Siblings of persons with mental illness who assume primary caregiving roles experience substantial and tangible economic impacts associated with this responsibility. This study investigated mailed ...survey responses collected from 156 adult siblings of persons with mental illness from New York State to examine instrumental costs associated with providing support to siblings with illness. Genders of both siblings, severity of the relatives' mental illness, and number of surviving parents in the family distinguished those occupying primary caregiving responsibility from those not in primary roles. Current caregivers incurred greater instrumental costs in the form of financial expenses, time spent in care activities, and crisis involvement than did those who were not primary care providers. Additional demographic and behavioral factors related to siblings with and without illness were associated with specific dimensions of instrumental expenditure. As siblings become increasingly engaged in caregiving, social service professionals must assume leadership in promoting programs and policies that meaningfully support family involvement for relatives with mental illness.
Objectives: Long-term care (LTC) ombudsmen advocate for the health, safety, welfare, and rights of residents in LTC facilities. This article examines factors associated with self-rated effectiveness ...of local LTC Ombudsman Programs (LTCOPs) in California and New York across the five statutorily mandated activities under the Older Americans Act: complaint investigation, resident/family education, community education, monitoring laws, and policy advocacy. Method: Data were collected from telephone interviews with coordinators of local LTCOPs in California and New York and from the National Ombudsman Reporting System. Analyses examined factors associated with effectiveness: program size, resource adequacy, organizational autonomy, interorganizational relationships, and program outputs. Results: Resource and autonomy measures are significantly associated with different effectiveness measures in each state. Staff full-time equivalencies and coordinator hours per week in New York and the quality of training in California are significantly associated with effectiveness in most mandated activities. Discussion: Findings highlight variability within and between the local LTCOPs in California and New York.
This study examined knowledge of New York's Assisted Outpatient Treatment law, enacted November 1999, among adult siblings of persons with mental illness. Mailed survey responses collected between ...April, 2000 and September, 2001 from 100 siblings residing in New York State were reviewed. Only 48% acknowledged familiarity with the law. Possessing higher education, reading about mental illness more often, planning to occupy future caregiving roles, maintaining membership in a support group, and reporting that their siblings experienced more difficulties with treatment compliance were associated with a familiarity with the law. Among those aware of the law, two thirds incorrectly believed eligibility for a court order was contingent on a history of violent behavior. Low rates of general awareness and knowledge of the law highlight the need for further community education.
This study examines the complex and varied effects associated with having a brother or sister with a severe and persistent mental illness (SPMI) on the lives of adult siblings without chronic ...disability. Through five focus group interviews, 19 participants were asked to describe the impact that having a brother or sister with mental illness had on their lives. Codes and categories derived from the text of the transcribed interviews were grouped into broad themes. The respondents described the manifestations and challenges of contending with the SPMI of an adult sibling. They focused on gaps in services and communication with mental health providers, particularly with regard to timing of interventions and identifying readiness for treatment, as well as their own mental health needs. The article concludes with a discussion of the increased need for exchange of information and clarity of communication among family members and providers, following best practice guidelines that are well documented but not well implemented.
Anecdotal reports suggest that persons with a dual diagnosis (mental retardation and psychiatric illness) admitted to acute psychiatric hospitals stay longer and require more services than ...individuals without mental retardation. To test these hypotheses, a questionnaire was completed for 64 people with dual diagnosis admitted to 10 psychiatric hospitals over 3 months. Multivariate analysis revealed that a diagnosis of mental retardation was not a predictor of length of stay. Use of 1-to-1 staffing was more likely, while arrangement of different community placement at discharge was less likely for persons with than without dual diagnosis. Additionally, age, diagnosis, symtomatology, living arrangement, insurance status, and service use distinguished the patient groups. Implications are discussed in the context of a need for further examination and training focused toward this population.
Sibling Perspectives on Severe Mental Illness Lukens, Ellen P; Thorning, Helle; Lohrer, Steven
American journal of orthopsychiatry,
October 2004, Letnik:
74, Številka:
4
Journal Article
Recenzirano
Through focus group interviews, participants were asked to describe the impact over time of having a sibling with severe mental illness. Transcript content was then organized into categories and ...overarching themes using grounded-theory analysis. Respondents' personal and interpersonal experiences are presented, along with suggestions for professional outreach and further research.
