Mental Health Care For Families Research Articles

Implementing an integrated family approach in mental health care for families experiencing complex and multiple problems: a case example in Amsterdam.

For youth care professionals who work with families with complex needs, we implemented an interagency, family-focused approach involving child and adult mental health care services and child protection services. The primary objective of the collaboration was to minimize fragmentation in service delivery and to improve practitioners' self-efficacy in supporting families. A total of 50 families were enrolled between 2020 and 2023. Quantitative descriptive analysis was conducted to map the sample characteristics and the correlations between the practitioners' consultation requests and the recommendations they received. We evaluated the applicability of the model using semi-structured interviews. Results revealed the frequent socioeconomic and psychosocial challenges and co-current mental health issues faced by the families. As expected, practitioners who work with families experiencing complex and multiple problems encountered a range of difficulties in their service delivery. These related to barriers such as poor role demarcation between organizations, practitioners' unrealistic expectations of other services, the impact of multiple problems on family well-being, and complicated family dynamics. The interprofessional collaboration improved the practitioners' self-efficacy in supporting families. They also perceived improvements in child safety. The study emphasizes the need for clear pathways for youth care practitioners to obtain assistance from adult mental health services and to liaise with community support and services. It proposes including adults and young people with lived experiences in the interprofessional collaboration. The study data provides initial evidence that the interagency model has added value for youth care professionals who struggle with issues in family-focused care.

Barriers to Mental Health Services for Parents and Siblings of Children with Special Health Care Needs.

Caregivers of children with special health care needs (CSHCNs), especially those whose children have emotional, behavioral, or developmental problems (EBDPs), experience considerable strain and stress related to caring for their child’s special needs. The enormous burden of caregiving can decrease a parent’s ability to provide care, impacting the health of the child, the parents, and overall family functioning. To manage these challenges, these parents report the need for mental health care for themselves or their children, but many families with need go without care. Comprehensive knowledge about barriers to family mental health care for families of CSHCN is lacking. This study examines data from the National Survey of Children with Special Health Care Needs (2005/2006 and 2009/2010) to estimate time-specific, population-based prevalence of fourteen specific barriers to family mental health services and identifies risk factors for experiencing barriers to care for families of CSHCN. Among all CSHCN, cost barriers (33.5%) and lack of insurance (15.9%) were the most commonly reported obstacles to service access in 2005 and 2009, followed by inconvenient service times (12.3%), and locations (8.7%). Reports of these barriers increased significantly from 2005 to 2009. All types of barriers to family mental health services were reported significantly more frequently by CSHCN with EBDPs than by those without. CSHCN’s race, insurance, and parent education and income levels were factors associated with cost barriers to family mental health care. Understanding barriers to mental health care for families of CSHCN is critical to creating policy and practice solutions that increase access to mental health care for these families.

Factors Associated With Primary Family Caregivers' Perceptions on Quality of Family-Centered Care in Mental Health Practice.

This study aimed to examine the quality of family-centered care perceived by primary family caregivers and its influencing factors in mental healthcare practice. A cross-sectional, correlational study. A convenience sample of 121 mental health nurses and 164 primary family caregivers of patients with schizophrenia was recruited from acute psychiatric wards and chronic psychiatric rehabilitation wards in three psychiatric hospitals in Taiwan. Structured questionnaires for mental health nurses were designed to examine nurses' attitudes toward schizophrenia and the importance of families in nursing care. Primary family caregivers were assessed to determine their perceptions of quality of family-centered care. At least one primary family caregiver of patients was matched to a nurse who took major responsibility for the patient during the hospitalization. Data were analyzed with descriptive statistics, Pearson's product-moment correlations, independent t-test, one-way analysis of variance, and stepwise regression analyses. Quality of family-centered care perceived by primary family caregivers regarding the provision of general and specific information, as compared to enabling and partnership, coordinated and comprehensive care, and respectful and supportive care, was relatively inadequate. Younger and more educated primary family caregivers, having relatives with schizophrenia in acute wards, less supportive nurses' attitudes toward schizophrenia, and the importance of family in nursing care were correlated with poor primary family caregivers' perceptions of quality of family-centered care. Nurses' supportive attitudes toward schizophrenia and chronic psychiatric rehabilitation wards where patients received care were key factors in determining better quality of family-centered care. Findings provide a platform for the development of effective continuing education and training programs to equip mental health nurses with supportive attitudes toward mental illness and an integration of the family in nursing care, which will ultimately improve mental health care for families experiencing mental health problems. Efforts in professional training to address stigma and encourage a family-centered approach into recovery-oriented practice for practicing mental healthcare providers, including mental health nurses, are recommended.

Distance-Delivered Parent Training for Childhood Disruptive Behavior (Strongest Families™): a Randomized Controlled Trial and Economic Analysis.

