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Great expectations: a systematic review of the literature on the role of family carers in severe mental illness, and their relationships and engagement with professionals

Authors

  • J. ROWE MA BA RMN

    Corresponding author
    1. Lecturer, Mental Health Nursing, The Open University, Health and Social Care, Horlock, Walton Hall, Milton Keynes, Bucks, UK
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  • There are no conflicts of interest associated with the submission of this paper. This paper is not being considered for publication elsewhere.

J. Rowe, Mental Health Nursing, The Open University, Health and Social Care, Horlock, Walton Hall, Milton Keynes, Bucks MK7 6AA, UK, E-mail: j.m.rowe@open.ac.uk

Abstract

Accessible summary

  • • A systematic review of the literature on family carers and severe mental illness.
  • • Investigating expectations of the role of carer, and relationships and engagement with professionals.
  • • Begins to recognize that carers are expected to fulfil some obligations and that they also have rights associated with their role.
  • • Recommendations for future practice between mental health professionals and family carers that include more empathic communication, and a covenant between mental health services and people who rely on services.

Abstract

As community care has become embedded in the UK as in much of the western world more responsibility for psychosocial care has been placed on family carers. A systematic review of the literature about the role of family carers supporting a relative with severe mental illness and their relationships and engagement with professionals was carried out. The review aimed to find out what professionals expected of family carers and what family carers expected of themselves. Themes were identified: the distinct and personal nature of family caring, potentially effective family caring, barriers to effective caring and ways to overcome barriers. There were expectations that family carers were obligated to help support effective care, but that the rights to enable carers to fulfil these obligations were not consistently upheld. Barriers to upholding rights include: types of service provision, professional attitudes to communication and engagement with carers, and carer ability to cope. Recommendations for practice included: service provision aimed at including carers, more empathic communication by professionals, and a covenant between mental health services and people who depend on them. The idea of a covenant requires more discussion and research is needed into what is expected of family carers.

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