Individuals with first-episode psychosis (FEP) often have a prolonged and complicated path to accessing appropriate treatment. Research shows families frequently initiate treatment though often delays remain even after problems are detected. Understanding and improving pathways to care is crucial to minimising the impact of psychosis for individuals and families.
This study explored families’ experiences of seeking help from both informal and formal sources for a relative with FEP. A systematic review of qualitative evidence was the chosen methodology. Twenty-two studies were included in the review. Delays in accessing appropriate treatment arose at the stages of illness recognition, help-seeking and service response. These areas were found to be interrelated. Barriers to seeking help included fear of stigma and reluctance of the ill relative to participate in the process. Service response was often a further barrier to accessing help. Crises and overt psychotic symptoms were promoters of active help-seeking and facilitators to accessing services. Overall the impact on carers throughout each of the stages was significant.

There is a wealth of information available on working with families of the mentally ill. This is driven by research and international literature and supported by a range of federal and state policies within NSW. However families and carers of forensic patients have largely been neglected in the literature in relation to the provision of adequate and tailored services. These families and carers face lengthy and often complex legal issues and they encounter unique challenges during these processes which can bring chaos and devastation to their own lives and that of their families, especially for those being the victim of the patients’ crime. How best to deliver support services to meet these carers needs is difficult to ascertain, what is clear however is that they have unique needs and require specialised support.

The formation of the Justice Health & Forensic Mental Health Network (JH&FMHN) provided an opportunity to establish a co-ordinated approach for both the patient and their families and carers. The establishment of the Family & Care Network has been designed to provide such an avenue for these carers to share their stories, concerns and issues, in a safe environment with the support of non-government organizations and JH&FMHN clinicians.

Family members affected by mental illness are often excluded by mental health professionals from the treatment of their adult children diagnosed with a mental illness. Confidentiality and privacy legislation and risk management are usually the basis of exclusion. Negative attitudes of mental health professionals towards carers may also influence whether a family member(s) are included in the treatment of their children. What is problematic in this scenario is that family members care for consumers across many years. They experience stigma, discrimination and burnout and yet they continue to love and support their children while holding onto hope (Bland and Foster, 2012). Mental health professionals have opportunities to work with families to address stigma and discrimination and enhance recovery. Benefits to working closely with family members include: learning about their lived experience and supporting family members and consumers in their recovery journey, service delivery and outcomes can also be improved by meeting national standards on participation and recovery and, government health budgets may be reduced. This presentation considers mental illness stigma and discrimination and the stages of family recovery (Worrall, 2008) through the lens of a mental health practitioner and mother affected by mental illness.

Mental health services need to be informed by a holistic, family and recovery- orientated philosophy. While mental health services are increasingly encouraged to engage in family-focused practice, this is an unclear and poorly understood aspect of service provision. The aim of this presentation is to present the findings from a systematically-conducted review of international literature on how family-focused practice is conceptualised and practised in child and youth and adult mental health services.
In mental health services, family-focused practice is understood variously depending on who is included in the ‘family’, whether the focus is family of origin or family of procreation, and the context of practice. ‘Family’ as defined by its members forms a basis for practice that is oriented to providing a whole-of-family approach to care. Six core family-focused practices were identified: family care planning and goal-setting; liaison between families and services; instrumental, emotional and social support; assessment; psychoeducation; and a coordinated system of care between families and services. In order to achieve a whole-of-family approach to service delivery and strengthen family members’ wellbeing and their individual and collective outcomes, key principles and practices of family-focused practice are recommended for clinicians and policy makers across mental health services.

This paper will outline the development of the Carers ACT Keeping Families Connected (KFC) program for carers of family members with mental health issues and who may also have drug and/or alcohol dependencies. The paper describes aspects of the strengths-based KFC model, recognising the resilience, skills and knowledge of the participants.
This program has developed from a forum for the provision of information on mental illness and its effects to its present structure that includes the recognition of the overwhelming affect, and the often intense isolation, experienced by these carers. Many carers are disclosing this for the first time although some may have been caring for many years and some may have been diagnosed with their own mental health issues –depression and anxiety are common amongst this cohort.
The paper considers the overall aims of the KFC program and describes its adaptation this year for young teenage mental health carers. It will also discuss the program’s expansion to be culturally appropriate for Aboriginal and Torres Strait Islander and Vietnamese carers. Both programs ran in conjunction with Carers ACT Aboriginal and Torres Strait Islander worker and our Culturally and Linguistically Diverse worker.