will need to ensure that there is a system in place to collect data on the outcomes of the practice. This will help to identify systemic problems and help sustain the program.
What roles do families have?
PMHAs are generally aware that families can help create an optimal home and social environment for the individual with mental illness. Families should participate in decision- making about their loved ones future life and living situation. Families are playing new roles in public mental health and are willing to work with mental health authorities. For family psychoeducation to be successful and sustained, it is important that the mental health authority include families as an important stakeholder group in planning the implementation of a family psychoeducation program.
How can family psychoeducation be funded?
Funding mechanisms may vary from agency to agency and state to state. For the most part, funds are used from the state Division of Mental Health and Medicaid. State leaders from the agencies work out a mechanism on how to pool monies that can be used to reimburse the services of family psychoeducation programs. In some cases Medicaid rules and codes have been rewritten to allow reimbursement for family psychoeducation. One state has adopted a case-rate approach, which fits well with implementation and promotes use of the modality (details available on request). In some states, Medicaid authorities support funding for family psychoeducation because there is such a large reduction in emergency room visits and hospital admission costs.
Who supports family psychoeducation?
There are several sources of support to help implement and sustain family psychoeducation. For example, constituency groups that can serve as allies to help change the system include:
Family advocacy organizations such as The National Alliance on Mental Illness (state and local chapters) and state mental health associations have long recognized that education and support programs are beneficial for families coping with mental illness. Reports show that families who have participated in the family psychoeducation programs often become strong advocates. They may be more willing to financially support and advocate for the general operations of the community mental health service system. They may also get involved on planning committees, advisory boards or in political activities to support mental health programs and funding.
The Agency for Health Care Policy and Research supported an extensive review of the scientific literature on the outcomes of family psychoeducation. The Patient Outcomes Research Team's (PORT) findings were that FPE greatly reduces relapse, rehospitalization, and improves community functioning. Subsequent studies and reviews have concluded the same. Recently, family psychoeducation in multifamily groups has been found to reduce negative symptoms (the control group's symptoms increased) and medical care use and medical illness among the participating relatives.
The American Psychiatric Association practice guidelines recommend family psychoeducation as a first line or indicated treatment for schizophrenic and bipolar disorders. (For more information, see the clinical measures section of their website at www.psych.org.)
Family Psychoeducation Toolkit