Disruptive behavior disorders are prevalent in youth, yet most children with disruptive behavior do not have access to timely, effective treatment. Distance-delivered service (e.g., via telephone, Internet) can overcome several barriers to care. This study tested the effectiveness of a 12-week parent training program, Strongest Families™ Parenting the Active Child, delivered via written material, skill-based videos, and telephone coaching sessions, as compared to usual care in reducing child externalizing behavior. Participants were 172 primary caregivers of a 6- to 12-year-old (29% girls; M age = 8.5years) recruited from community children's mental health clinics. Participants were randomized to either Strongest Families™ or usual care and completed measures of child externalizing behavior, parenting practices, parent distress, and intervention services consumed at baseline and 5-, 10-, 16-, and 22-months post-baseline. Growth curve analysis showed significant reductions in externalizing behavior in both conditions over time. Improvements were significantly greater at 10months in the Strongest Families™ condition (d= 0.43). At 22months, however, the differences were not significant and small in magnitude (d= -0.05). The intervention decreased inconsistent discipline significantly more than usual care. Parents in both conditions showed significant reductions in distress. We also conducted a cost-effectiveness analysis to assess the value for money of the Strongest Families™ program versus usual care. Distance parent training is a promising way to increase access to, and reduce costs associated with, mental health care for families with a child with disruptive behavior.

Challenge Demcare: management of challenging behaviour in dementia at home and in care homes – development, evaluation and implementation of an online individualised intervention for care homes; and a cohort study of specialist community mental health care for families

Challenge Demcare: management of challenging behaviour in dementia at home and in care homes – development, evaluation and implementation of an online individualised intervention for care homes; and a cohort study of specialist community mental health care for families

Newtown Shuns Spotlight as It Tries to Heal

Back to table of contents Previous article Community NewsFull AccessNewtown Shuns Spotlight as It Tries to HealAaron LevinAaron LevinSearch for more papers by this authorPublished Online:18 Dec 2013https://doi.org/10.1176/appi.pn.2013.12b29AbstractThe people of Newtown, Conn., choose a low-key remembrance for the children and educators lost in last year’s mass shooting at an elementary school.Yet another melancholy anniversary passed December 14 as Newtown, Conn., chose to remember in its own way the massacre of 20 schoolchildren and seven adults last year in Sandy Hook Elementary School.The town’s first selectman (mayor), Pat Llodra, announced in October that there would be no official activity to mark the tragedy. Remembrance would be “quiet, personal, and respectful,” she said.To do otherwise would only open old wounds, said Charles Herrick, M.D., chair of the Department of Psychiatry and Behavioral Health at Danbury Hospital (Psychiatric News, July 10).“The experience last December was traumatizing for the whole town,” he told Psychiatric News. “The press, the gifts, the donations overwhelmed the town. They fear something like that will happen again, and that would not be appropriate.”That the anniversary falls in the midst of the holiday season is no help either, he said.Some area residents have sought to turn their grief into action under the aegis of Sandy Hook Promise. The organization advocates prevention of gun violence by promoting “mental wellness, connection to the community, and gun safety.”“They want to educate people, to give them a better understanding of mental health issues, and when and where and how to seek help,” said Herrick.Over the intervening year, mental health care for families, survivors, and other residents has largely been provided by private clinicians in the area, said Herrick. A Yale University team offered training in cognitive-behavioral therapy and trauma-informed care to those clinicians. Danbury Hospital has provided other support and education. The state chapter of the American Academy of Child and Adolescent Psychiatry granted funds for a mental health “navigator” in a local pediatrician’s office, a role that will be taken over by the local Office of Victim’s Services next summer.In October and November, Sandy Hook Elementary School was demolished. The building, constructed in 1956, would have required an expensive renovation to bring it up to code, but some townspeople were not sorry to see it erased from the map, said Herrick.On November 25, the state’s attorney released a 48-page summary of the Connecticut State Police investigation into the incident. The report noted that the gunman, Adam Lanza, was given a diagnosis of Asperger’s syndrome in 2005 and was treated by “mental health professionals.”It went into detail on how Lanza spent his last months, and then on December 14, killed his mother, went to the school, and shot the children and educators.The report did not suggest a motive. ■ ISSUES NewArchived

Creative Thinking Needed To Stretch Limited Budgets

Creative Thinking Needed To Stretch Limited Budgets

African-American and Latino families in TADS: Recruitment and treatment considerations

The goal of this article is to review the experiences of some of the African-American and Lutino families who participated in the Treatment for Adolescents With Depression Study (TADS). The importance of this article derives from the historical and current inequities in mental health care for families of color. We describe the attempts within the TADS study to ensure an appropriate representation of families of color, a description of the age, and of the length and severity of depression of the African-American and Latino adolescents who participated in the TADS trial. The article additionally attempts, through case example, to convey the experiences of several of the African-American and Latino families who participated in TADS.