A Mismatch of Paradigms Disrupts the Introduction of Psycho-Educative Interventions for Families of Persons with SMI: An Interview Study with Staff from Community Services

Abstract

Treatment and support of people diagnosed with severe mental illness in Sweden takes place in out-patient psychiatric services or municipality services. Most of the responsibility for support in daily life are provided by the close family. One crucial matter is how to support these families. This research project aimed to investigate the Swedish construction with shared responsibility between county psychiatric care and municipality social care for consumers with severe mental illness affects actions in municipalities in relation to family support. Ten representatives from five municipality settings were interviewed. Five semi-structured interviews were analysed using a thematic analysis. The following themes emerged; One overarching theme, "a mismatch of paradigms", and sub-themes: (a) "accentuating differences", (b) "doubts about including the entire family in the same session" and (c) "lack of a uniform family support policy". We conclude that a shared mandate needs a dialogue between psychiatric and municipality services concerning this mismatch.

Proactive Community Occupational Therapy Service for Social Participation Development of Thai Adults with Depression: A Grounded Theory Study from Occupational Therapists’ Perspective

“…On the other hand, all participants perceived several barriers to the professional development of PCOTS-D, such as funding, setting, mental health knowledge, clinical workload, time limitation, and expectation of tangible outcome within a short duration [ 45 , 46 ] as well as sensitive issues of mental health service (social attitude toward home visits or use of the word “depression” resulting in stigmatization) [ 47 – 49 ]. This issue concerns an ethical dilemma regarding the clinical interventions for mental disabilities [ 50 ] because the participants advocated for the right to depression rehabilitation and the opportunity to express the patients' need for social support; the existing negative viewpoint could be seen as the threat to working with COTS, such as resorting to secret or underhanded means or infringing on one's privacy.…”

Experiences of clinicians and managers in the implementation of a family focused model in child and adult psychiatry

“…Position within the data CL, a PhD student, had extensive experience of working alongside mental health professionals, in both CAMHS and AMHS as well as MÖ, with an substantial experience of interviewing healthcare professionals (e.g., [5,39]) and longstanding research concerning family aspects around the person with mental illness. BW was a senior researcher in mental health and inclusivity, whose research has examined family models.…”

“…In view of the increasingly subspecialized treatment approach, the challenges with including FFP in line with national laws and regulations, it is particularly important to explore how clinicians perceive the implementation of a broader family focused approach. While there is increasing research examining clinicians’ experience when implementing other models to assist FFP, (i.e., Lets Talk), in adult mental health services ( 11 , 26 , 27 ), to the best of our knowledge, there is limited research on clinicians´ experiences with implementing TFM parallel in both adult mental health and children’s services ( 39 ).…”