CAREGIVER BURDEN AND SERVICES FOR THE MENTALLY ILL

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The proposed study examines mental health services and mental health service systems as these are related to caregiver burden with families having a severely mentally ill member. The subjective and objective burdens of having a severely mentally ill family member, often called family burden, are often high and may vary depending on the advice, support, crisis help, and other mental health services provided to family members. this perspective recognizes the general proposition that burdens placed on families caring for ill members are important outcomes of health care systems. This proposed research would describe what types of mental health services to family members contrasting family burden across systems of services which are selected to provide wide variations in mental health services to family members and to patients. The study would have a non-experimental design, examining the natural variation of experiences of burden within 689 families each having a severely mentally ill member in treatment within nine public mental health systems. These nine county-based systems of care in Wisconsin represent diverse intervention strategies including 1) predominantly inpatient, 2) CSP team, 3) social caseworker model, 4) patients having one-on-one contacts with para-professionals, and 5) lay persons as case manager extenders. Variation within county systems in the type and amount of services family members receive will also be examined. Data will be gathered using a 1/2 hour long telephone interview with family members concerning their experiences of burden, the services they received, their patient's behavior, other stressors impacting the family, attributions by the family concerning the patient's behavior, and family attempts to cope with the behavior.