Families' and Decision Makers' Experiences With Mental Health Care Reform: The Challenge of Collaboration

      Family-driven collaboration is fundamental to developing a new model of health care and eliminating fragmented services in mental health. The province of Québec (Canada) recently undertook major transformations of its mental health care system. These transformations represent an opportunity to improve collaboration between families and health care practitioners and to understand which factors facilitate this collaboration. This article describes how families and decision makers perceive collaboration in the context of a major transformation of mental health services and identifies the factors that facilitate and hinder family collaboration.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Psychiatric Nursing
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Biegel D.
        • Milligan S.
        • Putnam P.
        • Song L.-Y.
        Predictors of burden among lower socioeconomic status caregivers of persons with chronic mental illness.
        Community Mental Health Journal. 1994; 30: 473-494
        • Brand U.
        Mental health care in Germany: Carers' perspectives.
        Acta Psychiatrica Scandinavica. 2001; 104: 35-40
        • Cleary M.
        • Freeman A.
        • Hunt G.E.
        • Walter G.
        What patients and carers want to know: An exploration of information and resource needs in adult mental health services.
        The Australian and New Zealand Journal of Psychiatry. 2005; 39: 507-513
        • Contandriopoulos A.P.
        Inertie et changement.
        Ruptures, revue transdisciplinaire en santé. 2003; 9: 4-31
        • Davidson L.
        • O'Connell M.
        • Tondora J.
        • Styron T.
        • Kangas K.
        The top ten concerns about recovery encountered in mental health system transformation.
        Psychiatric Services. 2006; 57: 640-645
        • Dixon L.
        • Lucksted A.
        • Stewart B.
        • Delahanty J.
        Therapists' contacts with family members of persons with severe mental illness in a community treatment program.
        Psychiatric Services. 2000; 51: 1449-1451
        • Doornbos M.M.
        Family caregivers and the mental health care system: Reality and dreams.
        Archives of Psychiatric Nursing. 2002; 16 (10.1053/apnu.2002.30541): 39-46
        • European Observatory on Health Systems and Policies
        Mental health policy and practice across Europe: The future direction of mental health care.
        World Health Organisation, Maidenhead2007
        • Ewertzon M.
        • Andershed B.
        • Svensson E.
        • Lutzen K.
        Family member's expectation of the psychiatric healthcare professionals' approach towards them.
        Journal of Psychiatric and Mental Health Nursing. 2011; 18: 146-157
        • Ewertzon M.
        • Lutzen K.
        • Svensson E.
        • Andershed B.
        Family members' involvement in psychiatric care: Experiences of the healthcare professionals' approach and feeling of alienation.
        Journal of Psychiatric and Mental Health Nursing. 2010; 17: 422-432
        • Gagné M.A.
        Les soins de santé mentale axés sur la collaboration, de quoi s'agit-il? Une introduction au Cadre de travail en soins de santé mentale axés sur la collaboration. Canadian Collaborative Mental Health Initiative, Mississauga Ontario2005 (
        • Ganju V.
        Mental health transformation: Moving toward a public health, early-intervention approach in Texas.
        Psychiatric Services. 2008; 59: 17-20
        • Goodwin V.
        • Happell B.
        Conflicting agendas between consumers and carers: The perspectives of carers and nurses.
        nternational Journal of Mental Health Nursing. 2006; 15: 135-143
        • Goodwin V.
        • Happell B.
        Psychiatric nurses' attitudes toward consumer and carer participation in care.
        Policy, Politics & Nursing Practice. 2008; 9: 249-256
        • Hallam L.
        How involuntary commitment impacts on the burden of care of the family.
        International Journal of Mental Health Nursing. 2007; 16: 247-256
        • Happell B.
        • Moxham L.
        • Platania-Phung C.
        The impact of mental health nursing education on undergraduate nursing students' attitudes to consumer participation.
        Issues in Mental Health Nursing. 2011; 32: 108
        • Haswell-Elkins M.
        • Reilly L.
        • Fagan R.
        • Ypinazar V.
        • Hunter E.
        • Tsey K.
        • et al.
        Listening, sharing understanding and facilitating consumer, family and community empowerment through a priority driven partnership in Far North Queensland.
        Australasian Psychiatry. 2009; 17: 54-58
        • Hunt R.
        Community-based nursing: Philosophy or setting?.
        AJN The American Journal of Nursing. 1998; 98: 44
      1. Institut des services et des politiques de la santé. (2007). Thèmes préliminaires de recherche.

