An emotive subject: insights from social, voluntary and healthcare professionals into the feelings of family carers for people with mental health problems

Abstract

Caring for people with mental health problems can generate a whole range of positive and negative emotions, including fear, disbelief, guilt and chaos as well as a sense of purpose, pride and achievement. This paper explores the emotions of family carers from the perspectives of social, voluntary and healthcare professionals. Sixty-five participants were interviewed, the sample included directors, managers and senior staff from social, voluntary and healthcare organisations. Participants were encouraged to talk in detail about their understanding of the emotions of family carers. Findings highlight a rich understanding of the broad spectrum of carer emotions and the huge emotional adjustments that are often involved. Diagnosis was seen to be imbued with negative emotions, such as fear, anger and denial. However, feelings of hopelessness and desolation were often counterbalanced by feelings of hope, satisfaction and the emotional rewards of caring for a loved one. Participants noted a clear lack of emotional support for family carers, with accompanying feelings of marginalisation, particularly during transitions and especially involving young carers as well as ethnic minorities. By way of contrast, carer support groups were suggested by professionals to be a holistic, effective and economical way of meeting carers' emotional needs. This paper explores the challenge of family carer emotions from the perspective of managers and practitioners and draws out implications for research, policy and practice.

Great expectations: a systematic review of the literature on the role of family carers in severe mental illness, and their relationships and engagement with professionals

“…For many carers the onset of a severe mental illness in a relative was a steep and unsupported learning curve (Gray et al . 2009).…”

Carers and co-production: enabling expertise through experience?

“…Indeed, scarce contact between caregivers and health professionals has been shown to increase subjective carer burden (Jacob et al 1987;Chang et al, 2010cited in Hastrup et al, 2011). Ostman and Kjellin (2002 noted that relatives who acted as carers had deep-seated feelings of inferiority to staff, which could explain low levels of cooperation between relatives and professionals as well as subsequent difficulties with access to services (cited in Gray et al, 2009). Lack of carer involvement reinforced the view of some professionals that silence means acquiescence / acceptance (Chiu et al, 2006).…”

“…Caring for people with SMI can generate fear, disbelief, guilt and chaos, and coping mechanisms may include the seeking of relevant information, optimism, routine living and re-evaluating social expectation (James, 1989 cited in Gray et al, 2009) Active strategies have been associated with lower levels of mental health distress amongst carers when compared to avoidance strategies. O-Doherty and Doherty (2008) conducted study with the carers of people with SMI and found few participants who combined the use of active coping strategies with avoidance strategies, leading to the suggestion that these strategies could be mutually exclusive within these relationships.…”

Psychiatric worker and family members: pathways towards co-operation networks within psychiatric assistance services

“…A year later, Gray proposed drawing up a covenant between mental health services and family carers, one based on mutual obligations. 7 He claimed that much of the relationship between families and services puts the interests of service users and providers ahead of family members and suggested that family members were hidden and invisible, trapped and isolated in narrow roles. Therefore, a covenant would help clarify what professionals expect of carers; and would ultimately improve engagement and relationships.…”