"Everyone Has a Role": Perspectives of Service Users With First-Episode Psychosis, Family Caregivers, Treatment Providers, and Policymakers on Responsibility for Supporting Individuals With Mental Health Problems

Qual Health Res. 2019 Jul;29(9):1299-1312. doi: 10.1177/1049732318812422. Epub 2018 Dec 4.


Varying perceptions of who should be responsible for supporting individuals with mental health problems may contribute to their needs remaining unmet. A qualitative descriptive design was used to explore these perceptions among key stakeholders. Focus groups were conducted with 13 service users, 12 family members, and 18 treatment providers from an early psychosis intervention program in Montreal, Canada. Individual interviews were conducted with six mental health policy-/decision-makers. Participants across stakeholder groups assigned a range of responsibilities to individuals with mental health problems, stakeholders in these individuals' immediate and extended social networks (e.g., families), macro-level stakeholders with influence (e.g., government), and society as a whole. Perceived failings of the health care system and the need for greater sharing of roles and responsibilities also emerged as important themes. Our findings suggest that different stakeholders should collectively assume certain responsibilities and that systems-level failings may contribute to unmet needs for mental health support.

Keywords: Canada; access to health care; adaptation; adolescents; agency; coping; empowerment; enduring; families; health; health care; mental health and illness; policy; policy analysis; power; psychosis; qualitative description; recovery; responsibility; schizophrenia; support needs; teamwork; young adults; youth.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Canada
  • Caregivers / psychology*
  • Family / psychology*
  • Female
  • Focus Groups
  • Health Personnel / psychology*
  • Humans
  • Male
  • Mental Health Services / organization & administration*
  • Psychotic Disorders / psychology*
  • Psychotic Disorders / therapy*
  • Qualitative Research