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

Abstract

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.

Perceptions of shared decision‐making in severe mental illness: An integrative review

“…Consistent with previous reviews (Doody et al, ; Lamore, Montalescot, & Untas, ), this review demonstrated that families are often uninvolved in SDM, although they supported treatment decisions. Because most consumers preferred family involvement, it is recommended to provide a range of approaches to engage families in SDM.…”

“…Although several SDM models explicitly mention the involvement of families or carers (Charles et al, 1997;Légaré et al, 2011), limited interventions explicitly facilitated their involvement (Stomski & Morrison, 2018). Recent studies note the preference of consumers' families to be involved in decisions regarding the consumers' treatment and care planning because they believe that they could contribute to the recovery of the consumer (Doody, Butler, Lyons, & Newman, 2017;Stomski & Morrison, 2018). Families who are involved in daily care do inevitably influence decision-making during and outside consultations (Laidsaar-Powell et al, 2013).…”

“…Families who are involved in daily care do inevitably influence decision-making during and outside consultations (Laidsaar-Powell et al, 2013). However, most families felt that they were not supported to engage in care and were excluded from medical decisions (Doody et al, 2017;Stomski & Morrison, 2018).…”

What factors influence the decisions of mental health professionals to release service users from seclusion?

“…Similar data are extrapolated, reduced, and categorized for analysis into themes (Doody et al . ). Despite criticism that integrative reviews may lack rigour and introduce bias, they can directly address clinical practice and policy enquiries (Whittemore & Knafl ).…”

A lack of therapeutic engagement and consumer input in acute inpatient care planning limits fully accountable mental health nursing practice

“…It should also describe the strategies and resources to achieve these outcomes and should give clear criteria for assessing the satisfaction and outcomes of care for the consumer (Bee et al 2015a;McHugh & Byrne 2012). However, the research indicates that mental health service staff often fail to develop meaningful well thought out care plans with consumers (Bee et al 2015a;Bee et al 2015b;Doody et al 2017;Stomski et al 2017). Consumers and their carers have expressed dissatisfaction with a lack of therapeutic engagement in mental health services (McAllister et al 2019;Rydon 2005;Tee et al 2007;Theodoridou et al 2012;Walsh & Boyle 2009), and that they want strengthbased approaches based on concepts of recovery (Dobie, Bulla & Swanke 2010;Henderson et al 2010;Rose 2003).…”