Double deprivation: a phenomenological study into the experience of being a carer during a mental health crisis

Albert, Rikke; Simpson, Alan

doi:10.1111/jan.12742

Cited by 30 publications

(35 citation statements)

References 25 publications

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“…On the one hand, they are positioned passively by being excluded from involvement in risk discussions, which works to deny them agency. On the other hand, patients and their families feel they are responsible for chasing up their own support or initiating contact in the event of a crisis event, suggesting that in order to get help they have to be active and agentive …”

Section: Methodsmentioning

confidence: 99%

Ordinary risks and accepted fictions: how contrasting and competing priorities work in risk assessment and mental health care planning

Coffey

Cohen

Faulkner³

et al. 2016

Health Expectations

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BackgroundCommunication and information sharing are considered crucial to recovery‐focused mental health services. Effective mental health care planning and coordination includes assessment and management of risk and safety.ObjectiveUsing data from our cross‐national mixed‐method study of care planning and coordination, we examined what patients, family members and workers say about risk assessment and management and explored the contents of care plans.DesignThematic analysis of qualitative research interviews (n = 117) with patients, family members and workers, across four English and two Welsh National Health Service sites. Care plans were reviewed (n = 33) using a structured template.FindingsParticipants have contrasting priorities in relation to risk. Patients see benefit in discussions about risk, but cast the process as a worker priority that may lead to loss of liberty. Relationships with workers are key to family members and patients; however, worker claims of involving people in the care planning process do not extend to risk assessment and management procedures for fear of causing upset. Workers locate risk as coming from the person rather than social or environmental factors, are risk averse and appear to prioritize the procedural aspects of assessment.ConclusionsDespite limitations, risk assessment is treated as legitimate work by professionals. Risk assessment practice operates as a type of fiction in which poor predictive ability and fear of consequences are accepted in the interests of normative certainty by all parties. As a consequence, risk adverse options are encouraged by workers and patients steered away from opportunities for ordinary risks thereby hindering the mobilization of their strengths and abilities.

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Section: Methodsmentioning

confidence: 99%

Ordinary risks and accepted fictions: how contrasting and competing priorities work in risk assessment and mental health care planning

Coffey

Cohen

Faulkner³

et al. 2016

Health Expectations

Self Cite

View full text Add to dashboard Cite

show abstract

“…Caring for a person with severe mental illness is a long‐term commitment, intersected with crisis management and the lived experience of everyday functioning. Crisis management is particularly stressful for families with the twin challenges of accessing service support and buffering their social network from the crisis (Albert & Simpson ). Caring also implies considerable change in family roles and functioning, particularly in the contemporary community care model of service provision with increased demands on their support both instrumental and emotional (O'Riordan & Kelleher ).…”

Section: Introductionmentioning

confidence: 99%

Families’ experiences of involvement in care planning in mental health services: an integrative literature review

Doody

Butler

Lyons

et al. 2017

Psychiatric Ment Health Nurs

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Introduction Mental health service policy stipulates that family carers be involved in care planning. Aim To identify families' experiences of care planning involvement in adult mental health services. Method An integrative review where electronic databases and grey literature were searched for papers published between 01 January 2005 and 10 February 2016. Results Fifteen papers met the inclusion criteria. Thematic analysis generated three themes: (1) families' experience of collaboration, (2) families' perceptions of professionals and (3) families' impressions of the care planning process. Collaborative decision-making is not regularly experienced by families with an 'us' and 'them' divide, perpetuated by a lack of communication, confidentiality constraints and a claim of 'insider knowledge' of service users. When involved, families perceive care planning to be uncoordinated and that their lived experiences are not always appreciated. Discussion Families need to be valued, empowered and engaged in care planning and the partnership distance be addressed. Accommodating the views of family, service user and professionals is preferable but not always possible. Our findings suggest that the key element for professionals is to value all 'insider knowledge' where possible. Implications for Practice Services should develop written information on confidentiality for families and facilitate open communication concerning their involvement in care planning.

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“…These findings underline the need to offer practical and psychological support to family carers of mental health service users (Kuipers, ; Roddy, Onwumere & Kuipers, ). However, mental health service user family caregivers often receive neither advice nor information, and health professionals frequently do not legitimise their concerns (Albert & Simpson, ; Askey, Holmshaw, Gamble & Gray, ).…”

Section: Introductionmentioning

confidence: 99%

Experiences of Family Carers for Persons Using Antipsychotic Medication

Morrison

Stomski

2017

ANZ J of Family Therapy

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Given the emphasis on the use of antipsychotic medication for severe mental illness, it is important to understand family carers’ perspectives on these medications and their effects on consumers’ lives. Such information may enable providers of family interventions to better understand families’ circumstances and more effectively support them in caring for mental health service users. Snowball sampling was used to recruit 29 family carers. Family carers acknowledged the calming effect of antipsychotic medication on service users, but also noted that there were few other therapeutic benefits. Moreover, the positive influence of antipsychotic medication was in most cases largely offset by the detrimental impact of antipsychotic medication on service users’ quality of life. The family carers in rationalising the trade‐off between beneficial and adverse antipsychotic medication effects typically experienced resignation, which was often accompanied by a sense of frustration that resulted from the reliance on medication.

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Double deprivation: a phenomenological study into the experience of being a carer during a mental health crisis

Cited by 30 publications

References 25 publications

Ordinary risks and accepted fictions: how contrasting and competing priorities work in risk assessment and mental health care planning

Ordinary risks and accepted fictions: how contrasting and competing priorities work in risk assessment and mental health care planning

Families’ experiences of involvement in care planning in mental health services: an integrative literature review

Experiences of Family Carers for Persons Using Antipsychotic Medication

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