National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; and Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK
National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK; and Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK; and Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
Elizabeth Monaghan
National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
Jonathan Smith
National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
Stephen Barlow
National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK
Roger T. Webb
National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK; and Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
National Institute for Health and Care Research (NIHR) Greater Manchester Patient Safety Translational Research Centre, University of Manchester, Manchester, UK; Centre for Mental Health and Safety, School of Health Sciences, University of Manchester, Manchester, UK; Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; and Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
Background Family involvement has been identified as a key aspect of clinical practice that may help to prevent suicide. Aims To investigate how families can be effectively involved in supporting a patient accessing crisis mental health services. Method A multi-site ethnographic investigation was undertaken with two crisis resolution home treatment teams in England. Data included 27 observations of clinical practice and interviews with 6 patients, 4 family members, and 13 healthcare professionals. Data were analysed using framework analysis. Results Three overarching themes described how families and carers are involved in mental healthcare. Families played a key role in keeping patients safe by reducing access to means of self-harm. They also provided useful contextual information to healthcare professionals delivering the service. However, delivering a home-based service can be challenging in the absence of a supportive family environment or because of practical problems such as the lack of suitable private spaces within the home. At an organisational level, service design and delivery can be adjusted to promote family involvement. Conclusions Findings from this study indicate that better communication and dissemination of safety and care plans, shared learning, signposting to carer groups and support for carers may facilitate better family involvement. Organisationally, offering flexible appointment times and alternative spaces for appointments may help improve services for patients.
