This article starts by setting the context for Maltese families with a member who has mental health problems by providing an overview of the mental health services on offer. It explores the considerable stress that primary caregivers endure and the effects of the person’s mental health problems on their own children. In the study, views were elicited from 81 caregivers accompanying patients attending the psychiatric outpatients clinic in the main state hospital in Malta. The Involvement Evaluation Questionnaire was also used. Findings show that 47% of caregivers felt under pressure, 42% claimed to be depressed and 34% were receiving help from their general practitioner (GP). Only 38% reported receiving any help from mental health services and up to 82% of the children of mental health patients were ignored by the same services. Challenging behaviour and lack of appetite were among the direct effects on children. Current mental health services in Malta are critiqued and ways of setting up a family-inclusive service in a familialistic country such as Malta are put forward.

Problem gambling not only impacts gamblers but also protrudes onto several affected others who experience adverse impacts, including financial, health, relationships, and psychological problems. The aims of this systematic review were twofold; to identify the psychosocial interventions to minimise the harm caused to affected others of problem gambling and to assess their efficacy. This study was conducted as outlined in the research protocol PROSPERO (CRD42021239138). Database searches were conducted in CENTRAL, MEDLINE, Social Science Database, CINHAL Complete, Academic Search Ultimate and PsycINFO. Randomised controlled trials of psychosocial interventions that aimed to minimise the harm caused to affected others of problem gambling written in English were eligible for inclusion. Risk of bias for included studies was assessed using the Cochrane ROB 2.0 tool. The identified interventions focused on two approaches to supporting affected others: interventions involving both the problem gambler and affected others, and interventions involving affected others only. As the interventions and outcome measures used were sufficiently similar, a meta-analysis was conducted. The quantitative synthesis revealed that generally, treatment groups were unable to show greater benefits over control groups. The goal for future interventions aimed at affected others of problem gambling should focus primarily on the wellbeing of affected others. The standardisation of outcome measures and data collection time points for better comparison of future research is needed.