Who Should Be Responsible For Supporting Individuals With Mental Health Problems? Views of Multiple Stakeholders in Montréal, Canada and Chennai, India.
Background: In both Canada and India, individuals with mental health problems, particularly those with serious mental illnesses like first-episode psychosis (FEP), have many inadequately met needs for support. Relevant stakeholders’ perceptions of who should be responsible for meeting these needs remain unexplored; yet, varying perceptions could contribute to this group’s unmet support needs.
Aims/Objectives: Our objectives were to explore and compare the views of youth with FEP, their families, and treatment providers in Montreal, Canada and Chennai, India as to who should be responsible for supporting individuals with mental health problems and to discover what responsibilities they ascribe to these parties.
Methods: Using a qualitative descriptive design, 11 focus groups were conducted with service users, families, and treatment providers (psychiatrists and case managers) at two similar early psychosis intervention programs in Montreal and Chennai. Focus group discussions were audiotaped and transcribed verbatim. Thematic analysis was used to identify recurring themes.
Results: Across sites, individuals with mental illnesses, their families, treatment providers/mental health institutions, and the government were assigned the most important responsibilities. In Montreal, individuals with mental illnesses were seen to play a much more fundamental role, while the roles of families and NGOs were more strongly emphasized in Chennai. A wide range of roles and responsibilities were assigned to these groups (e.g., raising awareness about mental health problems; advocating for the needs of individuals with mental illnesses; being involved in mental health policy/ decision-making, etc.), with several responsibilities ascribed to various stakeholder groups.
Discussion/Implications: Our findings suggest that various stakeholder groups with different levels of influence, from individuals with mental illnesses themselves to the government and NGOs, can and should collectively assume certain responsibilities. Differing expectations of youth with mental illnesses, views of the role of the family, and healthcare systems across sociocultural contexts likely contribute to the varying emphases on the responsibilities of individuals with mental health problems, families, and NGOs across sites. Nevertheless, many views are shared by different stakeholders across contexts. The implications of this study for shaping mental health policies and services in Montreal and Chennai will be discussed.