The health education needs of families caring for a schizophrenic relative and the potential role for community psychiatric nurses.

Community care policies for the mentally ill rely, to a large extent, on the informal contribution that often seems to be made willingly by families. In financial terms alone, it has been calculated by the British Government that families caring for a relative with schizophrenia at home save the country 25 billion pounds a year. Nearly 15 years ago, it was argued that community mental health services were failing to monitor the relationships in homes where this situation prevailed and provide the support mechanisms that were required. Further, it has been noted that when there is an over-emphasis on community care, family crises can become severe and remain undetected. This paper reviews the literature relating to the needs of families caring for a schizophrenic relative at home. It concludes that a major service that should be offered to families is education about the illness, schizophrenia, itself. Strategies for undertaking this role are examined within the overall context of 'psychosocial interventions' and the literature on 'high expressed emotion'. Finally, an experimental course, funded by the Department of Health, and located in the Department of Nursing at Manchester University, is described. Here, community psychiatric nurses are being taught to recognize the value of health education for those living with a schizophrenic relative. As a consequence, a number of valuable initiatives have been developed and these are briefly outlined.