Labrum Travis, Solomon Phyllis
Travis Labrum, PhD, LCSW, is assistant professor, Division of Social Work, University of Wyoming, 1000 E University Avenue, Laramie, WY; e-mail:
Health Soc Work. 2018 Aug 1;43(3):165-174. doi: 10.1093/hsw/hly013.
In this period of post-deinstitutionalization, much of the care for people with severe psychiatric disorders (PD) is provided by their families. A primary stressor for caregivers is fears regarding their own safety and that of others, which has been virtually unexplored. To fill this gap, factors in three domains were assessed: (1) relatives with PD, (2) family caregivers, and (3) interactions with each other. This investigation was a secondary analysis of data obtained from a national survey of caregivers of adults with mental illness conducted by the National Alliance for Caregiving. A subsample of 1,505 was used in the present study. Fear of harm was positively associated with the following factors: relatives with PD-serious mental health problem, alcohol and substance abuse, receipt of crisis mental health treatment, history of arrest; interaction-greater difficulty getting relative to take medications as prescribed; and fear that relative would be hurt by others or die by suicide. Social workers need to be cognizant of risk of potential violence against caregivers and ensure the safety of these family members, even if they may not be their primary clients. The article includes recommendations for family inclusion in the treatment of people with PD.
在这个去机构化的时期，重度精神疾病患者的护理工作大多由其家人承担。照顾者面临的一个主要压力源是对自身及他人安全的担忧，而这一点几乎未被探讨过。为填补这一空白，我们评估了三个领域的因素：（1）患有精神疾病的亲属，（2）家庭照顾者，以及（3）彼此之间的互动。本调查是对美国国家护理联盟开展的一项针对成年精神疾病患者照顾者的全国性调查所获数据进行的二次分析。本研究使用了一个包含1505人的子样本。对伤害的恐惧与以下因素呈正相关：患有精神疾病的亲属——严重心理健康问题、酒精和药物滥用、接受过危机心理健康治疗、有被捕记录；互动——让亲属按规定服药困难更大；以及担心亲属会受到他人伤害或自杀身亡。社会工作者需要认识到照顾者可能遭受潜在暴力的风险，并确保这些家庭成员的安全，即便他们可能并非主要服务对象。本文还包括关于让家庭参与精神疾病患者治疗的建议。
