Scoping the field: services for carers of people with mental health problems

Abstract

Mental ill health is very common. Most people with mental health problems live in the community, and as many as 1.5 million people in the UK may be involved in caring for a relative or friend with a mental illness or some form of dementia. Recent legislation and policy initiatives such as the National Strategy for Carers, and the National Service Frameworks for Mental Health and Older People emphasise the importance of providing support for this particular group of carers. The present paper reports the findings of a scoping study to identify what the research tells us about the effectiveness and cost-effectiveness of interventions for the carers of people with mental health problems, and also where there are gaps in the knowledge base. Some 204 evaluation studies were included in the review, just 13 of which had an economic component. The majority of studies were conducted in the USA, and were aimed at carers of people with Alzheimer disease or other forms of dementia. Overall, there was a lack of strong evidence to support any specific interventions, although almost all studies were able to identify some positive outcomes of services provided. In contrast to the relatively narrow approach to effectiveness adopted in most of the studies reviewed, the contributors to a consultation exercise perceived this concept in a far more rounded and holistic way. For them, the process of service delivery was as important as the outcome. There was relatively little research evaluating interventions and services singled out in UK policy initiatives as potentially useful in supporting this group of carers, and further evaluation studies are needed.

Patterns of exclusion of carers for people with mental health problems — the perspectives of professionals

“…Recent innovations which are responsive to hidden carers and the needs of invisible groups such as young carers and refugee families, are within Arksey's (2002Arksey's ( , 2003 P A T T E R N S O F E X C L U S I O N O F C A R E R S four principles of service provision and Frank and McLarnon's (2008) six Key Principles of Practice with young carers (see also : Frank, 2002;Children's Society, 2008). There are also tools that are available for practitioners to respond to the needs of families where there are young carers, including refugee families where there can be particular cultural perceptions of mental health and how this can impact upon carers in these families:…”

“…Even assessing the prevalence of mental health problems is made problematic because of the considerable stigma and discrimination attached to mental illness in society, leading to high levels of secrecy and shame (Dearden & Becker, 1999;Tanner, 2000;Cree, 2003aCree, , 2003b. There is the keeping of secrets and maintenance of silence -again due to the fear of punitive professional responses or public hostility (Crabtree & Warner, 1999;Frank et al, 1999;Aldridge & Becker, 1993, 1994, 2003.…”

“…According to Arksey (2002Arksey ( , 2003, there are four main principles for how services should be delivered in order to promote access, flexibility and effectiveness. First, services need to be positive and inclusive.…”

Perceptions of the Relationship Between Mental Health Professionals and Family Caregivers: Has There Been Any Change?

“…The introduction of educational training programmes for both professionals and carers (including information sharing strategies), support services (e.g., the provision of breaks from caring), and a number of family interventions offered by some mental health services and/or NGOs in the United States, England and New Zealand (Arksey et al, 2002;Arksey, 2003;Falloon, 1999) resulted in some positive outcomes.…”

Mall Walking Program Environments, Features, and Participants: A Scoping Review

“…A scoping review differs from other reviews in that it addresses broader topics, may include a larger variety of study designs, and may not assess study quality (19–21). Scoping reviews are useful in areas in which researchers are unable to perform systematic reviews because of a lack of studies that use rigorous designs, such as randomized controlled trials.…”