T186. IMPACT OF A STRUCTURED VALIDATED FAMILY PSYCHOEDUCATIONAL PROGRAM (PROFAMILLE) ON MENTAL HEALTH CARE OF PEOPLE WITH SCHIZOPHRENIA SPECTRUM DISORDERS: PRELIMINARY RESULTS
Authors: Bralet Marie-Cécile ,   Cocrimasatrié CRISALID Team, Willard Dominique , Hodé Yann , Kremers Laura 
Published: May 2020

Abstract

Background
Psychoeducational programs for caregivers are essential to support the rehabilitation process and recovery in patients with severe psychiatric disorders. PROFAMILLE is a French psychoeducational program first developed in 1987 in Quebec for caregivers of people suffering from schizophrenia spectrum disorders. Its efficacy has already been proven: increased mental well-being of caregivers, 50 % less hospitalisations and improvement of the rehabilitation process of their ill relatives. Nowadays, this program exists in 6 different countries. While psychosocial rehabilitation programs should be proposed to all patients with schizophrenia spectrum disorders, the access to them seems to be limited. Moreover, the adherence rate to mental health care is low, partially because of lack of motivation and insight. We postulate that proposing a psychoeducational intervention to caregivers with a validated psychoeducational program such as PROFAMILLE, could improve commitment of patients to their mental health care and also to more specific psychosocial rehabilitation interventions (psychoeducation, cognitive remediation, social skills, cognitive behavioural therapy, social and employment supports). This present study aims to analyse the effect of PROFAMILLE program on the quality of mental healthcare given to the ill relatives of participants.

Methods
We conducted in September 2019 a retrospective observational study in a Cognitive Remediation and Psychosocial Rehabilitation Department, CRISALID (area Hauts de France, France) which proposes PROFAMILLE program since 2010. PROFAMILLE is a groupal intervention program structured in two modules including first 14 sessions then 4 sessions with animators and 4 sessions without animators. There are home exercises between the sessions. All the caregivers are assessed with several socio-demographic, clinical and psychological tools during all the program. We used patient’s on-line medical files and caregivers phone calls to collect following data: first contact with the mental health care department, next contacts with mental health care departments, improvement of the quality of mental health care, participation to a cognitive remediation and psychosocial rehabilitation program.

Results
94 caregivers who participated to the whole program were included (PROFAMILLE program between 2012 and 2019). We obtained data about ill relatives of 81 caregivers (86 %). Relatives report the following data: 14 % (11) patients were able to benefit for the first time health mental care after their caregiver followed the program. 57 % (25) of the already followed up patients (44) improved the quality of their health mental care. 44, 5 % (36) of the patients were participated to the integrative cognitive remediation and psychosocial rehabilitation program in CRISALID; 12, 4% (10/36) of the patients entered to this cognitive remediation and psychosocial rehabilitation program after their caregiver followed the PROFAMILLE program.

Discussion
These first preliminary results are interesting in several aspects of the mental health care, mostly concerning the first access to mental health care and the improvement of its quality, including the participation to cognitive and psychosocial rehabilitation programs. Thus, these results confirm the previous findings regarding PROFAMILLE Program: this program not only benefits directly to the caregivers, but also to their ill relatives by improving the quality and the access to mental health care. These results must be confirmed including more participants and a control group (without PROFAMILLE program). In conclusion, a validated psychoeducational program for caregivers represents an important stake in the rehabilitation process for people suffering from schizophrenia spectrum disorders on their way to recovery; these programs should be systematically implemented in mental health care.