Mental health system historians: adults with schizophrenia describe changes in community mental health care over time.

This qualitative study examined changes in community mental health care as described by adults diagnosed with schizophrenia with long-term involvement in the mental health system to situate their experiences within the context of mental health reform movements in the United States. A sample of 14 adults with schizophrenia who had been consumers of mental health services from 12 to 40 years completed interviews about their hospital and outpatient experiences over time and factors that contributed most to their mental health. Overall, adults noted gradual changes in mental health care over time that included higher quality of care, more humane treatment, increased partnership with providers, shorter hospital stays, and better conditions in inpatient settings. Regardless of the mental health reform era in which they were hospitalized, participants described negative hospitalization experiences resulting in considerable personal distress, powerlessness, and trauma. Adults with less than 27 years involvement in the system reported relationships with friends and family as most important to their mental health, while adults with more than 27 years involvement reported mental health services and relationships with professionals as the most important factors in their mental health. The sample did not differ in self-reported use of services during their initial and most recent hospitalization experiences, but differences were found in participants' reported use of outpatient services over time. Findings underscore the importance of the lived experience of adults with schizophrenia in grounding current discourse on mental health care reform.

The role of personal loss in the caregiving experiences of well siblings of adults with serious mental illness.

OBJECTIVE: The present study examined the role of personal loss due to mental illness and meaning-related coping strategies on reports of caregiving among well siblings of adults with serious mental illness. METHOD: A sample of 103 well siblings of adults with serious mental illness completed an online survey. Participants were recruited through websites related to mental illness and through contact with leaders of family support groups. RESULTS: Personal loss, not meaning-related coping, was the strongest predictor of current caregiving among well siblings. Well siblings' age, support group affiliation, and perceived level of sibling dependence also contributed to variation in reports of current caregiving. CONCLUSION: Personal loss has powerful implications for research and interventions focused on sibling involvement in caregiving for adults with mental illness.

Family ties in tough times: how young adults and their parents view the U.S. economic crisis.

The present intergenerational study examined the perceived impact of the recent U.S. economic crisis on a sample of 68 young adult-parent dyads. The relative contribution of perceived economic pressure, reports of adult child-parent relationship quality, and concerns about the economic future in accounting for variation in self-reports of psychological distress for adult children and their middle-aged parents were examined. Parents' concerns about their children's economic future accounted for variation in their reports of anxiety and depressed mood above and beyond that of perceived economic pressures and their views of the parent-child relationship. In contrast, for young adults, reports of personal economic pressure were generally related to self-reported anxiety and depressed mood. Implications of findings for research and practice are discussed.