Phase-based concerns of caregivers for individuals with a bipolar disorder.

BACKGROUND: Caregivers have a key role in providing social and practical support for individuals with bipolar disorder. As such, their perspectives are uniquely important when collaborative decisions are made on management priorities and potential treatment options. AIMS: This study aims to identify common concerns that caregivers have in the management of an individual with a bipolar disorder. METHOD: 111 caregivers were recruited from online advertisements and social media support groups. They completed a questionnaire that obtained demographic and clinical feature details, in addition to whether a series of generic and phase-specific (i.e. depressive or hypo/manic) management concerns reflected their experiences of caregiving. RESULTS: Concerns about work capacity and family impacts were almost ubiquitous, as were general feelings of ineffectiveness and irritation. Depressive phases were more likely to elicit fears of suicide by caregivers, while during hypo/manic phases caregivers were more likely to be angered, have concerns for their own safety, call emergency services or to take safety precautions. There were no differences between bipolar subtypes with regards to concerns during depressive phases, but concerns around safety, reputational damage and risky behaviours were more likely in relation to those experiencing bipolar I manic phases compared to bipolar II hypomanic phases. CONCLUSIONS: The concerns identified by caregivers in this paper are consistent with clinical expectations, with concerns regarding insularity and externalisation being prominent for depression and hypo/mania respectively. Not all of these caregivers' concerns would necessarily be communicated in a healthcare setting, highlighting the need for an embracive approach to improve management outcomes. Additionally, caregivers' emphasis on their distinctive altruistic concerns highlights their commitment to care despite the challenges, and thus further highlights the potential for clinicians to implement a more proactive role for them in patient care.

Tele-Mental Health Utilization Among People with Mental Illness to Access Care During the COVID-19 Pandemic.

Shortly after the COVID-19 pandemic arrived at the United States, mental health services moved towards using tele-mental health to provide care. A survey about resilience and tele-mental health was developed and conducted with ForLikeMinds' members and followers. Correlational analysis was used to examine relationships between quantitative variables. A phenomenological approach was used to analyze open questions responses. Sixteen percent of participants were coping well with the pandemic; 50% were coping okay; and 34% said that they were coping poorly. Three main themes emerged from the qualitative analysis: accessibility to care; self-care strategies; and community support and relationship. The responses from participants seems to reflect the combination of two main factors-the challenges they were facing in accessing care through tele-mental health plus the mental health consequences from COVID-19. This survey reflects the importance of building innovative strategies to create a working alliance with people who need care through tele-mental health.

COVID-19 Concerns Among Persons With Mental Illness.

OBJECTIVE: The coronavirus disease (COVID-19) pandemic has been recognized as causing a wide variety of behavioral health problems. Society must mitigate this impact by recognizing that COVID-19 can trigger people's fears of exacerbating an existing mental illness. A survey about COVID-19 for people with mental illness was developed. METHODS: Two hundred fourteen people responded to the survey, of whom 193 self-identified as living with a mental illness. RESULTS: Almost all participants living with a mental illness (98%) said they had at least one major concern regarding the COVID-19 pandemic, and 62% said they had at least three major concerns. CONCLUSIONS: People living with a mental illness are very concerned about disruption of services, running out of medication, and social isolation during this pandemic. Providers and mental health services could address these fears by connecting with people living with mental illness through text messaging and social media.