Counselling the Relatives of the Long-Term Adult Mentally Ill

1989 ◽  
Vol 154 (6) ◽  
pp. 775-782 ◽  
Author(s):  
Liz Kuipers ◽  
Brigid MacCarthy ◽  
Jane Hurry ◽  
Rod Harper ◽  
Alain LeSage

A psychosocial intervention is described geared to the needs of carers of the long-term mentally ill, which is feasible for a busy clinical team to implement: relatives were not selected for the group by patient diagnosis or motivation and little extra staff input was required. An interactive education session at home was followed by a monthly relatives group which aimed to reduce components of expressed emotion (EE) and to alleviate burden. The group facilitators adopted a directive but non-judgemental style, and constructive coping efforts were encouraged. The intervention was effective at reducing EE and improving family relationships. The study offers a realistic model of how to offer support to people providing long-term care for the severely mentally ill.

1989 ◽  
Vol 154 (6) ◽  
pp. 768-775 ◽  
Author(s):  
Brigid MacCarthy ◽  
Liz Kuipers ◽  
Jane Hurry ◽  
Rod Harper ◽  
Alain LeSage

The efficacy of implementing a clinically feasible psychosocial intervention which addresses the needs of carers of the long-term mentally ill is reported. All the relatives of patients in continuous high contact with one clinical team in a local day-care facility were offered the intervention. An interactive education session at home was followed by a monthly relatives group which aimed to reduce components of expressed emotion and to alleviate burden. Patients and relatives were assessed. The controls were the patients in contact with the other teams in the day-care facility, and their relatives. The intervention was effective at reducing EE and improving family relationships. Offering this kind of support to people who are providing long-term care for the severely mentally ill can contribute significantly to the quality of life of both supporters and patients.


PLoS ONE ◽  
2012 ◽  
Vol 7 (8) ◽  
pp. e43252 ◽  
Author(s):  
Supriya Jasuja ◽  
Nicola D. Thompson ◽  
Philip J. Peters ◽  
Yury E. Khudyakov ◽  
Megan T. Patel ◽  
...  

1995 ◽  
Vol 19 (3) ◽  
pp. 151-154
Author(s):  
Jon Spear ◽  
Andrew Cole ◽  
Jan Scott

Community mental health services have been criticised for seeing those with minor psychiatric disorders at the expense of those with severe and long-term illness. We report a cross-sectional evaluation of a UK service based entirely within the community. Most patients in contact with the service (66%) had a psychotic disorder or an affective disorder. Patients with greater impairment were likely to receive more intensive treatment. Only 20% of the community psychiatric nurse (CPN) case load focused on acute distress and neurotic disorders. Within this service careful operational planning and maintaining CPNs within the secondary care system appear to be critical factors in achieving the goal of giving priority to the severely mentally ill.


1992 ◽  
Vol 161 (6) ◽  
pp. 802-808 ◽  
Author(s):  
E. Moore ◽  
R. A. Ball ◽  
L. Kuipers

Staff-patient relationships in long-term settings were examined in 35 staff and 61 patients. Measures were also taken of the staff's general health, their coping style in relation to work events, and job satisfaction. A range of ratings of EE was evident in staff descriptions of patients under their care. Strain and criticism in the relationship were not associated with identified stressors in the workplace, or the general health of the carer. When patients were grouped according to high-EE and low-EE interviews, there were no significant differences in their symptoms. Criticism was associated with other patient characteristics, including aggressive and attention-seeking behaviour, underactivity, and limited social interaction. The findings have implications for staff training and for the maintenance of optimal staff-patient relationships in services supporting severely disabled patients.


2005 ◽  
Vol 24 (2) ◽  
pp. 127-137
Author(s):  
Sepali Guruge ◽  
Katherine McGilton ◽  
Linda Yetman ◽  
Heather Campbell ◽  
Ruby Librado ◽  
...  

