title: Preferences for family involvement in care among consumers with serious mental illness.
abstract: OBJECTIVE
  Despite robust evidence of efficacy, family services for individuals diagnosed as having serious mental illness are of limited availability and drastically underutilized. This underutilization may be due to a mismatch between consumer and family preferences and the services offered. This study is the first systematic report on preferences expressed by consumers with serious mental illness for family involvement.
  
  
  METHODS
  The study enrolled 232 mental health consumers with serious mental illness who had contact with family but did not have any family regularly involved in their mental health care. Consumers were recruited from outpatient mental health clinics at three large medical centers in two Veterans Integrated Service Networks. Interviews elicited demographic characteristics, treatment preferences regarding family involvement, and perceived benefits and barriers to involvement. Chart diagnoses and measures of symptom severity, family functioning, and contact were collected.
  
  
  RESULTS
  Seventy-eight percent (171 of 219) of the consumers wanted family members to be involved in their care, and many desired involvement through several methods. Consumers were concerned with the impact of involvement on both themselves and their family member. The consumer's degree of perceived benefit of family involvement significantly predicted the degree of desire for family involvement after analyses controlled for service need (family conflict, family-related quality of life, and symptom severity), enabling factors (family contact and family capacity), demographic variables (age, gender, race, living with family, and marital status), and barriers perceived by the consumer.
  
  
  CONCLUSIONS
  The extent of overall support for family involvement in care coupled with the heterogeneity of preferred modes and concerns and anticipated benefits underscore the imperative to offer diverse family services and to elicit consumers' preferences regarding whether and how to involve their families.
authors.affiliation: Veterans Affairs (VA) Desert Pacific Mental Illness Research, Education and Clinical Center (MIRECC), 11301 Wilshire Blvd. (210A), Los Angeles, CA 90073, USA. amy.cohen@va.gov
authors.forename: Amy N
authors.initials: AN
authors.lastname: Cohen
authors.forename: Amy L
authors.initials: AL
authors.lastname: Drapalski
authors.forename: Shirley M
authors.initials: SM
authors.lastname: Glynn
authors.forename: Deborah
authors.initials: D
authors.lastname: Medoff
authors.forename: Li Juan
authors.initials: LJ
authors.lastname: Fang
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Dixon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003657:Decision Making; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D057240:Patient Preference; D011795:Surveys and Questionnaires; D014481:United States; D055815:Young Adult