‘From my point of view,my wife has recovered’: A qualitative investigation of caregivers’ perceptions of recovery and peer support services for people with bipolar disorder in a Chinese community

Abstract

Background:

Bipolar disorder (BD) is a chronic mental disorder, and family members play a key role in taking care of the affected individuals. The recovery movement has gradually transformed mental health services, for example, through the introduction of peer support services (sharing of expert-by-experience knowledge), and it has challenged the prevailing view that people with mental illness cannot recover.

Aims:

Through this study, the researchers explored how family caregivers in a Chinese context conceptualise recovery, how caregivers interact with peer support workers (PSWs) and how they perceive peer support services.

Methods:

Fourteen family caregivers from community settings participated in individual semi-structured interviews. The data were analysed through thematic analysis.

Results:

Family caregivers had multifaceted definitions of recovery and had various degrees of contact with PSWs. The views and experiences shared by PSWs were hope-instilling for caregivers and changed their perception of BD and their loved ones. Some limitations of PSWs were also identified.

Conclusion:

Social connectedness and functional outcomes were important indicators of recovery among Chinese family caregivers. Caregivers began to understand the benefits of PSWs after experiencing their services. Peer-led services could be a helpful support for both service users and family caregivers.

Keywords

Family mental health services peer supporters psychiatric rehabilitation recovery

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References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Baronet

A.-M.

(1999). Factors associated with caregiver burden in mental illness: A critical review of the research literature. Clinical Psychology Review, 19, 819–841.

Bellamy

Schmutte

Davidson

(2017). An update on the growing evidence base for peer support. Mental Health and Social Inclusion, 21, 161–167.

Bland

Darlington

(2002). The nature and sources of hope: Perspectives of family caregivers of people with serious mental illness. Perspectives in Psychiatric Care, 38, 61–68. doi:10.1111/j.1744-6163.2002.tb00658.x

Braun

Clarke

(2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3, 77–101.

Cabassa

L. J.

Camacho

Vélez-Grau

C. M.

Stefancic

(2017). Peer-based health interventions for people with serious mental illness: A systematic literature review. Journal of Psychiatric Research, 84, 80–89.

Castelein

Bruggeman

Davidson

van der Gaag

(2015). Creating a supportive environment: Peer support groups for psychotic disorders. Schizophrenia Bulletin, 41, 1211–1213.

Chang

W. C.

Wong

C. S. M.

Chen

E. Y. H.

Lam

L. C. W.

Chan

W. C.

R. M. K.

… Bebbington

H. F. K.

(2017). Lifetime prevalence and correlates of schizophrenia-spectrum, affective, and other non-affective psychotic disorders in the Chinese adult population. Schizophrenia Bulletin, 43, 1280–1290.

Chien

W. T.

Chan

S. W.

(2004). One-year follow-up of a multiple-family-group intervention for Chinese families of patients with schizophrenia. Psychiatric Services, 55, 1276–1284.

10.

Chien

W. T.

Thompson

D. R.

(2013). An RCT with three-year follow-up of peer support groups for Chinese families of persons with schizophrenia. Psychiatric Services, 64, 997–1005.

11.

Chinman

George

Dougherty

R. H.

Daniels

A. S.

Ghose

S. S.

Swift

Delphin-Rittmon

M. E.

(2014). Peer support services for individuals with serious mental illnesses: Assessing the evidence. Psychiatric Services, 65, 429–441.

12.

Davidson

Bellamy

Guy

Miller

(2012). Peer support among persons with severe mental illnesses: A review of evidence and experience. World Psychiatry, 11, 123–128.

13.

Davidson

Lawless

M. S.

Leary

(2005). Concepts of recovery: Competing or complementary? Current Opinion in Psychiatry, 18, 664–667.

14.

Ferrari

A. J.

Baxter

A. J.

Whiteford

H. A.

(2011). A systematic review of the global distribution and availability of prevalence data for bipolar disorder. Journal of Affective Disorders, 134(1–3), 1–13.

15.

Gehart

D. R.

(2012). The mental health recovery movement and family therapy, Part I: Consumer-led reform of services to persons diagnosed with severe mental illness. Journal of Marital and Family Therapy, 38, 429–442.

16.

Goossens

P. J.

Van Wijngaarden

Knoppert-Van Der Klein

E. A.

Van Achterberg

(2008). Family caregiving in bipolar disorder: Caregiver consequences, caregiver coping styles, and caregiver distress. International Journal of Social Psychiatry, 54, 303–316.

17.

Gumber

Stein

C. H.

(2013). Consumer perspectives and mental health reform movements in the United States: 30 years of first-person accounts. Psychiatric Rehabilitation Journal, 36, 187–194.

18.

Hsiao

F.-H.

Klimidis

Minas

Tan

E.-S.

(2006). Cultural attribution of mental health suffering in Chinese societies: The views of Chinese patients with mental illness and their caregivers. Journal of Clinical Nursing, 15, 998–1006. doi:10.1111/j.1365-2702.2006.01331.x

19.

Jacob

Munro

Taylor

B. J.

Griffiths

(2017). Mental health recovery: A review of the peer-reviewed published literature. Collegian, 24, 53–61.

20.