Through focus group interviews, participants were asked to describe the impact over time of having a sibling with severe mental illness. Transcript content was then organized into categories and ...overarching themes using grounded-theory analysis. Respondents' personal and interpersonal experiences are presented, along with suggestions for professional outreach and further research. PUBLICATION ABSTRACT
Adult siblings of persons with severe mental illness are likely to assume increasing roles in the care and support of their brothers and sisters. The present study investigated the current and ...anticipated future involvement of adult siblings of persons with mental illness in the instrumental care of their brothers and sisters. In addition, the study provides projected estimations of the economic costs that siblings could expect to experience as a result of assuming primary caregiving responsibility for their relatives with illness. Data stem from survey responses collected from 125 adult siblings of persons with mental illness, drawn primarily from New York State. Multivariate analyses indicated that siblings who identified themselves as primary family caregivers provided significantly more care in terms of direct financial support, time spent in care related activities, involvement in crisis management activities, and time taken-off from employment to assist their relatives with mental illness than those who were not primary caregivers. Predictors of future intentions to provide care included: annual household income, geographic proximity, whether the relative with mental illness received residential programming, and current caregiver status. Comparisons between siblings who identified themselves as current primary caregivers and siblings who anticipated assuming a primary role in the future, suggested that siblings who plan to occupy primary caregiving roles could expect to incur additional financial costs, time spent in caregiving and were more likely to become involved in crisis management activities upon assuming primary care responsibility. Time taken-off from employment was not found to be related to becoming a primary family caregiver. These findings indicate that assuming a primary caregiving role is likely to have an associated economic impact; necessitating that sibling caregivers alter their lifestyle and incur economic costs affecting their own well-being. As siblings become increasingly involved in caregiving, particularly as the abilities of parental caregivers decline, mental health professionals, policy makers, and researchers must assume leadership in promoting programs and policies that meaningfully support family involvement in the care of their relatives with mental illness. Implications of this study for program and policy development are examined.
Adult siblings of persons with severe mental illness are likely to assume increasing roles in the care and support of their brothers and sisters. The present study investigated the current and ...anticipated future involvement of adult siblings of persons with mental illness in the instrumental care of their brothers and sisters. In addition, the study provides projected estimations of the economic costs that siblings could expect to experience as a result of assuming primary caregiving responsibility for their relatives with illness. Data stem from survey responses collected from 125 adult siblings of persons with mental illness, drawn primarily from New York State. Multivariate analyses indicted that siblings who identified themselves as primary family caregivers provided significantly more care in terms of direct financial support, time spent in care related activities, involvement in crisis management activities, and time taken-off from employment to assist their relatives with mental illness than those who were not primary caregivers. Predictors of future intentions to provide care included: annual household income, geographic proximity, whether the relative with mental illness received residential programming, and current caregiver status. Comparisons between siblings who identified themselves as current primary caregivers and siblings who anticipated assuming a primary role in the future, suggested that siblings who plan to occupy primary caregiving roles could expect to incur additional financial costs, time spent in caregiving and were more likely to become involved in crisis management activities upon assuming primary care responsibility. Time taken-off from employment was not found to be related to becoming a primary family caregiver. These findings indicate that assuming a primary caregiving role is likely to have an associated economic impact; necessitating that sibling caregivers alter their lifestyle and incur economic costs affecting their own well-being. As siblings become increasingly involved in caregiving, particularly as the abilities of parental caregivers decline, mental health professionals, policy makers, and researchers must assume leadership in promoting programs and policies that meaningfully support family involvement in the care of their relatives with mental illness. Implications of this study for program and policy development are examined.
Understanding the responses of organisms to different environmental drivers is critical for improving ecosystem management and conservation. Estuarine ecosystems are under pressure from multiple ...anthropogenic stressors (e.g. increasing sediment and nutrient loads, pollution, climate change) that are affecting the functions and services these ecosystems provide. Here, we used long-term estuarine benthic invertebrate monitoring data (∼30 year time-series) to evaluate the responses of macrobenthic invertebrate communities and indicator species to climatic, oceanic, freshwater, and local environmental drivers in New Zealand estuaries. We aimed to improve our ability to predict ecosystem change and understand the effects of multiple environment drivers on benthic communities. Our analyses showed that the abundance and richness of macrobenthic fauna and four indicator taxa (bivalves known to have differing tolerances to sediment mud content: Austrovenus stutchburyi, Macomona liliana, Theora lubrica, and Arthritica bifurca) responded to unique combinations of multiple environmental drivers across sites and times. Macrobenthic responses were highly mixed (i.e., positive and negative) and site-dependent. We also show that responses of macrobenthic fauna were lagged and most strongly related to climatic and oceanic drivers. The way the macrobenthos responded has implications for predicting and understanding the ecological consequences of a rapidly changing environment and how we conserve and manage coastal ecosystems.
•Long-term estuarine monitoring data (∼30 yrs) was used to evaluate the responses of macrofauna to environmental drivers.•Macrofauna responded to unique combinations of multiple environmental drivers.•Macrofaunal responses to environmental drivers were idiosyncratic and site-mediated.•Macrofaunal responses were mostly related to lagged permutations of climatic and oceanic drivers.•We highlight the complexity of predicting macrofauna responses to environmental change.
