Does face-to-face psychoeducation help parents of people with severe mental illness?

Key messages

• Psychoeducation (i.e. face-to-face teaching about a health condition by a professional) for parents of people with severe mental illness may improve the parents’ psychosocial well-being (i.e. their mental, emotional, and social health) in the short and medium term, and may improve their anxiety in the short term.

• The evidence is very uncertain about the effect of psychoeducation on parents' quality of life and their experience of providing care to their children.

• The available evidence is limited. More research is needed to understand better how psychoeducation can support the parents of people with severe mental illness.

How are parents affected by their child's severe mental illness?

Severe mental illness is a mental, behavioural or emotional condition that seriously affects how a person functions in daily life. It can significantly limit a person's ability to work, care for themselves, maintain relationships or participate in other important activities. Severe mental illness includes conditions like schizophrenia, bipolar disorder and major depression. These illnesses last a long time and make everyday life very difficult. Parents often take care of their sons or daughters with severe mental illness, which can cause the parents a lot of stress, worry and sadness. Parents may also face health problems and feel isolated or overwhelmed.

What is psychoeducation?

Psychoeducation is when doctors, nurses, or mental health professionals teach people with severe mental illness and their family members (like parents, spouses or siblings) about the condition. This teaching covers topics such as what symptoms to expect, how treatments work, the likely course of the illness and how to manage day-to-day care. Psychoeducation can help parents feel more confident and better able to handle the challenges of caring for their child, regardless of the child's age. Psychoeducation often includes group sessions with other parents, where participants get information, share experiences and receive support. In this review, we focused on psychoeducation delivered in person rather than online.

What did we want to find out?

We wanted to know if giving parents support through face-to-face psychoeducation provided by health professionals or trained facilitators helps the parents cope better when their son or daughter has a severe mental illness. Other forms of caregiver support were not included.

We compared psychoeducation versus 'inactive' interventions (e.g. no treatment, waiting list, usual care) or active treatments (e.g. medication). The aspects of the parents' experience that we were most interested in measuring (i.e. our 'critical outcomes') were 'short-term clinically important change' in 'psychosocial well-being' (which is mental, emotional, and social health), 'short-term clinically important change' in quality of life, and 'adverse events' (negative side effects).

What did we do?

We looked for studies (of a type known as 'randomised controlled trials') that measured the effects of face-to-face psychoeducation for parents of people with severe mental illness. We combined the studies' results and judged the reliability of the evidence.

What did we find?

We identified five studies, which involved 304 participants. Most participants were women over 45 years old, and the individuals with severe mental illness mainly had schizophrenia. The studies were conducted in Asia (Iran, Indonesia, Japan and China) and published between 2006 and 2020. The psychoeducational interventions lasted 3 to 12 weeks, with 4 to 12 sessions.

The studies only reported average scores at the end of the intervention; they did not report results as 'any change' or 'clinically important change'. None of the studies reported adverse events. Therefore, no data were available for our critical outcomes. However, the studies measured some of our other outcomes of interest.

Main results

Compared to inactive intervention, psychoeducation for parents of people with severe mental illness:

• may result in a large improvement in parents' psychosocial well-being in the short term (3 studies, 150 participants);

• may result in a large improvement in parents' psychosocial well-being in the medium term (1 study, 37 participants);

• has very uncertain effects on parents' quality of life in the short term (1 study, 40 participants);

• may result in a large improvement in parents' anxiety in the short term (1 study, 73 participants); and

• has very uncertain effects on parents' experience of providing care to their children in the short term (1 study, 36 participants).

Compared to other active interventions (not including medication), the effects of psychoeducation with parents of children with severe mental illness on parents' psychosocial well-being in the short and medium term are very uncertain (1 study, 37 participants).

There were no studies comparing psychoeducation to medication.

What are the limitations of the evidence?

This review assessed face-to-face psychoeducation for parents of individuals with severe mental illness. Evidence was limited, as only five small studies from Asia reported short-term effects. Most participants were mothers of people with schizophrenia; fathers were under-represented. Long-term outcomes and adverse events were not reported. The interventions and comparisons varied, and key participant information was often missing. These limitations weaken the review’s conclusions and highlight the need for larger, well-designed studies.

How up-to-date is this evidence?

The evidence is based on searches carried out up to 11 November 2024.