Collaborating with Families: Exploring Family Member and Health Care Provider Perspectives on Engaging Families Within Medical Education
With 40 to 65% of mental health patients being cared for by family members, nearly 500,000 Canadians are serving as caregivers. Yet family members are often excluded from daily clinical interactions and the development of mental health continuing medical education (CME). This qualitative study aimed to understand how best to involve families in mental health CME and how to advance their meaningful and equitable engagement in such initiatives.
Semi-structured interviews were conducted with two samples: mental health care providers (n = 8) and family members of individuals diagnosed with a co-occurring addiction and mental health problems (n = 12) to explore barriers, facilitators, and strategies for family engagement.
Several themes related to the perception of expertise emerged from the interviews, including the tension between the validity of knowledge based on education/credentials and knowledge based on lived experience, as well as expressions of “voice.” Participants also identified barriers to, and ethical considerations related to, family engagement, including stigma and confidentiality, and recommended strategies and supports to meaningfully include the family perspective within mental health CME.
Aligning with the movement to improve collaboration between mental health professionals and service users requires developing relationships with family members. Identifying strategies to involve families in the development of CME is crucial to initiating and maintaining family engagement.
KeywordsCME Curriculum development Evaluation
The authors would like to thank the family members and health care providers who participated in this study. The authors would also like to thank Hema Zbogar for editorial assistance.
Compliance with Ethical Standards
On behalf of all authors, the corresponding author states that there is no conflict of interest.
This study was approved by the research ethics boards of the Centre for Addiction and Mental Health (#067/2013).
- 3.Mental Health and Substance Use Services (2011). Families are part of the solution: a strategic direction for family support and inclusion. http://www.bcss.org/wp-content/uploads/FHA-Families-Are-Part-of-the-Solution.pdf. Accessed February 21, 2017.
- 4.MacCourt P. National guidelines for a comprehensive service system to support family caregivers of adults with mental health problems and illnesses. Mental Health Commission of Canada; 2013. https://www.mentalhealthcommission.ca/sites/default/files/Caregiving_MHCC_Family_Caregivers_Guidelines_ENG_0.pdf. Accessed March 1, 2017.
- 5.Ontario Centre of Excellence for Child and Youth Mental Health. Bringing family engagement into action. 2012. Retrieved from http://www.excellenceforchildandyouth.ca/sites/default/files/docs/family_engagement_participant_guide_en.pdf
- 6.Mohammed S, Priya SS, George C. Caregiver burden in a community mental health program—a cross sectional study. Kerala J Psychiatry. 2015;28:26–33.Google Scholar
- 9.Dokken D, Moretz J, Black J. The many roles of families in family-centered care—Part V 2007;33:356–359.Google Scholar
- 11.Wahl OF. Mental health consumers’ experience of stigma. Schizophr Bull. 1999;25(3):467–78. https://doi.org/10.1093/oxfordjournals.schbul.a033394.CrossRefPubMedGoogle Scholar
- 13.Patton MQ. Qualitative evaluation and research methods. SAGE Publications. 1990;Google Scholar
- 20.Ontario Mental Health Act, Revised States of Ontario. 1990: http://www.ontario.ca/laws/statute/90m07. Accessed January 20, 2017.
- 22.Heflinger CA, Hinshaw SP. Stigma in child and adolescent mental health services research: understanding professional and institutional stigmatization of youth with mental health problems and their families. Adm Policy Ment Health Ment Health Serv Res. 2010;37(1–2):61–70. https://doi.org/10.1007/s10488-010-0294-z.CrossRefGoogle Scholar
- 24.Centre for Addiction and Mental Health. (2012). Collaborating with families affected by concurrent disorders online course. http://www.camh.ca/en/education/about/AZCourses/Pages/collaborating_ol.aspx. Accessed March 3, 2017.