How involuntary commitment impacts on the burden of care of the family

Abstract

Little research has examined how, or if, involuntary commitment has impacted on the burden experienced by the family. This paper reports a qualitative study which explored how involuntary commitment under the Mental Health Act (MHA) 2000 in Queensland, Australia impacted on families of people with mental illness. Family members of a person with a mental illness, under involuntary commitment at the time or in the previous 12 months, participated in focus groups. Thematic analysis was used to determine the themes. It was apparent from the views of the family that the use of the involuntary commitment was influenced greatly by the pressures experienced by the mental health services (MHS). The MHA did little to assist the family in gaining access to MHS. It was not until after the family made repeated attempts that they were taken seriously. Often the family had few options other than to use deceit and threats to obtain the necessary treatment required. In view of this, the inherit nature of what involuntary commitment implies for persons under it, such as refusing treatment and management difficulties, indicates the family with such an individual experience more hardship in trying to obtain assistance for that person. Thus, the MHA in Queensland has not met its goals of increasing access to MHS. Family members perceive that they were not being listened to and their concerns were not acted upon. The current culture of the MHS appears to serve, to a large degree, to estrange the family from the consumer making relationships difficult and time-consuming to repair. The mental health profession is urged to consider the culture within their workplace and move towards constructive involvement of the family.

‘Responsible, but Still not a Real Treatment Partner’: A Qualitative Study of the Experiences of Relatives of Patients on Outpatient Commitment Orders

“…They need to feel that their experience is acknowledged and worked on. Hallam (2007) found that treatment cultures which exclude relatives, can lead to a climate of cooperation that alienates the family from the patient's life. Such a development could make relatives distance themselves from the patient to protect themselves rather than involving themselves to promote the patient's recovery process.…”

Review: a conceptual model of perceived burden of informal caregivers for older persons with a severe functional psychiatric syndrome and concomitant problematic behaviour

“…1996) makes it imperative to include resilience in the conception of the experience of informal caregivers. Informal caregivers feel relief if the responsibility for the welfare of the older person with a mental illness can be shared not only with other family members or friends but also with a mental health professional who is familiar with the situation (Hallam 2007).…”

“…Diverse activities. Informal caregivers who maintain some form of employment express less distress because work provides a distraction from the impact of the illness (Hallam 2007). Relatives who are forced to give up leisure activities or their occupation have fewer sources of positive feedback.…”

Qualitative exploration of stakeholders’ perspectives of involuntary admission under the Mental Health Act 2001 in Ireland

“…There is international interest in, and continued concern about, the potential long-term impact of involuntary admission to psychiatric institutions, and the effect this coercive action has on a person's well-being and human rights (van den Hooff et al 2015;Hughes et al 2009;Johansson & Lundman 2002;McGuinness et al 2013;Newton-Homes & Mullen 2011;Svindseth et al 2007). In Ireland, the Mental Health Act (MHA) 2001 was implemented on 1 November 2006, replacing previous legislation, the Mental Treatment Act (MTA) 1945, and incorporating a number of changes to the process of involuntary admission and treatment of service users.…”

“…Other stakeholders, including GP, relatives, and MHN, report that the application process of involuntary detention is time-consuming and complex, and impacts negatively on long-term relationships with individuals. These stakeholders also report often feeling alone when dealing with the crisis (Doherty et al 2014;van den Hooff & Goossensen 2015;Jabbar et al 2010;Jankovic et al 2011;Jespen et al 2010;Røtvold & Wynn 2014). Studies exploring GP perspectives highlight the complexity of the admission process and associated stresses.…”