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8. Decisions about the use of psychotropic medication during pregnancy: a qualitative study

Author

Stevenson, Fiona, Hamilton, Sarah, Pinfold, Vanessa, Walker, Charlotte, Dare, Ceri R J, Kaur, Harminder, Lambley, Ruth, Szymczynska, Paulina, Nicolls, Vicky, and Petersen, Irene

Subjects
Adult, DECISION MAKING, Health Knowledge, Attitudes, Practice, Physician-Patient Relations, Psychotropic Drugs, Research, Mental Disorders, Prenatal Care, QUALITATIVE RESEARCH, HEALTH EXPERIENCES, Middle Aged, Health Services Accessibility, Pregnancy Complications, Mental Health, Patient Education as Topic, Pregnancy, Humans, MEDICINE TAKING, Female, Pregnant Women
Abstract

Objective To understand the perspectives of women with severe mental illness concerning the use of psychotropic medicines while pregnant. Design Interviews conducted by female peer researchers with personal experience of making or considering decisions about using psychotropic medicines in pregnancy, supported by professional researchers. Participants 12 women who had had a baby in the past 5 years and had taken antipsychotics or mood-stabilisers for severe mental illness within the 12-month period immediately prior to that pregnancy. Recruitment to the study was via peer networks and the women interviewed came from different regions of England. Setting Interviews were arranged in places where women felt comfortable and that accommodated their childcare needs including their home, local library and the research office. Results The views expressed demonstrated complex attempts to engage with decision-making about the use of psychotropic medicines in pregnancy. In nearly all cases, the women expressed the view that healthcare professionals had access to limited information leaving women to rely on experiential and common sense evidence when making decisions about medicine taking during pregnancy. Conclusions The findings complement existing work using electronic health records by providing explanations for the discontinuation of psychotropic medicines in pregnancy. Further work is necessary to understand health professionals’ perspectives on the provision of services and care to women with severe mental illness during pregnancy.

Published
2016

15. The role of family carers in the use of personal budgets by people with mental health problems.

Author

Hamilton, Sarah, Szymczynska, Paulina, Clewett, Naomi, Manthorpe, Jill, Tew, Jerry, Larsen, John, and Pinfold, Vanessa

Subjects
*PUBLIC welfare, *CAREGIVERS, *BLACK people, *BUDGET, *FAMILIES, *INTERVIEWING, *RESEARCH methodology, *MENTAL illness, *WHITE people, *DATA analysis software
Abstract

Personal budgets aim to increase choice and independence for people with social care needs but they remain underused by people with mental health problems compared to other disability groups. The use of personal budgets may impact on families in a variety of ways, both positive and negative. This paper draws on interviews, undertaken in 2012-2013 with 18 family carers and 12 mental health service users, that explored experiences of family involvement in accessing and managing personal budgets for a person with mental health-related social care needs. The sample was drawn from three sites across England, with additional carers being recruited via voluntary sector networks. Our findings show that for many people with severe mental health needs who lack motivation and confidence to negotiate access to personal budgets, carers may provide the necessary support to enable them to benefit from this form of social care support. We illustrate the role carers may play in initiating, pursuing and maximising the level of support available through personal budgets. However, some carers interviewed considered that personal budget funding was reduced because of practitioners' assumptions about carers' willingness and ability to provide support. We also report perceived tensions between family carers and practitioners around appropriate involvement in decision-making. The study findings have implications for local authorities, practitioners and family carers in supporting the involvement of family carers in support for people with severe mental health problems. [ABSTRACT FROM AUTHOR]

Published
2017
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