"Measuring the effect of the campaign"
Management summary - August 2005

Q2 Research and Consultancy

What is the Partners in Care Campaign?

• The Royal College of Psychiatrists and The Princess Royal Trust for Carers joined together to mount a campaign from January 2004 to June 2005 for carers of all ages to:
  • highlight the problems faced by carers of people with different mental health problems and learning disabilities
  • encourage true partnerships between carers, patients and professionals.

• "Carers are an integral part of the patient's support system... They are the ones with the day-to-day experience of the patient's condition and they carry the most intimate responsibility for the patient's welfare. The carer's voice in decision making about admission and discharge is ignored at everyone's peril and yet so often is." Dr. Mike Shooter, Past-President, Royal College of Psychiatrists.

• "The Partners in Care campaign helps to develop a dialogue on vital issues that affect the mental health and well-being of some of the most vulnerable people in Britain, including the carers themselves. We hope that the campaign will leave a legacy of better mutual understanding and improved care." Peter Tihanyi, Head of Policy, The Princess Royal Trust for Carers.

Highlights

Research Objectives and Method

To determine the effect of the Partners in Care campaign with:

• Psychiatrists - from a random sample of members of the Royal College of Psychiatrists
  Information Requesters - people who had specifically requested campaign materials (representatives from mental health teams, carers and carers organisations, both voluntary and statutory).
• Carers' Centres - from within The Princess Royal Trust for Carers Network of Carers' Centres. The person answering the questionnaire did so as a representative of their centre.
• Carers - individual people who care for someone with a mental health problem (including dementia) or learning disability.

To measure:

• Level of awareness and understanding of the campaign
• Impact and effectiveness
• Changes in perceived beliefs
• Changes in practices.

Main Findings

• The 'Partners in Care' campaign has generated significant awareness among the key audiences:
• Psychiatrists 42% of those who responded were aware of the campaign although 20% of these were not aware of any of the specific campaign materials or event. However, 50% of those aware of the campaign claim not to be involved personally with any of the specific elements.
• Carers 48% were aware of the campaign by name, and 66% of a component element of the campaign.
• Carers' Centres 100% of those who responded were of the campaign.
• Information Requesters 100% of those who responded were aware of the campaign.
• Awareness of the specific campaign leaflets/checklists was remarkably good (over 70%), although less so for psychiatrists (over 40%). There was less awareness of specific events, such as conferences and tutor days, because these were regional events.

Awareness of 'Partners in Care' Campaign:

Where Heard About

Encouragingly, most respondents had heard about the campaign through more than one source. Psychiatrists were likely to have heard about the campaign through College publications, and carers through The Princess Royal Trust for Carers, their local Carers' Centre or publicity/mailings. There was evidence that respondents would have appreciated the campaign having an even higher profile, as there was recognition that carers' issues really ought to be more publicly addressed.

Understanding of the Campaign

• Carers' Centres understood the campaign as having a more far-reaching role in terms of involving carers in the treatment, and aiding greater communication between the psychiatrist and the carer.
• Information Requesters were more likely to say the campaign was primarily about information giving.
• Psychiatrists felt the campaign related to communication with, and involvement of, carers in the treatment of the patient. But only 40% agree that it was about helping, them personally, in the treatment of their patients.

Usefulness, Appreciation and Effectiveness of Campaign

Base: Those finding the campaign very or quite helpful, amongst those aware and involved)

Note: +Small sample sizes

• The perceived helpfulness among those who were involved with each of the individual campaign elements (specific leaflets, checklists, roadshows etc.) was very high, with 80% or more (very/quite helpful), with the exception of psychiatrists among whom only 60% of those involved found them useful.

Psychiatrists

• There is some evidence that female psychiatrists were slightly more aware of the campaign than men. Psychiatrists appear to be less positive in their views of the campaign, compared with other audiences researched; they tend to feel the individual materials were ‘somewhat', but not ‘very' helpful. They did feel that that the most useful publications were the leaflet on confidentiality, the checklist for professionals, and some of the leaflets for carers on specific disorders.
• A third of psychiatrists felt that the campaign had caused an actual change in their day-to-day practice, with them giving carers more information, listening more, greater discussion of confidentiality issues, offering more help and support and some signposting pf carers to other sources of help.
• A quarter said that being more involved with carers had changed the way they assess their patients.
• In terms of the campaign's effect on them personally, the awareness of carers' issues increased in 6 out of 10 psychiatrists, but they had not seen the campaign as having a very significant effect; they felt it did not affect their understanding of confidentiality issues and young carers. Just over a fifth felt that the campaign had made them significantly more aware of the mandatory inclusion of carers and patients in psychiatric training.

