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Giving Back to Families: Evidence and Predictors of Persons with Serious Mental Illness Contributing Help and Support to Families

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Abstract

Persons with serious mental illness (SMI) often rely on family for significant assistance and support, but the contributions made by persons with SMI to their families have been overlooked. This study assessed the extent to which persons with SMI contribute help or support to their families and identified significant predictors of contribution using an analysis of 1 year of clinicians’ electronic health record (EHR) notes. EHR notes with reference to families of 226 Veterans with SMI were extracted and classified as suggesting help being given to and/or received from families. Forty-one percent of the sample contributed to family in a variety of ways. More frequent contact with family and being female were significant predictors of contribution. This study underlines the potential for reciprocal relationships within families of individuals with SMI. Clinicians can help clients and families maximize the support they provide to one another and possibly improve outcomes.

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References

  • Aschbrenner, K. A., Greenberg, J. S., Allen, S. A., & Seltzer, M. M. (2010). Subjective burden and personal gains among older parents of adults with serious mental illness. Psychiatric Services, 61(6), 605–611. doi:10.1176/appi.ps.61.6.605.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bengtsson-Tops, A., & Hansson, L. (2001). Quantitative and qualitative aspects of the social network in schizophrenia patients living in the community. Relationship to sociodemographic characteristics and clinical factors and subjective quality of life. International Journal of Social Psychiatry, 47(3), 67–77. doi:10.1177/002076400104700307.

    Article  CAS  PubMed  Google Scholar 

  • Chan, S. W. (2011). Global perspective of burden of family caregivers for persons with schizophrenia. Archives of Psychiatric Nursing, 25(5), 339–349. doi:10.1016/j.apnu.2011.03.008.

    Article  PubMed  Google Scholar 

  • 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. doi:10.1176/appi.ps.201200176.

    Article  PubMed  Google Scholar 

  • Corcoran, K., & Fischer, J. (2013). Measures for clinical practice and research. A sourcebook. Couples, families, and children (Vol. 1, 5th ed.). New York: Oxford University Press.

    Google Scholar 

  • Dixon, L. B., Glynn, S. M., Cohen, A. N., Drapalski, A. L., Medoff, D., Fang, L. J., … Gioia, D. (2014). Outcomes of a brief program, REORDER, to promote consumer recovery and family involvement in care. Psychiatric Services, 65(1), 116–120. doi:10.1176/appi.ps.201300074.

    Article  PubMed  Google Scholar 

  • Drapalski, A., Leith, J., & Dixon, L. (2009). Involving families in the care of persons with schizophrenia and other serious mental illnesses: History, evidence, and recommendations. Clinical Schizophrenia & Related Psychoses, 3(1), 39–49. doi:10.3371/CSRP.3.1.4.

    Article  Google Scholar 

  • Epstein, N. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9(2), 171–180. doi:10.1111/j.1752-0606.1983.tb01497.x.

    Article  Google Scholar 

  • Gioia, D., Autrey, S., Drapalski, A. L., Glynn, S., Cohen, A. N., & Dixon, L. B. (2014). Veterans’ views of a shared decision-making process: A qualitative substudy of REORDER. American Journal of Psychiatric Rehabilitation, 17(4), 348–364. doi:10.1080/15487768.2014.903877.

    Article  Google Scholar 

  • Goldman, H. H. (1982). Mental illness and family burden: A public health perspective. Hospital & Community Psychiatry, 33(7), 557–560. doi:10.1176/ps.33.7.557.

    CAS  Google Scholar 

  • Gouldner, A. W. (1960). The norm of reciprocity—A preliminary statement. American Sociological Review, 25(2), 161–178. doi:10.2307/2092623.

    Article  Google Scholar 

  • Greenberg, J. S., Greenley, J. R., & Benedict, P. (1994). Contributions of persons with serious mental illness to their families. Hospital & Community Psychiatry, 45(5), 475–480. doi:10.1176/ps.45.5.475.

    CAS  Google Scholar 

  • Hamera, E., Cobb, A. K., & Burris-Fish, J. L. (1998). Reciprocity between individuals with severe and persistent mental illness and their family members. Journal of the American Psychiatric Nurses Association, 4(6), 182–189. doi:10.1016/S1078-3903(98)90029-5.

