Coproduction with peer support groups: A new approach to culturally responsive social services.

The disparity of access to suitable social services for people from culturally diverse backgrounds is receiving increased attention. Coproduction between service users and providers has the potential as an approach to improve the cultural responsiveness of social services. What remains unknown is how social service organizations can facilitate and support coproduction with people from culturally diverse backgrounds. This article examines how three disability support organizations in Australia worked with peer support groups run by people with disability and their families from Chinese background to improve the organizations' service provision. We collected qualitative data through observations of activities in the groups and semistructured interviews with group members and organization staff. We found that organizing peer support groups facilitated knowledge exchange between people from culturally diverse backgrounds and organizations to inform practice development. Five contributors to the knowledge exchange were as follows: (1) assigning staff responsibility for exchange and trust with the group; (2) encouraging the group to challenge practice and cultural norms; (3) identifying and supporting the capacity of peer facilitators; (4) fostering trust within the group; and (5) collaborating with other organizations. Cultural responsiveness means incorporating people's cultural preferences in support provision and addressing the negative influences of cultural norms on people.

Social isolation and loneliness in family caregivers of people with severe mental illness: A scoping review.

Family caregivers of people with severe mental illness (SMI) have been increasingly observed to experience social isolation and/or loneliness (SI/L) which are risk factors for ill health. This scoping review aimed to map existing evidence and identify knowledge gaps in studies on SI/L in this population using the Arksey and O'Malley's framework. Parallel searches (2011-2021) conducted in 10 databases identified 51 publications from 18 countries fully meeting the inclusion criteria. Over half of the included studies were quantitative. We found that the definition of loneliness reached a consensus, while the definition of social isolation varied across studies. Risk factors and correlates of SI/L were grouped into sociodemographic factors, illness-related factors, health and wellbeing, and stigma. The evidence showed a lack of comprehensive measurements assessing SI/L, few longitudinal studies, and little knowledge of interventions specifically addressing SI/L. Future studies are recommended to address these knowledge gaps and explore effective interventions on SI/L in family caregivers of people with SMI.

Social connectedness of carers: An Australian national survey of carers.

Carers of people living with a disability, mental health problems, alcohol or drug dependency, chronic condition, terminal illness or who are frail due to age may experience negative caregiving impacts. Although carers' social isolation has been reported in many qualitative studies, it has largely been neglected in quantitative studies. Using data collected in the Carers NSW 2020 National Carer Survey, this large-scale quantitative study aimed to identify the extent of Australian carers' social connectedness and what factors may be related to their social well-being. The validated Friendship Scale was used to measure social connectedness of 5585 carers. More than half (56.2%) of these carers were socially isolated. Analysis found that a longer duration of caring, more time spent weekly caring, living with the care recipient, caring for a greater number of people, receiving no help from others, higher reported psychological distress and reporting perceived needs were all associated with greater social isolation. Identifying as female or nonbinary/gender diverse, identifying with a culturally and linguistically diverse background, and caring as a parent, former partner or young carer were also related to poorer social connectedness. Health and social services need to consider the needs of carers, identify carers who are socially isolated and provide resources to promote social connectedness. Greater attention in practice and research to focus on carers' social connectedness to address this crucial caregiving experience is required.

Well-being and needs of Malay carers of people with mental illness in Singapore.

Despite the importance of carers supporting the lives of people with mental illness, there are limited studies investigating the well-being and needs of Malay carers in multicultural Singapore. The Malays consist of 13.4% of Singapore's population. A mixed methods qualitative dominant research approach was used to explore the well-being and needs of Malay carers in a voluntary welfare organisation. The Kessler-10, Friendship Scale and Carers' and Users' Expectations of Services-Carer version were used to assess the needs and well-being of 17 Malay carers. Findings show that Malay carers experienced poor well-being and had numerous unmet needs. Four main themes were found: (a) Concerns related to relatives with mental illness, (b) Mental health practices related to carers, (c) Holistic support for carers and (d) Preference for greater spiritual support in mental health. Recovery-oriented mental health practice implications are discussed. Spirituality of Malay carers needs to be given greater consideration in recovery-oriented mental health services.

