Prevalence and Influencing Factors of Receiving Regular Interviews for Patients with Severe Mental Disorders in Communities
Patients with severe mental disorders pose a serious threat to social stability due to lack of insight and high recurrence and disability rates. Therefore, it is essential to conduct regular interviews with these patients to better evaluate their conditions comprehensively, so as to timely deliver appropriate interventions, thereby improving the level of severe mental disorder management.
To explore the prevalence of receiving regular interviews and associated factors in patients with severe mental disorders in the community, providing information for improving the quality of severe mental disorder management via interviews.
Basic and follow-up management data of Wuxi severe mental disorder patients with files created as of 2019 were collected from Jiangsu Severe Mental Disorder Patients Management System during October to December 2020. The prevalence of these patients receiving regular interviews was analyzed, and associated factors were examined by Logistic regression analysis.
A total of 27 778 samples were included, with a prevalence of receiving regular interviews of 81.08% (22 523/27 778) . Logistic regression analysis showed that non-local hukou〔OR (95%CI) =0.704 (0.640, 0.775) 〕, ≤44 years old〔OR (95%CI) =0.522 (0.472, 0.578) 〕, education level〔high school/secondary vocational school: OR (95%CI) =0.493 (0.446, 0.545) and junior college: OR (95%CI) =0.470 (0.415, 0.532) 〕, full-time employment〔OR (95%CI) =0.715 (0.668, 0.766) 〕, unmarried〔OR (95%CI) =0.746 (0.665, 0.838) 〕, non-poor〔OR (95%CI) =0.587 (0.517, 0.666) 〕, no antipsychotic treatment〔OR (95%CI) =0.491 (0.440, 0.548) 〕, 0-10-year medication treatment〔OR (95%CI) =0.881 (0.778, 0.998) 〕, receiving no management subsidy〔OR (95%CI) =0.807 (0.704, 0.926) 〕, not participating in community rehabilitation services〔OR (95%CI) =0.844 (0.716, 0.996) 〕were barriers to receive regular interviews (P<0.05) .
The prevalence of receiving regular interviews in Wuxi severe mental disorder patients needs to be improved. And recommended interventions include developing favorable policies for conducting regular interviews, carrying out relevant heath publicity and education, reducing the stigma of mental disorders, improving the awareness of mental disorders, and increasing social supports, with special focus on patients who are non-locals, aged≤44 years old, employed full-time, unmarried, non-poor, have high school or above education, have 0-10-year medication treatment but no antipsychotic treatment, have no subsidy for management, and do not participate in community rehabilitation services.
Social Support and Its Associated Factors among Family Caregivers of Persons with Severe Mental Illness
Understanding the characteristics of social support of family caregivers of persons with severe mental illness, and identifying the associated factors are the preconditions of developing evidence-based intervention strategies to improve social support for this vulnerable group. Among the limited studies concerned family caregivers of patients with severe mental illness, the majority focused on their own individual factors, leaving patient- and family-level associated factors largely under-investigated.
To explore the social support and associated factors among family caregivers of persons with severe mental illness, providing a theoretical basis for the development of evidence-based strategies to enhance the level of social support in this group.
A cross-sectional design was used. Multistage sampling was used to select three tertiary grade A mental health organizations from three cities located in eastern, central, and western China, respectively (one was extracted from each city) , then from which, family caregivers of persons with severe mental illness who received outpatient services between August 2018 and December 2019 were selected, and their family caregivers (n=1 001) were recruited as participants. A self-administered survey was conducted in the family caregivers using a questionnaire〔consisting of two parts: demographics and the Social Support Rating Scale (SSRS) 〕compiled by our research team to collect their individual and family information and social support status, as well as patients' (the care receivers') information. Multiple linear regression was employed to identify associated factors for the total score and domain scores of SSRS.
The mean total score of SSRS for the family caregivers was (34.4±9.1) . And the mean score for its three domains, subjective social support, objective social support, and social support utilization was (20.3±6.2) , (7.5±2.8) , (6.6±2.3) , respectively. The type of occupation of the caregivers, and the type of mental diseases and stability of symptoms of patients cared by them, as well as mean household monthly income per person were associated with the total score of SSRS for the family caregivers (P<0.05) . Furthermore, marital status and religious belief of caregivers, as well as their relationship with the patients cared by them also affected the total score of SSRS of the family caregivers (P<0.05) . As for the scores of domains of SSRS, they were found to be influenced by the type of occupation of the caregivers, the type of mental diseases and stability of symptoms of patients cared by them, and mean household monthly income per person (P<0.05) . Besides that, gender, marital status, living area (rural or urban) , and religious belief of caregivers, their relationship with patients cared by them, and the amount of family subsidies also affected the score of subjective social support of family caregivers (P<0.05) ; the amount of family subsidies also affected the objective social support score of family caregivers (P<0.05) ; gender and living area (rural or urban) of caregivers, and the amount of family subsidies also affected the score of social support utilization of family caregivers (P<0.05) .
Family caregivers of patients with severe mental illness possessed a low level of social support, had limited access to social support, perceived insufficient support, and used social support rather insufficiently. There were differences in factors associated with their overall social support and domain-specific social support. More attention should be paid to family caregivers who are single, unemployed, have low household monthly income per person, care for patients with schizophrenia or unstable mental symptoms, and provide them with support in accordance with their needs, by which their care burden can be alleviated, and their physical and mental health will be improved eventually.
