 623–632.CrossRefGoogle Scholar
  29. Horwitz, A.V., & Uttaro, T. (1998). Age and mental health services. Community Mental Health Journal, 34(3), 275–287.PubMedCrossRefGoogle Scholar
  30. Joyce, J., Leese, M., Szmukler, G., Harris, T., & Staples, E. (2003). Evaluating a model of caregiving for people with psychosis. Social Psychiatry and Psychiatric Epidemiology, 38(4), 189–195.PubMedCrossRefGoogle Scholar
  31. Kaiser, W. (2000). Cognitive effects of antipsychotics in schizophrenia and relationship to quality of life. British Journal of Psychiatry, 176, 92–93.PubMedCrossRefGoogle Scholar
  32. King, S., & Dixon, M. J. (1999). Expressed emotion and relapse in young schizophrenia outpatients. Schizophrenia Bulletin, 25(2), 377–386.PubMedGoogle Scholar
  33. King, S., & Rochon, V. (1995). Le rôle de l’émotion exprimée dans le cours de la schizophrénie. Santé Mentale au Québec, 20(2), 99–118.PubMedGoogle Scholar
  34. Korkeila, J., Heikkilä, J., Hansson, L., Sorgaard, K. W., Vahlberg, T., & Karlsson, H. (2005). Structure of needs among persons with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 40, 233–239.PubMedCrossRefGoogle Scholar
  35. Leavey, G., King, M., Cole, E., Hoar, A., & Johnson-Sabine, E. (1997). First-onset Psychotic illness: Patients’ and relatives’ satisfaction with services. British Journal of Psychiatry, 40, 53–57.CrossRefGoogle Scholar
  36. Lefebre, J., Cyr, M., Lesage, A., Fournier L., & Toupin, J. (2000). Unmet needs in the community: Can existing services meet them? Acta Psychiatrica Scandinavica, 102, 65–70.CrossRefGoogle Scholar
  37. Macpherson, R., Haynes, R., Summerfield, L., Foy, C., & Slade, M. (2003). From research to practice. A local mental health services needs assessment. Social Psychiatry and Psychiatric Epidemiology, 38(5), 276–281.PubMedCrossRefGoogle Scholar
  38. Magliano, L., Fiorillo, A., Fadden, G., Gair, F., Economou, M., Kallert, T., Schellong, J., Xavier, M., Pereira, M.G., Gonzales, F.T., Palma-Crespo, A., & Maj, M. (2005). Effectiveness of a psychoeducational intervention of patients with schizophrenia: preliminary results of a study funded by the European Commission. Word Psychiatry, 4(1), 45–49.Google Scholar
  39. Magliano, L., Fiorillo, A., Malangone, C., De Rosa, C., Maj, M., & The Family Intervention Working Group (2006). Patient functioning and family burden in a controlled, real-world trial of family psychoducation for schizophrenia. Psychiatric Services, 57(12), 1784–1791.Google Scholar
  40. MED-ECHO (septembre 2003-mai 2004), banque de données des hospitalisations du Ministère de la santé et des services sociaux du Québec.Google Scholar
  41. Merinder, L. B., Vuiff, A. G., Laugeser, H. D., Clemmensen, K., Misfelt, S., & Espensen, B. (1999). Patient and relative education in community psychiatry: A randomized controlled trial regarding its effectiveness. Social Psychiatry and Psychiatric Epidemiology, 34(6), 287–294.PubMedCrossRefGoogle Scholar
  42. Middelboe, T., Mackeprang, T., Hansson, L., Werdelin, G., Karlsson, H., Bjarnason, O., Bengtsson-Tops, A., Dybbro, J., Nillson, L. L., Sandlund, M., & Sorgaard, K. W. (2001). The nordic study on schizophrenic patients living in the community. Subjective needs and perceived help. European Psychiatry, 16(4), 207–214.PubMedCrossRefGoogle Scholar
  43. Perreault, M., Provencher, H., St-Onge, M., & Rousseau, M. (2002). Le point de vue des aidants familiaux sur les services en santé mentale offerts à leurs proches. Santé mentale au Québec, 27(2), 198–214.PubMedGoogle Scholar
  44. Perreault, M., Tardif, H., Provencher, H., Paquin, G., Desmarais, J., & Pawliuk, N. (2005). The role of relatives in discharge planning from psychiatric hospitals: the perspective of patients and their relatives. Psychiatric Quarterly, 76(4), 297–315.PubMedCrossRefGoogle Scholar
  45. Phelan, M., Slade, M., Thornicroft, G., Dunn, G., Halloway, F., Wykes, T., Starthdee, G., Loftus, L., McCrone, P., & Hayward, P. (1995). The Camberwell Assessment of Need (CAN): The validity and reliability of an instrument to assess the needs of people with severe mental illness. British Journal of Psychiatry, 167(5), 589–595.PubMedCrossRefGoogle Scholar