Care-giving by people with psychotic disorders in the second Australian prevalence study of psychosis.

Increasing numbers of people living with psychosis are providing care for others, although the associated benefits and impacts are poorly understood. This innovative quantitative study investigated this life role using a population-based framework aiming to compare the mental health and functioning of those providing care to and/or receiving care from others. Care-giving provided by people with psychosis was examined using data from the second Australian prevalence survey of psychosis. This epidemiologically based sample (n = 1,822) was divided into four subgroups based on providing and/or receiving care from others. Independent functioning, cognitive functioning, social functioning, social connection and mental health were compared between the four subgroups. One in seven participants were providing care to others. The majority of carers were female and half were living with the care recipients. Caregivers were more likely to experience better illness course and were more commonly diagnosed with bipolar disorder. Almost one-third of caregivers reported that caring adversely affected their lives a great deal. Functioning and social connection were better in caregivers compared to non-caregivers, although cognitive functioning did not differ. People with psychosis who were neither providing nor receiving care were more likely to be single and perceive less warmth in their relationships. As expected, those only in receipt of care were living with greater disability and poorer illness course. It is relatively common to encounter people with psychosis who provide care to others in clinical settings, and women in particular combine care-giving with multiple other roles. Despite most experiencing some negative emotional impact, care-giving is associated with enhanced social relationships which may provide meaning and purpose for recovery. Care-giving roles should be addressed in recovery and care planning so as to provide people with psychosis with adequate information and support to fulfil these potentially important life roles.

Is gender important? Victimisation and perpetration of intimate partner violence in mainland China.

Establishing the prevalence of intimate partner violence (IPV) has been recommended by International Conventions and Declarations for some time beginning with the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW Articles 12 and 19) in 1979. One important recommendation of such international protocols is the implementation of national population prevalence surveys to establishing IPV as a serious social issue globally, which is intended to provide data for planning effective responses within signatory countries. However, not all countries have undertaken national prevalence surveys meaning that there are gaps in our understanding of who are the perpetrators and victims of IPV in different cultural contexts. This article presents the results of a scoping review of literature examining gender differences in prevalence rates of victimisation and perpetration of IPV in mainland China (hereon China). There has been little written about the prevalence of IPV in China generally, and this scoping process located only nine peer-reviewed articles written in both English- and Chinese-language journals focusing on both gender and IPV published between 1997 and 2016. Results of this scoping review demonstrate that while both women and men perpetrate IPV in China, the prevalence rates of different types of IPV reflect gender differences in both perpetration and victimisation, suggesting that IPV is not a unitary phenomenon. The paper concludes by discussing the implications of the findings including the importance of increasing awareness of IPV in China more generally and developing gender-specific interventions to directly address different types of IPV. Directions for future research are also canvassed.

Implementing a family-inclusive practice model in youth mental health services in Australia.

AIM: A brief family-inclusive practice model, single session family consultation (SSFC), was introduced at 4 youth mental health service sites to determine the extent to which the model could be implemented in this context and its acceptability as a means of engaging families of young people. METHODS: Within an action research paradigm, both quantitative and qualitative measures were used for this implementation project with the former reported here. There were 2 components: (1) evaluation of the experiences of young people and their families and (2) evaluation of the extent of implementation of SSFC. Quantitative data were analysed descriptively (item scores, range and any changes over time). RESULTS: Twenty practitioners who were trained and supported in the use of SSFC participated in the 6-month implementation evaluation. In 6 months, 131 SSFC sessions were conducted across the 4 sites and the young people and their families were very satisfied with sessions (overall mean = 5.2, range = 0-6). Six months post-training, there were statistically significant improvements in the practitioners' confidence in providing family interventions (mean improvement = -0.47 (95% confidence interval (CI) = -0.91, -0.04), P = .035) and familiarity with approaches to working with families (mean improvement = -0.61 (95% CI = -1.13, -0.10, P = .023). Practitioners perceived significant improvement in organizational support for working with families. CONCLUSIONS: SSFC was acceptable to clients and their families, was adopted by practitioners and was successfully implemented in the participating sites. This suggests that SSFC, when appropriately implemented, is useful to engage families in the treatment of young people facing mental health issues.

