Innovative Approaches to Working with Families and Carers of Young People in Early Psychosis – Everything Old is New Again.
The early development of psychosis impacts on the individuals affected and on those around them and may be both a cause and a consequence of family/relationship difficulties. Psychosis (both emergent and established) can have an enormous impact on the family system, as it can lead to bewilderment, fear, grief and suffering for both the person and their families. Family includes all types of families such as nuclear, extended, blended, single-parent, heterosexual and same-sex couples. With early psychosis most young people are living with their families when psychosis begins. The combined aim of alleviating distress in families and maximizing client prognosis suggests the importance of the provision of support to families.
This lecture will present a tripartite approach in working with families, carers and other important relationships for young people at risk of psychosis. It explains how much earlier work of McFarlane with Expressed Emotion (EE) and current collaboration with Relationships Australia, sees our early psychosis service engaging in 1. co-case management, 2. intensive couple and family interventions and 3. multiple family interventions.

The social, emotional and physical demands of caregiving impact carers’ health and wellbeing. Carer partnerships, involvement in consumer care pathways, and maximising carer wellbeing are National Standards for Mental Health Services1.
Aims:The purpose of this research was to: explore carers’ views on managing their health and wellbeing, identify service and funding gaps, and inform service planning for Mental Illness Fellowship Victoria.
Method: The mixed methods research involved 30 carers from Victoria’s South Metropolitan and Gippsland regions. Between them, participants supported 38 consumers. Data were gathered through four focus groups, nine telephone interviews, and written feedback. Descriptive statistics and thematic analysis were the data analysis methods.
Findings: Service gaps were identified under two main themes: Improvement to the healthcare system, and Direct carer support. Similar to previous investigation2, major needs identified include: An integrated healthcare system; personalised, continued service provision for consumers; and comprehensive health support for carers. Findings were similar across both regions. Issues with isolation, transport, and quantity of localised services were reported more frequently in Gippsland.
Conclusions: Closing the identified gaps would enable carers to better care for consumers and themselves. This research highlights existing service gaps, and provides insight into how best carer support can be achieved.

In Australia there are high levels of unmet need for mental health care for older people. Consequences of inadequate primary mental health care include frequent and longer hospitalisation, deterioration of physical and mental health, and earlier entry into residential care. Policy and services acknowledge carers importance in care provision though little is known about their experience in obtaining appropriate care and support for an older person. This paper discusses service navigation from the carers’ perspective. Nine in-depth interviews were conducted with rural carers of persons with a mental health concern. Results highlighted the significant role carers had in navigating care options and operationalising care. Enablers to accessing care included carer and worker attributes and roles, and case reviews facilitating collaboration between services and with carers. Barriers included carer issues (mental health literacy), consumer issues (readiness for services) and worker issues (confidentiality). Multiple services were often involved with gaps in linking between different service sectors (health, social and aged care). Positive aspects of living in small communities were emphasised. It is concluded that to best manage the health and care of an older person, carers should be considered key partners by service providers in care planning that crosses the service sectors.