Family Group Conferencing in public mental health and social capital theory

Abstract

Summary Clients in public mental health care have limited social capital; they lack trusting and mutually supportive relations within bonded groups and do not have access to supportive external groups. Family Group Conferencing (FGC) is a promising decision-making model to restore social ties and mobilise informal support. From January 2011 to September 2013, 41 family group conferences were organised in a Dutch public mental health care setting and studied using a qualitative case study methodology. Twenty-three of the conferences were successful in meeting their goals. This article reports on findings from the other 18 family group conferences that apparently had failed as the preparations became stuck or because a plan was never reached or fully implemented. Semi-structured interviews with 118 out of a possible total of 215 FGC participants were conducted to examine the process and impact of the conferences. Findings The interviews indicate that conferences were often held as a last resort, in situations where professional care had already failed prior to the conference. The intended goals of the conferences were not achieved because support from the social network was insufficiently mobilised and clients themselves felt helpless that they could improve their conditions. Applications A single conference seems insufficient on its own to break through a sense of inadequacy and paralysis. Social capital theory points to the necessity of not only renewing informal networks (‘strong ties’) but of expanding networks through connecting public mental health care clients to paid and volunteer work (‘weak ties’). FGC plans can include such action steps. Instituting a ‘family manager’ to monitor these steps may support the bonding of ‘strong ties’ and the bridging to ‘weak ties’.