Family involvement in the lives and treatment of youth with first-episode psychosis in Chennai, India and Montreal, Canada: A mixed-methods study

Poster A74, Monday, October 8, 11:30 am - 1:00 pm, Essex Ballroom

Srividya N. Iyer1,2,3, Megan Pope2,3, Padmavati Ramachandran4, Ashok K. Malla1,2,3; 1McGill University, 2Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), 3Douglas Mental Health University Institute, 4Schizophrenia Research Foundation, Chennai, India

Much remains unknown about what underpins the variations in the outcomes of psychosis across different sociocultural contexts. One factor that may contribute to better outcomes, particularly in contexts like India, may be the extent and types of family involvement. We conducted a mixed-methods study to examine family factors in first-episode psychosis (FEP) in Chennai, India and Montreal, Canada. In the quantitative arm, FEP patients, families, and clinicians at both sites completed questionnaires assessing family involvement and the factors influencing it. Across sites, most families were involved in treatment. However, significantly more patients in Chennai reported family involvement in treatment. Chennai families were likelier to accompany patients to appointments and give medication and appointment reminders. Stakeholders across sites also significantly differed in terms of their trust in healthcare systems and providers; insight; and attributions of responsibility for recovery. In the qualitative arm, focus groups with families at both sites explored definitions/views of "family", the perceived role of families, and the morality/motivations underlying caregiving. Families “being there” for their ill relative was an important theme across sites. While Chennai families largely described their involvement as executing treatment providers' recommendations, Montreal families described their role as complementary to, but distinct from, the treatment team's. Different moral languages around caregiving emerged, with greater emphasis on prescriptive roles and duty in Chennai and personal choice in Montreal. These findings highlight the role families play in supporting a loved one with FEP and yield insights on how sociocultural contexts influence family involvement and outcomes in psychosis.

Topic Area: First Episode Psychosis

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