Services to families of adults with schizophrenia: From treatment recommendations to dissemination

Objective: Data front the Schizophrenia Patient Outcomes Research Team proj ect were examined to determine the extent to which families of adults with schizophrenia receive sen ices and whether training staff in the provision of family services increases service availability. Methods: For patients wi th a diagnosis of schizophrenia, paid claims for family therapy were identi fied in 1991 in a nationally representative sample of Medicare data and one state's Medicaid data. In a field study in two states, 530 patients were a sked about scn ices received by their families. A quasiexperimental dissemi nation of a family intervention was done at nine agencies; staff at four ag encies received a standard didactic presentation, and staff at five receive d that standard presentation paired with intensive training. Results: In th e representative national Medicare sample of 15,425 persons with schizophre nia, .7 percent (N=108) had an outpatient claim for family therapy. This fi gure was 7.1 percent in the Medicaid sample of 5,393 persons with schizophr enia in one state. Of the 530 patients in the field study who reported hati ng contact with their families, 159 (30 percent) reported that their famili es had received information, advice, or support about their illness, and 40 (8 percent) responded that their families had attended an educational or s upport program. At the four agencies where staff received only didactic tra ining, no changes in family services were found after one year. Three of th e five agencies where staff participated in intensive training enhanced the ir family services. Conclusions: A minority of families of persons with sch izophrenia receive information about the illness from providers. Implementa tion of model family interventions is possible with considerable technical assistance. A gap exists between best practices and standard practices for families of persons with schizophrenia.