  46. Pitschel-Walz, G., Leutch, S., Bäuml, J., Kissling, W, & Engel, R. R. (2001). The effect of family interventions on relapse and rehospitalization in schizophrenia—a meta-analysis. Schizophrenia Bulletin, 27(1), 73–92.PubMedGoogle Scholar
  47. Ricard, N., Lesage, A., Reinharz, D., Gélinas, D., Bisson, J., Lauzon, S., Ouadahi, Y., Beauvais, L., & Ohana, P. (2006). Évaluation des aspects organisationnels, professionnels et cliniques de l’implantation et du fonctionnement du suivi intensif dans le milieu. Hôpital Louis-H. Lafontaine/Centre Fernand-Séguin.Google Scholar
  48. Rose, L. E. (1996). Families of psychiatric patients: A critical review and future research directions. Archives of Psychiatric Nursing, 10(2), 67–76.PubMedCrossRefGoogle Scholar
  49. Rosenheck, R, & Lam, J. A. (1997). Client and site characteristics as barriers to service use by homeless persons with serious mental illness. Psychiatric Services, 48(3), 387–390.PubMedGoogle Scholar
  50. Salokangas, R. K. K., Honkonen, T., Stengard, W., & Koivisto, A. M. (2001). To be or not to be married-that is the question of quality of life in men with schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 36(8), 381–390.PubMedCrossRefGoogle Scholar
  51. Simons, L., & Petch, A. (2002). Needs assessment and discharge: A Scottish perspective. Journal of Psychiatric and Mental Health Nursing, 9(4), 435–445.PubMedCrossRefGoogle Scholar
  52. Slade, M., Beck, A., Bindman, J., Thornicroft, G., & Wright, S. (1999b). Routine clinical outcome measures for patients with severe mental illness: Cansas and HoNOS. British Journal of Psychiatry, 174, 404–408.PubMedCrossRefGoogle Scholar
  53. Slade, M., Leese, M., Ruggeri, M., Kuipers, E., Tansella, M., & Thornicroft, G. (2004). Does meeting need improve quality of life? Psychotherapy and psychosomatics, 73(3), 183–189.PubMedCrossRefGoogle Scholar
  54. Slade, M., Leese, M., Taylor, R., & Thornicroft, G. (1999a). The association between needs and quality of life in an epidemiologically representative sample of people with psychosis. Acta Psychiatrica Scandinavica, 100(2), 149–157.PubMedCrossRefGoogle Scholar
  55. Slade, M., Phelan, M., & Thornicroft G. (1998). A comparison of needs assessed by staff and by an epidemiologically representative sample of patients with psychosis. Psychological Medicine, 28(3), 543–550.PubMedCrossRefGoogle Scholar
  56. Stengard, E., Honkonen, T., Koivisto, A. M., & Salokangas, R. K. R. (2000). Satisfaction of caregivers of patients with schizophrenia in Finland. Psychiatric Services, 51(8), 1034–1039.PubMedCrossRefGoogle Scholar
  57. Tarricone, I., Leese, M., Szmukler, G. I., Bassi, M., & Berardi, D. (2006). The experience of carers of patients with severe mental illness: A comparison between London and Bologna. European Psychiatry, 21(2), 93–101.PubMedCrossRefGoogle Scholar
  58. Tennakoon, L., Fannon, D., Doku, V., O’Ceallaigh, S., Soni, W., Santamaria, M., Kuipers, E., & Sharma, T. (2000). Experience of caregiving: Relatives of people experiencing a first episode of psychosis. British Journal of Psychiatry, 177, 529–533.PubMedCrossRefGoogle Scholar
  59. Ward-Griffin, C., Scholfield, R., Vos, S., & Coatsworth-Puspoky, R. (2005). Canadian families caring for members with mental illness: A vicious cycle. Journal of Family Nursing, 11(2), 140–161.PubMedCrossRefGoogle Scholar
  60. Wennström, E., Sörbom, D, & Wiesel, FA. (2004). Factor structure in the Camberwell Assessment of Need. British Journal of Psychiatry, 185, 505–510.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Marie-Josée Fleury
    • 1
  • Guy Grenier
    • 1
  • Jean Caron
    • 1
  • Alain Lesage
    • 2
  1. 1.Department of Psychiatry, Douglas Hospital Research CentreMcGill UniversityMontrealCanada
  2. 2.Department of Psychiatry, Centre de Recherche Fernand-Seguin, Hôpital Louis-H. LafontaineUniversity of MontrealMontrealCanada

Personalised recommendations