LOS ANGELES — One of the most difficult issues in caring for adults with severe mental illness, including at the VA, is balancing privacy regulations with family members’ desire to be in the know.

A study published in the Psychiatric Rehabilitation Journal looked at preferences for family involvement in psychiatric care in a large, representative sample of veterans in treatment for schizophrenia.1

Researchers from the VA Desert Pacific Mental Health Research, Education, and Clinical Center at the Los Angeles VAMC, and colleagues collected completed assessment from 801 veterans with schizophrenia or schizoaffective disorder. Questions in the study, which also involved the RAND Corp., were about demographic and clinical characteristics, status of family support and preference for family involvement in their psychiatric care.

Responses were that 61.9% of the veterans indicated that they had a family member who provided them with regular support, although 37.9% reported that they had no family member who provided support, and one did not respond.

Among the 304 patients without support, 89.4% said they had a living family member.

Of the 496 participants who had a supportive family member, slightly more than one-quarter, 27.2%, said they wanted their family member involved in their care. Of the 272 participants who did not have a supportive family member but had living family, 21.0% responded that they wanted family involved.

Their preferred method of involvement included contact with the patient’s psychiatrist and education about the illness, although researchers pointed out that barriers to involvement including concerns about privacy and burden.

“Preferences indicated by this large representative sample of individuals in care for schizophrenia indicate that a majority have supportive family, and a substantial minority want family involved in their psychiatric care,” study authors concluded. “Clinicians can address concerns about privacy and burden and deliver preferred services by phone or mail, overcoming anticipated barriers. Desire for family support groups was limited but present.”

  1. Cohen AN, Pedersen ER, Glynn SM, Hamilton AB, McNagny KP, Reist C, Chemerinski E, Young AS. Preferences for family involvement among veterans in treatment for schizophrenia. Psychiatr Rehabil J. 2019 Mar 28. doi: 10.1037/prj0000352. [Epubahead of print] PubMed PMID: 30920257.