Physical and psychological health of carers of young people with first episode psychosis.

OBJECTIVE: Carers of people with psychosis may experience psychological distress and caregiving burden. However, few studies have examined both psychological and physical health of carers of young people with first episode psychosis (FEP). METHOD: A total of 32 young people with FEP and 42 of their carers were recruited from a mental health service. Standardised scales were administered to assess carers' psychological distress and risk for development of Type 2 diabetes. Their body mass index, waist circumference and blood pressure were measured. RESULTS: A total of 24% ( n = 10) of carers experienced high/very high psychological distress and 39.0% ( n = 16) had high risk for Type 2 diabetes. It was common for carers to be overweight ( n = 33, 78.6%) and to have hypertension ( n = 14, 33.3%). Carers' higher levels of psychological distress were associated with shorter duration of illness in the young person. CONCLUSIONS: Caring for a young person with FEP is associated with poor physical and psychological health. Findings show the importance of supporting carers' physical and psychological health early in treatment of young people with FEP.

Perceived needs of carers of people with psychosis: An Australian longitudinal population-based study of caregivers of people with psychotic disorders.

Studies have documented the perceived needs of carers of people with psychosis but most recruitment has utilised convenience sampling resulting in limited understanding of carers' needs. This longitudinal study was conducted within the second Australian prevalence study of psychosis, aiming to obtain generalisable findings regarding perceived needs of carers of people with psychosis. Semi-structured interviews were conducted with 98 carers of people with psychosis recruited in the Australian prevalence study of psychosis. Seventy-eight of the carers were reinterviewed 1 year later to measure changes in their perceived needs. Correlational and paired T tests were conducted to identify relationships between perceived needs and carer's health and well-being, and changes in levels of perceived needs over time. Qualitative responses were structurally coded by segmentation according to the Carers' and Users' Expectations of Services-Carer version. Thematic analysis of common words and phrases was undertaken to identify key themes concerning carers' perceived needs. There was minimal improvement in carers' perceived needs over time and their needs were closely related to their perception of their own social connectedness, psychological health and quality of life. Five themes were identified: Greater involvement of carers in the treatment plan, provision of relevant information to carers, multiple biopsychosocial support for carers, well-being and independence interventions for people with psychosis, and choice to care and alternate caring arrangements. Although policy recognises the need to support carers, findings show that focused interventions are required to address carers' perceived needs more holistically in current mental health services. To support carers' recovery, services need to include carers in treatment planning, and consider ways to address their needs and improve their own health and well-being.

The experiences of Australian parents with psychosis: the second Australian National Survey of Psychosis.

OBJECTIVE: Being a parent is an important part of one's identity and role. Previous research outlines many challenges associated with parenting by people with severe mental illness. However, there is a limited research describing parenting experiences of mothers and fathers who have psychosis. METHOD: The second Australian national survey of psychosis recruited 1825 people living with symptoms of, or a diagnosis of, psychosis. The survey was conducted through face-to-face interviews and included key clinical and demographic information, as well as parenting specific information. RESULTS: Over half of all women and a quarter of men were parents. Almost a quarter of women but only 5.5% of the men had dependent children (own and/or stepchildren) living at home with them. Of parents with dependent children, the most common diagnosis was schizophrenia (48.2% fathers, 28.9% mothers), and there were high rates of comorbidity with substance abuse/dependence (alcohol: fathers 69.2%, mothers 44.3%; cannabis: fathers 69.22%, mothers 47.8%). A substantial proportion of parents with dependent children experienced challenges including low educational attainment, unemployment, poverty, and social isolation. Although many parents living with dependent children functioned in the average range, a significant proportion was moderately to severely disabled on global independent functioning ratings (fathers 49.1%, mothers 35.7%) and some were identified as having obvious/severe impairments in their ability to care for their child(ren) (fathers 28.3%, mothers 21.3%). CONCLUSIONS: Most parents living with psychosis function well. However, a significant proportion has impairments in parenting and general functioning that could have adverse consequences for both the parent and children. This study brings into focus the need for interventions to optimise successful parenting outcomes.