Smoking Cessation Care for People with a Mental Illness: Family Carer Expectations of Health and Community Services

Abstract

Introduction: Smoking prevalence remains high among people with a mental illness, contributing to higher levels of morbidity and mortality. Health and community services are an opportune setting for the provision of smoking cessation care. Although family carers are acknowledged to play a critical role in supporting the care and assistance provided by such services to people with a mental illness, their expectations regarding the delivery of smoking cessation care have not been examined.Aims: To explore family carer expectations of smoking cessation care provision by four types of health services, to clients with a mental illness, and factors associated with expectations.Methods: A cross-sectional survey was conducted with carers of a person with a mental illness residing in New South Wales, Australia. Carers were surveyed regarding their expectations of smoking cessation care provision from four types of health services. Possible associations between carer expectation of smoking cessation care provision and socio-demographic and attitudinal variables were explored.Results: Of 144 carers, the majority of carers considered that smoking cessation care should be provided by: mental health hospitals (71.4%), community mental health services (78.0%), general practice (82.7%), and non-government organisations (56.6%). The factor most consistently related to expectation of care was a belief that smoking cessation could positively impact mental health.Conclusions: The majority of carers expected smoking cessation treatment to be provided by all services catering for people with a mental illness, reinforcing the appropriateness for such services to provide smoking cessation care for clients in an effective and systematic manner.

Preventive care for physical activity and fruit and vegetable consumption: a survey of family carer expectations of health service delivery for people with a mental health condition

“…A perception that the health risk behaviours have an impact on mental health is consistent with previous research among family carers, where carers reported a perception of a bidirectional relationship between physical and mental health, [79] and have expressed expectations for smoking cessation care to be provided to clients with a mental health condition [80]. Similarities were found between the results of the current study and a previous study exploring carer expectations of smoking cessation care by health and community services [80].…”

“…Similarities were found between the results of the current study and a previous study exploring carer expectations of smoking cessation care by health and community services [80]. Carers, in a previous study, who perceived that smoking cessation would have a positive impact on mental health were more likely to expect smoking cessation care in mental health hospitals, community mental health services, and non-government organisations [80]. Such findings suggest carers are aware of the impact of health risk behaviours on mental health.…”

“…Additionally, carers reported a desire for services accessed by their family member to provide holistic care, due to their awareness of the bidirectional relationship between physical and mental health. It has been found previously that carers are aware of the bidirectional relationship between physical and mental health, and this has been associated with carer expectations of smoking cessation care provision by services accessed by people with a mental health condition [80]. Further, carers have also reported that their capacity to support their family member in making health behaviour change is impacted by the need to maintain their own physical health and well-being [79].…”

“…To date however, there has been limited research undertaken with family carers to understand their expectations regarding what type of care to address the chronic disease risk behaviours should be provided to people with a mental health condition by health and community services. Only two previous studies have focused on this issue relevant to inadequate physical activity and nutrition generally [78][79][80]. One qualitative study from the US of 13 carers of older adults with serious mental illness found that carers reported a need for guidance from health care professionals regarding strategies to promote weight loss by their family member [78].…”

Exploring the Potential for Family Carers to Support People With Mental Illness to Stop Smoking

“…To begin addressing this evidence gap, the authors recently conducted two studies, in collaboration with Australian carer organisations (Bailey et al, accepted;Lawn, McNaughton & Fuller, 2015). First, a cross-sectional survey was conducted in partnership with Carer Assist New South Wales, with 144 carers (Bailey et al, accepted).…”