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Mental Health Problems/Diagnoses > Adult > Schizophrenia

Family Involvement Improves Outcomes in Schizophrenia

By Carla Quail, LCSW
As published in the Mental Health News, Fall 2005, http://www.mhnews.org.

The New York State Office of Mental Health (OMH) has made a commitment to families and consumers throughout the state to provide evidence-based family treatment. A partnership between the Office of Mental Health and The University of Rochester Medical Center’s Family Institute and in collaboration with NAMI, The Family Psycho-education Project sought qualified agencies to implement multi-family psycho-education groups. This evidence-based practice has proven to lower rates of relapse, improve vocational and independent living outcomes, as well as, enhance the coping skills and communication of families. In the fall of 2003, the Office of Mental Health selected The Mental Health Association of Westchester County Inc., (MHA) to be one of only twenty-one sites in the state to provide this service to consumers and families.

Two Multi-Family Groups Running and Third is Planned

MHA of Westchester has long been a leader in the treatment of people with serious mental illnesses. The Family Psycho-education Project offered MHA of Westchester and the families we serve a wonderful opportunity to implement truly effective family interventions. MHA’s plan, which the Project firmly supported, was to train staff representatives from as many programs as possible within the agency in order to disseminate this service as comprehensively as possibly. In January of 2004, eight staff attended a two-day training in the Multi-Family Psycho-education Model. Today, thanks to the commitment and enthusiasm of MHA’s consumers, families and staff, we have two multi-family groups running and are planning a third.

Multi-Family Psycho-education is not a new program. William McFarland, the originator of the model, developed multi-family psycho-education groups at least twenty years ago. The model provides families and consumers with education about mental illness and methods of coping and support in a structured environment. Families learn to address problems through concrete, strategic, and solution driven methods. Facilitators of Multi-family Psycho-education groups form collegial relationships with families and consumers. The model is dependent upon the successful restructuring of the traditional therapist role. Staff, families and consumers work together as equal parts of a triangle, in an effort to improve the quality of life of the consumer and family.

“Family Nights” Instituted to Engage Families of Those with Mental Illness

The original model was developed for families going through the first episode of a family member’s illness. MHA had to modify some of the original model to adapt to an outpatient setting, where most of the clients and families have been in treatment for some time. MHA reached out to families through direct conversations with our clients, through letters to people the clients identified as “family”, and finally through invitations to what we called “Family Nights”. MHA’s Family Nights became a very successful vehicle by which we engaged families. At least 75% of the families that attended a Family Night joined a Multi-Family Psycho-education Group. At Family Nights, we would meet and socialize with families, describe the model and its benefits and answer questions about the nature of the program. Once families committed to the program, the facilitators began joining sessions with families. This is where the relationships are established that connect the family to the facilitator and begin to acculturate the family to the model. Finally, all of the families come together for a Survival Skills Workshop. This workshop educates families about all facets of schizophrenia and from here the formal groups begin.

MHA has been running Multi-Family Psycho-education Groups for most of this year. Families make a commitment to attend for eighteen months and to date we have not had any families drop out of the program. Many families cite the education piece of the program as the most novel and helpful component. Others find the problem solving techniques to be useful in many areas of their lives. Not enough time has elapsed to assess outcomes, but our next project is to look at relapse rates and vocational/independent living status of participants at the beginning and one- year mark. We anticipate seeing some positive changes.

Consumers, Families and Staff All Benefit

In addition to the benefits to consumers and families, staff have benefited greatly from this program. The opportunity to work collaboratively with people from across the agency, the chance to try something new and see it through to implementation, the input of regular contact and supervision from an outside consultant, and the significant benefit to consumers and their families has contributed to high staff morale. Just as all of the families have remained engaged and active in the program, so have the staff. Many models of family involvement exist in the treatment and support group community, all providing wonderful opportunities for consumers and families. MHA has found this particular model to offer our families and staff much needed support, education and solutions. MHA anticipates that this model will grow within our agency and, hopefully, other agencies will take on this initiative as well. For more information about the Multi-Family Psycho-education program please contact Carla Quail, Project Coordinator at MHA of Westchester, 914-345-5900, extension 244.

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