Family-Based Psychosocial Interventions for Severe Mental Illness: Social Barriers and Policy Implications

Severe mental illnesses (SMI) such as schizophrenia, major depressive disorder, and bipolar disorder are prevalent, debilitating, and chronic conditions that come with significant costs to families, public health systems, and communities. Research indicates that emotional qualities within the family environment of the person with SMI (e.g., whether members are highly supportive, critical, or emotionally overinvolved) can either protect against or increase the risk for psychiatric relapse. Dovetailing this work is research indicating that family-based psychosocial interventions, which can increase family functioning through psychoeducation and skill building, can promote positive outcomes for individuals with SMI. Unfortunately, social barriers such as financial strain, inaccessibility of specialized care, stigma, and social marginalization may impede a patient's or family's ability to initiate and/or continue family services. We propose that improving treatment engagement requires a combination of state and federal policy initiatives supporting community resources, integrated health care, and partnerships with national organizations.