Kessler

R. C.

Aguilar-Gaxiola

Alonso

Chatterji

Lee

Ormel

… Wang

P. S.

(2009). The global burden of mental disorders: An update from the WHO World Mental Health (WMH) Surveys. Epidemiology and Psychiatric Sciences, 18, 23–33.

21.

Leamy

Bird

Le Boutillier

Williams

Slade

(2011). Conceptual framework for personal recovery in mental health: Systematic review and narrative synthesis. The British Journal of Psychiatry, 199, 445–452.

22.

Leung

(2010). Beliefs in Chinese culture. In Bond

M. H.

(Ed.), The Oxford handbook of Chinese psychology (pp. 221–240). Oxford, UK: Oxford University Press.

23.

Lloyd-Evans

Mayo-Wilson

Harrison

Istead

Brown

Pilling

… Kendall

(2014). A systematic review and meta-analysis of randomised controlled trials of peer support for people with severe mental illness. BMC Psychiatry, 14(1), Article 39.

24.

Mancini

M. A.

Hardiman

E. R.

Lawson

H. A.

(2005). Making sense of it all: Consumer providers’ theories about factors facilitating and impeding recovery from psychiatric disabilities. Psychiatric Rehabilitation Journal, 29, 48–55.

25.

Miklowitz

D. J.

(2010). Bipolar disorder: A family-focused treatment approach. New York, NY: Guilford Press.

26.

Miller

I. W.

Keitner

G. I.

Ryan

C. E.

Uebelacker

L. A.

Johnson

S. L.

Solomon

D. A.

(2008). Family treatment for bipolar disorder: Family impairment by treatment interactions. The Journal of Clinical Psychiatry, 69, 732–740.

27.

Moran

G. S.

Russinova

Gidugu

Yim

J. Y.

Sprague

(2012). Benefits and mechanisms of recovery among peer providers with psychiatric illnesses. Qualitative Health Research, 22, 304–319.

28.

Noiseux

Ricard

(2008). Recovery as perceived by people with schizophrenia, family members and health professionals: A grounded theory. International Journal of Nursing Studies, 45, 1148–1162.

29.

Noiseux

St-Cyr

D. T.

Corin

St-Hilaire

P.-L.

Morissette

Leclerc

… Gagnier

(2010). The process of recovery of people with mental illness: The perspectives of patients, family members and care providers: Part 1. BMC Health Services Research, 10(1), Article 161.

30.

Perlick

D. A.

Miklowitz

D. J.

Lopez

Chou

Kalvin

Adzhiashvili

Aronson

(2010). Family-focused treatment for caregivers of patients with bipolar disorder. Bipolar Disorders, 12, 627–637.

31.

Perlick

D. A.

Rosenheck

R. A.

Miklowitz

D. J.

Chessick

Wolff

Kaczynski

… STEP-BD Family Experience Collaborative Study Group. (2007). Prevalence and correlates of burden among caregivers of patients with bipolar disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder. Bipolar Disorders, 9, 262–273.

32.

Pharoah

Mari

Rathbone

Wong

(2010). Family intervention for schizophrenia. The Cochrane Database of Systematic Reviews, 12, CD000088.

33.

Ran

M.-S.

Xiang

M.-Z.

Chan

C. L.-W.

Leff

Simpson

Huang

M.-S.

… Li

S.-G.

(2003). Effectiveness of psychoeducational intervention for rural Chinese families experiencing schizophrenia. Social Psychiatry and Psychiatric Epidemiology, 38, 69–75.

34.

Ridgway

(2001). ReStorying psychiatric disability: Learning from first person recovery narratives. Psychiatric Rehabilitation Journal, 24, 335–343. doi:10.1037/h0095071

35.

Thomas

S. P.

Hall

J. M.

(2008). Life trajectories of female child abuse survivors thriving in adulthood. Qualitative Health Research, 18, 149–166.

36.

Tse

Mak

W. W.

I. W.

Liu

L. L.

Yuen

W. W.

Yau

Wong

(2017). A one-year longitudinal qualitative study of peer support services in a non-Western context: The perspectives of peer support workers, service users, and co-workers. Psychiatry Research, 255, 27–35.

37.

Tse

R. M.

(2014). Applying a mental health recovery approach for people from diverse backgrounds: The case of collectivism and individualism paradigms. Journal of Psychosocial Rehabilitation and Mental Health, 1(1), 7–13.

38.

Tse

R. M.

Tonsing

K. N.

Ran

(2012). Families and family therapy in Hong Kong. International Review of Psychiatry, 24, 115–120.

39.

Tse

Siu

B. W. M.

Kan

(2013). Can recovery-oriented mental health services be created in Hong Kong? Struggles and strategies. Administration and Policy in Mental Health and Mental Health Services Research, 40, 155–158.

40.

Whiteford

H. A.

Degenhardt

Rehm

Baxter

A. J.

Ferrari

A. J.

Erskine

H. E.

… Vos

(2013). Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. The Lancet, 382, 1575–1586.

41.

World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines (Vol. 1). Geneva, Switzerland: Author.

42.

Young

D. K.

P. Y.

Pan

(2017). Predictors and prevalence of recovery and remission for consumers discharged from mental hospitals in a Chinese society. Psychiatric Quarterly, 88, 839–851.