2257 – Family interventions for the severe mentally ill in portugal: a country-level project of training and implementation

Abstract

Introduction Psychiatric deinstitutionalization has been frequently associated with an increase in family burden in most Western countries. Research shows that notwithstanding of evidence of its usefulness, family interventions for psychotic disorders are not routinely applied in most public mental health services. This applies especially to countries where family issues are not so well documented, such as Portugal. To address that issue, the Ministry of Health hurled a training program on family interventions for the severe mentally ill, ensuing the recommendations of the National Mental Health Plan. Objectives a) to launch a family intervention training program on a national level, and b) to identify the obstacles to implementation in routine settings. Methods Professionals from public mental health services throughout Portugal attended a 3 days full-time course in which they were trained in the family intervention, consisting in guidelines presentation and discussion, demonstrative audios/videos and role-playing sessions. Results The trainees' acquisition of competences was found rather encouraging. Perceived obstacles to the implementation of the family intervention in routine practice comprised work overload, the nuisance to integrate weekly family sessions with other professional tasks, and the stunted availability of time to run the intervention on a regular basis. Conclusions Arrangements need to be envisaged in order to overcome deal with barriers limiting the implementation of family interventions in routine settings. Amelioration have to focus on changing the organisation of the mental health facilities, like greater handiness of dedicated hours and career inducements for professionals working with the families of psychotic patients.