        • Jacobson N.
        • Greenley D.
        What is recovery? A conceptual model and explication.
        Psychiatric Services. 2001; 52: 482
        • Jakobsen E.S.
        • Severinsson E.
        Parents' experiences of collaboration with community healthcare professionals.
        Journal of Psychiatric and Mental Health Nursing. 2006; 13: 498-505
        • Jubb M.
        • Shanley E.
        Family involvement: The key to opening locked wards and closed minds.
        International Journal of Mental Health Nursing. 2002; 11: 47-53
        • Kim H.-W.
        • Salyers M.
        Attitudes and perceived barriers to working with families of persons with severe mental illness: Mental health professionals' perspectives.
        Community Mental Health Journal. 2008; 44: 337-345
        • Kuipers L.
        Family burden in schizophrenia: Implications for services.
        Social Psychiatry and Psychiatric Epidemiology. 1993; 28: 207-210
        • Lakeman R.
        Practice standards to improve the quality of family and carer participation in adult mental health care: An overview and evaluation.
        International Journal of Mental Health Nursing. 2008; 17: 44-56
        • Lammers J.
        • Happell B.
        Mental health reforms and their impact on consumer and carer participation: A perspective from Victoria, Australia.
        Issues in Mental Health Nursing. 2004; 25: 261-276
        • Mancini M.A.
        • Hardiman E.R.
        • Lawson H.A.
        Making sense of it all: Consumer providers' theories about factors facilitating and impeding recovery from psychiatric disabilities.
        Psychiatric Rehabilitation Journal. 2005; 29: 48-55
        • Marshall T.
        • Solomon P.
        Provider contact with families of adults with severe mental illness: Taking a closer look.
        Family Process. 2004; 43: 209-216
        • Marshall T.B.
        • Solomon P.
        Releasing information to families of persons with severe mental illness: A survey of NAMI members.
        Psychiatric Services. 2000; 51: 1006-1011
        • Miles M.
        • Huberman A.
        Qualitative data analysis: An expanded sourcebook.
        Sage Publications, Thousand Oaks CA1994
      2. Ministry of Health and Social Service. (2005). Plan d'action en santé mentale: La force des liens, Gouvernement du Québec.

        • Nicholls E.
        • Pernice R.
        Perceptions of the relationship between mental health professionals and family caregivers: Has there been any change?.
        Issues in Mental Health Nursing. 2009; 30: 474-481
        • Ostman M.
        • Hansson L.
        • Andersson K.
        Family burden, participation in care and mental health—An 11-year comparison of the situation of relatives to compulsorily and voluntarily admitted patients.
        The International Journal of Social Psychiatry. 2000; 46: 191-200
      3. Piat, M., Fleury, MJ., Boyer, R., Lesage, A., Sabetti, J., & Lesage, A. (2010). Who Believes Most In Me And In My Recovery: The Importance of Families for Persons with Serious Mental Illness Living In Structured Community Housing. Submitted to Journal of Social Work in Disability and Rehabilitation.

        • Piat M.
        • Sabetti J.
        • Fleury M.J.
        • Boyer R.
        • Lesage A.
        “Who believes most in me and in my recovery”: The importance of families for persons with serious mental illness living in structured community housing.
        Journal of Social Work in Disability & Rehabilitation. 2011; 10: 49-65
        • Perreault M.
        • Paquin G.
        • Kennedy S.
        • Desmarais J.
        • Tardif H.
        Patients' perspective on their relatives' involvement in treatment during a short-term psychiatric hospitalization.
        Social Psychiatry and Psychiatric Epidemiology. 1999; 34 ([Article]): 157-165
      4. Perreault, M., Rousseau, M, Provencher, H., Roberts, S., & Milton, D. (2011). Predictors of Caregiver Satisfaction with Mental Health Services. Community Mental Health Journal Published online: 11 May 2011.

        • Power A.K.
        A public health model of mental health for the 21st century.
        Psychiatric Services. 2009; 60: 580-584
        • Provencher H.L.
        • Perreault M.
        • St-Onge M.
        • Rousseau M.
        Predictors of psychological distress in family caregivers of persons with psychiatric disabilities.
        Journal of Psychiatric and Mental Health Nursing. 2003; 10 ([10.1046/j.1365-2850.2003.00623.x): 592-604
        • Ricard N.
        • Bonin J.P.
        • Ezer H.
        Factors associated with burden in primary caregivers of mentally ill patients.
        International Journal of Nursing Studies. 1999; 36 ([Article]): 73-83
        • Rose L.E.
        • Mallinson R.K.
        • Walton-Moss B.
        Barriers to family care in psychiatric settings.
        Journal of Nursing Scholarship. 2004; 36: 39-47
        • Sin J.
        • Moone N.
        • Wellman N.
        Incorporating psycho-educational family and carers work into routine clinical practice.
        Journal of Psychiatric and Mental Health Nursing. 2003; 10: 730-734
        • Stefansson C.G.
        • Hansson L.
        Mental health care reform in Sweden, 1995.
        Acta Psychiatrica Scandinavica. 2001; 104: 82-88
        • Thornicroft G.
        • Tansella M.
        Balancing community-based and hospital-based mental health care.
        World Psychiatry. 2002; 1: 84
        • VandeBovenkamp H.M.
        • Trappenburg M.J.
        The relationship between mental health workers and family members.
        Patient Education and Counseling. 2010; 80: 120-125
        • Whiteford H.A.
        • Buckingham W.J.
        Ten years of mental health service reform in Australia: Are we getting it right.
        Medical Journal of Australia. 2005; 182: 396-400
        • World Health Organization
        Rapport sur la santé dans le monde 2001—la santé mentale.
        WHO, Genève2001
        • Wilkinson C.
        • McAndrew S.
        ‘I'm not an outsider, I'm his mother!’ A phenomenological enquiry into carer experiences of exclusion from acute psychiatric settings.
        International Journal of Mental Health Nursing. 2008; 17: 392-401
        • Wood P.A.
        • Hurlburt M.S.
        • Hough R.L.
        • Hofstetter C.R.
        Longitudinal assessment of family support among homeless mentally ill participants in a supported housing program.
        Journal Of Community Psychology. 1998; 26: 327-344
        • Wynaden D.
        • Orb A.
        Impact of patient confidentiality on carers of people who have a mental disorder.
        International Journal of Mental. 2005;