ABSTRACTMost literature on staff-family relationships has come from studies of long-term care settings, has focused mainly on the families' perspectives on factors affecting their relationships with staff, and has included scant findings from the staff's perspective. No studies that examined staff-family relationships in complex continuing care (CCC) environments from the perspective of staff were found in the literature. A qualitative study that draws on a grounded theory approach was conducted to explore staff-family relationships in CCC, and the findings presented in this article illuminate the unit manager's role. Data were collected through in-depth interviews with nine unit managers and a follow-up focus group with five unit managers who work in three CCC facilities. Three categories reflecting the unit manager's role with family members of clients in CCC settings were derived: establishing supportive entry; building and preserving relationships; and closing the loop. Implications of the findings for practice and future research are presented.


1994 ◽  
Vol 24 (1) ◽  
pp. 215-222 ◽  
Author(s):  
I. Van Haaster ◽  
A. D. Lesage ◽  
M. Cyr ◽  
J. Toupin

SynopsisThe Needs for Care Assessment Schedule (NFCAS; Brewin et al. 1987) is an itemized and systematic procedure that aims to evaluate the needs for care of long-term mentally ill patients. The present study pursues reliability and validity related issues with the NFCAS in a different cultural context applying the procedure to 98 severely mentally ill patients belonging to different patient groups: short-term, long-term, in-patient and out-patient.Inter-rater reliability was found to be excellent. The results suggest that a clinician with little practical experience and adequate training may effectively use the procedure. The assessment of clinical relevance suggested that the procedure is both applicable and pertinent to all the patients in the study. Additional guidelines were developed for its use with long-term in-patients.


1993 ◽  
Vol 17 (6) ◽  
pp. 344-346
Author(s):  
Richard Duffett ◽  
Claire Lawton

In spite of the moves over the last 20 years towards community care, there remain substantial numbers of elderly people with both physical and mental illness who require residential, nursing home and hospital care. There is evidence to suggest that health service provision of long term care for the mentally ill has been, and continues to be, reduced. In addition there has been reduction in beds for long term care by geriatric physicians and while the nursing home and residential care sectors have expanded, this expansion has been entirely within the ‘independent’ private and voluntary sector, with considerable contraction of local authority provision. Representations have been made about this to the Old Age Section of the Royal College of Psychiatrists and they have reported on this (Benbow & Jolley, 1992). Concern has not been confined to the profession. Over the last year, there has been considerable media publicity about the long term care of elderly people in institutions. Some of this has been very critical [Panorama, 20.1.92] and has provoked debate on the pages of the national papers.


1989 ◽  
Vol 45 (3) ◽  
pp. 173-186 ◽  
Author(s):  
Dan A. Lewis ◽  
William R. Shadish ◽  
Arthur J. Lurigio

2021 ◽  
pp. medhum-2020-012117
Author(s):  
Leah Sidi

The deinstitutionalisation of mental hospital patients made its way into UK statutory law in 1990 in the form of the NHS and the Community Care Act. The Act ushered in the final stage of asylum closures moving the responsibility for the long-term care of mentally ill individuals out of the NHS and into the hands of local authorities. This article examines the reaction to the passing of the Act in two major tabloid presses, The Sun and The Daily Mirror, in order to reveal how community care changed the emotional terrain of tabloid storytelling on mental health. Reviewing an archive of 15 years of tabloid reporting on mental illness, I argue that the generation of ‘objects of feeling’ in the tabloid media is dependent on the availability of recognisable and stable symbols. Tabloid reporting of mental illness before 1990 reveals the dominance of the image of the asylum in popular understandings of mental illness. Here the asylum is used to generate objects of hatred and disgust for the reader, even as it performs a straightforward othering and distancing function. In these articles, the image of the asylum and its implicit separation of different types of madness into categories also do normative gender work as mental illness is represented along predictable gendered stereotypes. By performing the abolition of asylums, the 1990 Act appears to have triggered a dislodging of these narrative norms in the tabloid press. After 1990, ‘asylum stories’ are replaced with ‘community care stories’ which contain more contradictory and confusing clusters of feeling. These stories rest less heavily on gendered binaries while also demonstrating a near-frantic desire on the part of the mass media for a return of institutional containment. Here, clusters of feeling becoming briefly ‘unstuck’ from their previous organisations, creating a moment of affective flux.


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