It takes two to tango: Explaining caregiver attitudes toward seriously mentally ill persons

Previous research has demonstrated that the caregivers of seriously mentally ill (SMI) persons influence the course of illness and outcomes of SMI persons. This study examined the variation in caregiver attitudes and the specificity of those attitudes. In addition, the relationship between caregiver attitudes and caregiver characteristics, as well as the relationship between caregiver attitudes and SMI characteristics were examined. Information concerning the attitudes, personality, burden of care, and perceptions of control was collected from 46 staff who worked in nine group homes for SMI persons. Information concerning the psychiatric functioning, social functioning, and problematic behaviors of the 44 residents who lived the in the group homes was collected. There were positive associations between staff's attitudes toward residents, staffs attitudes toward SMI persons, and staffs attitudes toward non-SMI persons. Staffs mean attitude toward residents and SMI persons was more negative than was the mean attitude toward their confidantes. Both staff and residents made significant contributions to the variation in caregiver attitudes and there appear to be important individual differences in both staff and residents that contribute to this variation. Staff who had warm personalities, who had confident personalities, and/or perceived less burden in caring for SMI persons also had positive attitudes toward residents. If residents exhibited more psychiatric symptoms, more hostile, illegal, or rule-breaking behavior, staff were likely to perceive them negatively and have negative attitudes toward them. If, however, residents exhibited higher social fanctioning, staff had positive attitudes toward them. This research demonstrates the importance of selecting staff caregivers who have qualities that are associated with positive attitudes toward SMI persons. This study also demonstrates the need to train and educate staff caregivers about how symptoms, behaviors and functioning may be related to their disorder and may not be within SMI persons' control. In addition, because specific symptoms and behaviors appear to elicit negative caregiver attitudes, it may useful to target these symptoms and behaviors for treatment so as to promote positive attitudes and relationships between SMI persons and their caregivers.