Family involvement and the treatment of Depression

There was an interesting study that came out this month in Psychiatr Serv. 2013 Feb 1. It was a study of Veterans who were being treated for Depression. It confirms what I have believed all along, that is to get the families involved in the treatment of those suffering with Depression.

In this study after questioning patients, it was found that 64% of Veterans did not have family involvement and the rest did. Among those that did it was found that the patients had better social support and medication adherence. This group had much better outcomes than the those that did not have family involvement.

In my practice I have always believed that a patient needs involvement of his family. Not only can family provide support and make sure that a patient takes their medications, a family can provide valuable feedback to the mental health practitioner about how the patient is doing. The family may notice side effects like irritability or anger or lack of social activity of which the patient may not be cognizant. It is common in mental illness for a patient to not have good insight regarding her illness. I often tell my patient with poor insight to ask his/her family how they think he is doing

Another reason I like to involve the family is that I like to educate them about the nature of mental illness and how to best help. Family may have wrong information about mental illness. Sometimes family may believe the patient has a character flaw that would be cured if “he would only try harder”. Proper psychoeducation can help the family be of the best help to the patient.
Depression is one of the top causes of disability benefits in this country. It a serious problem for all of us. I would like to see mental health practitioners include in the care of their patients the participation of families.

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