    Article  Google Scholar 

  • Hoenig, J., & Hamilton, M. W. (1966). The schizophrenic patient in the community and his effect on the household. International Journal of Social Psychiatry, 12(3), 165–176. doi:10.1177/002076406601200301.

    Article  CAS  PubMed  Google Scholar 

  • Horan, W. P., Kring, A. M., Gur, R. E., Reise, S. P., & Blanchard, J. J. (2011). Development and psychometric validation of the Clinical Assessment Interview for Negative Symptoms (CAINS). Schizophrenia Research, 132(2–3), 140–145. doi:10.1016/j.schres.2011.06.030.

    Article  PubMed  PubMed Central  Google Scholar 

  • Horwitz, A. V., Reinhard, S. C., & Howell-White, S. (1996). Caregiving as reciprocal exchange in families with seriously mentally ill members. Journal of Health and Social Behavior, 37(2), 149–162. doi:10.2307/2137270.

    Article  CAS  PubMed  Google Scholar 

  • IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp.

  • Kaufman, A. V., Scogin, F., MacNeil, G., Leeper, J., & Wimberly, J. (2010). Helping aging parents of adult children with serious mental illness. Journal of Social Service Research, 36(5), 445–459. doi:10.1080/01488376.2010.510949.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. doi:10.1093/schbul/13.2.261.

    Article  CAS  PubMed  Google Scholar 

  • Kramer, B. J. (1997). Gain in the caregiving experience: Where are we? What next? The Gerontologist, 37(2), 218–232. doi:10.1093/geront/37.2.218.

    Article  CAS  PubMed  Google Scholar 

  • Kring, A. M., Gur, R. E., Blanchard, J. J., Horan, W. P., & Reise, S. P. (2013). The Clinical Assessment Interview for Negative Symptoms (CAINS): Final development and validation. American Journal of Psychiatry, 170(2), 165–172. doi:10.1176/appi.ajp.2012.12010109.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lefley, H. P. (1989). Family burden and family stigma in major mental illness. American Psychologist, 44(3), 556–560. doi:10.1037/0003-066X.44.3.556.

    Article  CAS  PubMed  Google Scholar 

  • Lehman, A., Kernan, E., & Postrado, L. (1995). Toolkit for evaluating quality of life for persons with severe mental illness. Baltimore, MD: The Evaluation Center at Health Services Research Institute.

    Google Scholar 

  • Marsh, D. T., Lefley, H. P., Evans-Rhodes, D., Ansell, V. I., Doerzbacher, B. M., LaBarbera, L., & Paluzzi, J. E. (1996). The family experience of mental illness: Evidence for resilience. Psychiatric Rehabilitation Journal, 20(2), 3–12. doi:10.1037/h0095390.

    Article  Google Scholar 

  • McCubbin, H. I., Thompson, A. I., & McCubbin, M. A. (1996). Family Problem Solving Communication (FPSC). In H. I. McCubbin, A. I. Thompson & M. A. McCubbin (Eds.), Family assessment: Resiliency, coping and adaptation: Inventories for research and practice (pp. 639–684). Madison, WI: University of Wisconsin Press.

    Google Scholar 

  • 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. Journal of Rehabilitation Research & Development, 44(6), 801–811. doi:10.1682/JRRD.2006.08.0092.

    Article  Google Scholar 

  • Noh, S., & Avison, W. R. (1988). Spouses of discharged psychiatric patients: Factors associated with their experience of burden. Journal of Marriage and the Family, 50(2), 377–389. doi:10.2307/352004.

    Article  Google Scholar 

  • Potasznik, H., & Nelson, G. (1984). Stress and social support: The burden experienced by the family of a mentally ill person. American Journal of Community Psychology, 12(5), 589–607. doi:10.1007/BF00897214.

    CAS  PubMed  Google Scholar 

  • Rosen, C. S., Henson, B. R., Finney, J. W., & Moos, R. H. (2000). Consistency of self-administered and interview-based Addiction Severity Index composite scores. Addiction, 95(3), 419–425. doi:10.1046/j.1360-0443.2000.95341912.x.

    Article  CAS  PubMed  Google Scholar 

  • Saunders, J. C. (2003). Families living with severe mental illness: A literature review. Issues in Mental Health Nursing, 24(2), 175–198. doi:10.1080/01612840305301.

