Skip to main content

Table 2 Scheme of barriers –addressed by persons with SMI, families and professionals

From: Worlds apart? A scoping review addressing different stakeholder perspectives on barriers to family involvement in the care for persons with severe mental illness

Types of barriers →
Addressed by stakeholder perspectives   Barriers related to persons with SMI Barriers related to the family Barriers related to the professional Barriers related to the organization of care Barriers related to the culture- paradigm
Persons with SMI Privacy concerns (18–21) Low expectations of beneficence (18) Preventing own stress (21, 22) Concerns about burdening the family (18, 19, 21)
Not getting along with the family (18)
Unavailability of families (18, 23) Loss of role in families (21–23) Misunderstandings of families regarding illness/treatment (23, 24) Professionals do not offer the opportunity (18) Disrespect (25) Difficulty matching the families’ schedules (18) Stigma (24, 25) Language (25)
Family Dishonesty of clients (24) Mental illness (22) Protective attitudes (21) Discomfort regarding fellow families (26) Low expectations of effect (26, 27)
Responsibilities of/in families (21, 26) Roles in families (21) Need for privacy (28)
Lack of recognition (24, 25, 28–31) Strong emphasis on confidentiality (24, 29, 31)
Imposed responsibilities (31) Professionals knows best (22, 28)
Lack of resources (24, 28) Stigma (24, 25, 32) Racial issues (24) Pre-existing worldviews (22)
Profes-sionals Confidentiality (21, 22, 35, 36, 39) Lack of consent (35, 39–42) Mental illness (37, 43, 44) Lack of ‘suitable’ families (19, 34, 37, 41, 43, 45–47) Families not wanting to get involved (24, 40–42, 47) Difficult relationship between person with SMI and the family (37, 43, 48) Over-involvement of families (43, 49) Lack of competence in families (26, 33, 41, 49) Families’ attitudes (43) Burden for families (25, 40, 41) Power issues (22)Different cultural backgrounds of families (25, 49) Low expectations of effect (33, 34)Motivating persons with SMI (35) Lack of competence (35–37) Lack of experience (21, 24, 26, 38) Sustainability of training (52) Inter-professional struggles (36) Lack of time (19, 21, 22, 33, 34, 36, 40, 41, 44–46, 50) Logistical barriers (24–26, 36, 38, 40, 41, 45, 46) Priority settings (33, 34, 36, 43–45) Background expertise (34) Medical paradigm (22, 43, 50) Management attitudes (24, 40, 46) Stigma (25, 33, 49) Past experiences (43) Language (22)