A mixed methods exploration of family involvement in medical care for older adults with serious mental illness

Int J Psychiatry Med. 2014;48(2):121-33. doi: 10.2190/PM.48.2.e.


Objective: Many older persons with serious mental illness (SMI) suffer from high rates of comorbid medical conditions. Although families play a critical role in psychiatric illness management among adults with SMI, their contributions to improving health outcomes in this population has received little attention. This study explored family involvement in medical care for older adults with SMI.

Methods: This mixed methods study involved analysis of quantitative data collected from older adults with SMI and cardiovascular risk (n = 28) participating in a pilot study of an intervention designed to improve patient-centered primary care augmented by qualitative interviews with their relatives (n = 13) to explore family involvement in medical care.

Results: Approximately 89% of older adults with SMI reported family involvement in at least one aspect of their medical care (e.g., medication reminders, medical decision making). However, many family members reported that they were rarely involved in their relative's medical visits, and most did not perceive a need to be involved during routine care. Family members identified obesity as their relative's primary health concern and many wanted guidance from providers on effective strategies for supporting weight loss.

Conclusions: Although many family members did not perceive a need to be involved in their relative's routine medical visits, they expressed interest in talking with providers about how to help their relative change unhealthy behaviors. Educating patients, families, and providers about the potential benefits of family involvement in medical care, including routine medical visits for persons with SMI and cardiovascular health risk may promote patient- and family-centered collaboration in this high-risk population.

Keywords: families; medical care; older adults; serious mental illness.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Cardiovascular Diseases* / complications
  • Cardiovascular Diseases* / prevention & control
  • Cardiovascular Diseases* / psychology
  • Caregivers* / education
  • Caregivers* / psychology
  • Consumer Health Information / organization & administration
  • Cooperative Behavior
  • Family / psychology
  • Female
  • Health Services Needs and Demand
  • Healthy People Programs / organization & administration
  • Humans
  • Male
  • Mental Disorders* / complications
  • Mental Disorders* / diagnosis
  • Mental Disorders* / physiopathology
  • Middle Aged
  • Obesity / prevention & control
  • Obesity / psychology
  • Patient-Centered Care* / methods
  • Patient-Centered Care* / organization & administration
  • Pilot Projects
  • Program Evaluation
  • Psychiatric Status Rating Scales
  • Risk Factors
  • Risk Reduction Behavior
  • United States