Training to enhance partnerships between mental health professionals and family caregivers: a comparative study

A training program for mental health staff was collaboratively developed and delivered by family caregivers and professionals. It addressed calls for less blaming attitudes toward families and increased contact between professionals and families. Two levels of training were compared. Twenty-seven staff members completed a 30-hour extended 12-week program. Eighty-two percent of all eligible staff from area teams attended a brief program involving three or six hours of training. Self-ratings of competence and attitudes toward families improved only for staff receiving extended training. Contacts with families increased for those in the extended program but not for all types of teams, suggesting that length of training and service type may limit the impact of training.

Reconciling the patient's right to confidentiality and the family's need to know

OBJECTIVE

Persistent difficulties have been identified in relation to confidentiality in mental health settings. The objective of the current investigation was to develop practical options enabling clinicians to negotiate this issue in a manner that in sensitive to families.

METHOD

A review of the international literature, the current legal and policy settings, and the needs of clients and their families was undertaken. Additional material was drawn from the authors' own practice and advocacy experience.

RESULTS

The literature and policies reviewed emphasised the importance of meaningful collaboration between clinicians and families. A close reading of the relevant legislation revealed possibilities for an interpretation of confidentiality that facilitates such collaboration. Options for negotiating the engagement phase which are consistent with meaningful collaboration were then developed.

CONCLUSION

Rather than assuming that confidentiality is an intransient problem, the authors conclude that dealing with the question of confidentiality sensitively presents clinicians with an opportunity to develop quality relationships with both clients and their families.

Unhappy bedfellows. Psychiatric consultation in general practice

Interviews with 20 general practitioners within a five mile radius of a State Psychiatric Clinic in Melbourne, revealed many difficulties associated with the reported increase in social and emotional problems presented by their patients. Most general practices are structured to cope best with the medical aspects of patients' problems. Those problems that are essentially non-medical, create situations where the general practitioner makes decisions in areas not taught to medical students in the past. The directions in which he turns for assistance depend upon a variety of attitudinal factors and the availability of appropriate facilities. An uneasy relationship between many general practitioners, psychiatrists, and psychiatric agencies was noted. A sociological analysis of the results suggests that status and role inconsistencies could be a major factor in some of the problems. This paper aims to stimulate participants towards the resolution of the conflicts.