    Article  PubMed  Google Scholar 

  • Sawin, K. J., & Harrigan, M. P. (1995). Measures of family functioning for research and practice. New York: Springer Publishing Company.

    Google Scholar 

  • Srivastava, A., & Thomson, S. B. (2009). Framework analysis: A qualitative methodology for applied policy research. Journal of Administration and Governance, 4(2), 72–79. Retrieved from https://ssrn.com/abstract=2760705.

  • Stefanovics, E. A., Elkis, H., Zhening, L., Zhang, X. Y., & Rosenheck, R. A. (2014). A cross-national factor analytic comparison of three models of PANSS symptoms in schizophrenia. Psychiatry Research, 219(2), 283–289. doi:10.1016/j.psychres.2014.04.041.

    Article  PubMed  Google Scholar 

  • Thorning, H., & Dixon, L. (2016). Caregiving for individuals with serious mental illness: A life cycle perspective. In L. D. Burgio, J. E. Gaugler & M. M. Hilgeman (Eds.), The spectrum of family caregiving for adults and elders with chronic illness (pp. 173–211). New York: Oxford University Press. doi:10.1093/med:psych/9780199828036.003.0007.

    Chapter  Google Scholar 

  • Thurer, S. L. (1983). Deinstitutionalization and women: Where the buck stops. Hospital & Community Psychiatry, 34(12), 1162–1163. doi:10.1176/ps.34.12.1162.

    CAS  Google Scholar 

  • Uttaro, T., & Mechanic, D. (1994). The NAMI consumer survey analysis of unmet needs. Psychiatric Services, 45(4), 372–374. doi:10.1176/ps.34.12.1162.

    Article  CAS  Google Scholar 

  • Wallwork, R. S., Fortgang, R., Hashimoto, R., Weinberger, D. R., & Dickinson, D. (2012). Searching for a consensus five-factor model of the Positive and Negative Syndrome Scale for schizophrenia. Schizophrenia Research, 137(1–3), 246–250. doi:10.1016/j.schres.2012.01.031.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zauszniewski, J. A., Bekhet, A. K., & Suresky, M. J. (2010). Resilience in family members of persons with serious mental illness. Nursing Clinics of North America, 45(4), 613–626. doi:10.1016/j.cnur.2010.06.007.

    Article  PubMed  Google Scholar 

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Funding

This work was supported by VA Health Services Research and Development grant IIR 04-255 to Dr. Dixon and by the VA Capitol Network Mental Illness Research, Education and Clinical Center (MIRECC) and the VA Desert Pacific MIRECC.

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Authors and Affiliations

  1. New York State Psychiatric Institute, 1051 Riverside Drive, Box 100, Room 2702, New York, NY, 10032, USA

    Morgan Haselden, Lisa B. Dixon, Sarah Piscitelli & Helle Thorning

  2. Department of Psychiatry, Columbia University, New York, NY, USA

    Lisa B. Dixon

  3. Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA

    Ashley Overley

  4. Department of Veterans Affairs Desert Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Los Angeles, CA, USA

    Amy N. Cohen

  5. Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA

    Amy N. Cohen & Shirley M. Glynn

  6. Research Service, VA Greater Los Angeles Healthcare System, West Los Angeles, CA, USA

    Shirley M. Glynn

  7. (VA) Capital Healthcare Network (VISN 5) Mental Illness Research, Education, and Clinical Center (MIRECC), Baltimore, MD, USA

    Amy Drapalski

Authors
  1. Morgan Haselden
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  2. Lisa B. Dixon
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  3. Ashley Overley
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  4. Amy N. Cohen
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  5. Shirley M. Glynn
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  6. Amy Drapalski
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  7. Sarah Piscitelli
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  8. Helle Thorning
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Corresponding author

Correspondence to Morgan Haselden.

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The authors declare that they have no conflict of interest.

Ethical Approval

For this type of study formal consent is not required. All procedures performed in the primary REORDER study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Haselden, M., Dixon, L.B., Overley, A. et al. Giving Back to Families: Evidence and Predictors of Persons with Serious Mental Illness Contributing Help and Support to Families. Community Ment Health J 54, 383–394 (2018). https://doi.org/10.1007/s10597-017-0172-1

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  • DOI: https://doi.org/10.1007/s10597-017-0172-1

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