Family psychoeducation: chronic psychiatrically ill Caribbean patients

Abstract

This article described a method of patient and family intervention designed for psychotic patients who are prone to relapse. Issues addressed in a monthly group meeting were designed to clarify, inform, and support families on the facts of schizophrenia and bipolar disorder. This format succeeded in improving the rate of recidivism in the population of Caribbean patients because it clarified distortions of the nature of the illnesses and made obvious that medication compliance was separate and did not intrude on the culture and belief systems. Family dynamics were not a focus in this psychoeducation program, but alliances, boundaries, and process did change over the course of the 6 months of the program. Family members were engaged relatively easily and responded when it was clear there was no intention to intrude on culture or personal beliefs. Many expressed anger and frustrations that such a program had not been offered before, especially those families whose relatives had experienced multiple readmissions. The questionnaires clearly illustrated an increase in knowledge and understanding about the illness, and this correlated with reduced recidivism. A major effort is made to maintain contact with patients and their families following discharge from the day hospital for up to 3 years to ensure their follow-through. Follow-up phone calls ensure 100% follow-up. For the past few years, we have found that ongoing contact is also useful on a reduced frequency to reinforce the concepts communicated initially.