Community-based group psychoeducation for caregivers to individuals with mental illness: What works, for whom, and under what circumstances?

Introduction. Despite being recognized as a key strategy at political and strategic levels, cross-sectoral partnerships in the health domain remains largely unexplored, with limited evidence available on how regions and civil society organizations (CSO’s) can effectively combine expertise, resources, and innovation to achieve positive change for caregivers and their ill relatives.
Using a collaboratively developed six session community-based group psychoeducational program as a case, the purpose of this initial realist evaluation is to identify key context features and underlying mechanisms through which the program (and comparable programs) may promote positive outcomes in caregivers to persons with mental illness—or, conversely, produce adverse, unintended outcomes. As such, this study relates to the theme Patients and Caregivers in Psychiatric Research and Practice.
Methods. Data is collected simultaneously but analyzed sequentially, and approaches are integrated at methods and reporting levels. Using retroductive theorizing, we analyze multiple data sources (participant and instructor surveys and interviews) to uncover context-mechanism-outcome configurations (CMOCs). Following a thematic approach informed by realist epistemology, we code transcripts and open-ended text fields for contexts, mechanisms, and outcomes and trace the interconnections, eliciting CMOCs that are later collated into themes. In the next analytical phase, we explore whether these CMOCs can also explain broader regularities by investigating outcome patterns.
Results. We present preliminary findings based on 17 participant interviews collected from October 2023 to April 2024, providing the initial evidence on how this program works, for whom, and under what circumstances.
Discussion. Program effectiveness and implementation success are context dependent. By bringing the inner workings of a community-based psychoeducational program for caregivers to light, our findings has the potential to inform further intervention refinement, later phases of evaluation, and future policy and practice.