The development of anti-psychotic medications and deinstitutionalization has shifted the primary focus of mental health treatment from hospital to the community. As a consequence, carers have become an integral part of the care system (Thornicroft and Tansella, 2005). Historically, interventions for families with people with psychosis have tended to focus on service user outcomes that attempt to reduce or prevent relapse (Askey et al., 2007). As a consequence, carers often feel ignored or marginalized by services (Shepherd et al., 1995; Beck and Minghella, 1998; Henwood, 1998). This problem has recently been recognized, and it has been highlighted that there is a need for more involvement with carers of clients with mental illness (DoH, 1999). However, there continues to be a lack of knowledge about carers' needs and how professionals specifically meet carers' needs (Chambers et al., 2001). This article presents the results of a study aimed at exploring the views and experiences of carers, service users and professionals with regard to what carers of people with psychosis need from mental health services. It will initially review the literature on carer burden and needs, as well as interventions such as family intervention and carers' assessments/care plans which have been developed to address carer needs

Family intervention may be helpful for people with psychosis. We reviewed the literature for family intervention for people with a first-onset psychosis. There is limited and conflicting evidence of the efficacy of family intervention for this population. Definitive randomized controlled trials are required to establish the efficacy. At this time, evidence suggests that in High Expressed Emotion (EE) families, family intervention is a possible effective intervention. We suggest caution in families with Low EE as one study suggests that in Low EE families, family intervention can increase the levels of EE.

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