Information Requesters

• Requesters had actively requested campaign materials so it was not surprising to find that they were using them. They asked for the materials for a variety of reasons:
  - 85% to give them to patients or carers
  - 63% to increase the knowledge of staff or colleagues
  - Nearly half to improve their own understanding.
• The perception of the usefulness of the campaign was very high, with many respondents particularly appreciating the checklists, website and leaflets
  - Over 60% believed the checklists and leaflets were very useful, and a third felt that they had gained a significantly better understanding from the booklet on confidentiality.
• 51% related the campaign to their new awareness of the mandatory inclusion of carers in the training of psychiatrists.
• They perceived the campaign as empowering the carer, and improving communication, and thus ameliorating the relationship between professionals, carers and patients.

Carers Centres

• Unlike the previous groups, the Carers Centres found the events and training days for tutors as useful as the leaflets and checklists (as they significantly enabled carers and patients to access relevant information). They greatly appreciated the booklet on confidentiality (one third believing that it had significantly increased their knowledge of confidentiality issues).
• They felt the overall effect of the campaign had been to offer increased help and support to carers.
• They also felt that there had been some improvement in relationships between carers and Carers Centres, and psychiatrists and Mental Health teams.

Carers

• Only 48% of carers were aware of the campaign by name. However, as nearly 80% were aware of one or more elements of the campaign, the true figure is much higher. Two thirds of carers were personally involved with at least one element and the most common ones were the carer's checklist and the booklet on confidentiality. Many were involved with one of the disorder leaflets because it was relevant to them and the person they cared for.
• Carers were very positive about virtually all elements of the campaign. However the young carers' materials were less highly rated, possibly because they were irrelevant to those caring for an adult patient. In addition, only 60% felt the training days for tutors were helpful. The website was seen as less useful than among the other groups made up of professionals, possibly because use of the Internet is less common among carers.
• Overall, carers felt the campaign had given them a better knowledge of the mental health system, and they had increased their understanding of confidentiality issues (91%). Most felt slightly more empowered to talk to health professionals and were involved in the management of the illness. Half felt their relationship with the Mental Health Team or psychiatrist had improved.
• The number of carers that responded was small, so some caution must be exercised with these findings.

Considerations for the Future

• As the Carers' Centres are involved in carers' issues full time, they felt more strongly that many elements of the campaign still needed more attention. These include:
  • More training on carers' issues and carers' information for mental health professionals.
  • Inclusion of carers' modules delivered by carers in the Continuing Professional Development of mental health professionals (over 90%).
  • Greater media publicity of carers' issues (80%).
• Individual carers agreed that the same areas (as above) needed to be addressed in the future, but with considerably less fervour than the carers' centres.
• Just over half of the psychiatrists and information requesters felt that there should be more training in carers' issues for mental health professionals, and just under half that there ought to be more carers' information for mental health professionals. Just under half of the information requesters felt that there ought to be inclusion of carers' modules in Continuing Professional Development and greater media publicity of carers' issues.
• Other areas which all audiences felt still needed some attention in the future (although with less passion) included:

• more detailed materials for carers

• more conferences/roadshow events on carers

• carers' leaflets tailored to black and minority ethnic groups.
• Interestingly, 42% of information requesters, 19% of psychiatrists and 17% of carers felt that none of the above needed more attention.

Conclusions

• The overall aims of the 'Partners in Care Campaign" appear to have been achieved, and achieved well.
• Overall, psychiatrists rated the usefulness of different elements of the campaign much lower than the other three groups, but their ratings were still comparatively high, with over two thirds rating all elements of the campaign as useful and 86% and 87% respectively rating the booklet on confidentiality and the specific mental health disorders leaflets as useful.
• However, one of the aims of the campaign was to make a real breakthrough in the understanding of confidentiality issues. Some progress had been made on this, but perhaps not as much as hoped, though carers centres and requesters were more positive about progress than individual carers and psychiatrists.
• To end with some comments:

'It is a very worthwhile cause although I feel it will take some time for the changes to be noticed to any great extent. We will continue to support the 'Partners in Care Campaign" for as long as it takes."

'I've found that psychiatrists involved with my Alzheimer's parents were superb and obviously applying the principles of Partners in Care; I felt really well supported, informed and listened to by this service."

'A very welcome initiative."

'Have followed it with interest and welcome it greatly."

'It is very laudable. I think it needs our employers to provide more time for us to spend with carers."

"Encouraging to see the Royal Society publicly acknowledge carers and the issues that they face. It was obvious from the high quality of the leaflets that a lot of carers were consulted."

• And the final word: 'I feel that the campaign has raised an awareness of carer issues with mental health professionals but would like to see it continue and grow so that carers are not allowed to drop off the agenda."