Families – Privileged Partners and Living Resources in Social and Mental Health Care

This special issue of World Social Psychiatry on “Families, Family Interventions, and Social Psychiatry” brings together several communities of theory and practice under the rubric of social psychiatry. The first community is the work with families and their members suffering from mental illness in self-help groups and community support represented by the WASP Section on Family Intervention Programs with Section Chair Saïd Fattah and Section Secretary Yann Hodé, both in France.[1,2] This WASP section celebrated its 20th Anniversary at a meeting in Marrakesh, Morocco, in 2019 with over 300 participants from Europe and North Africa. The second community is family therapy which was first developed in the United States and is strongly associated with the community mental health movement and social psychiatry.[3] After spreading throughout the Western world, first in psychiatry, then among all the helping professions, family therapy, as our feature interview with Maurizio Andolfi demonstrates, is now practiced everywhere. This community is represented here by two experienced leaders in family therapy – Olga Garcia Falceto in Southern Brazil[4,5] and Vincenzo Di Nicola in French Canada.[6] The third community is social psychiatry itself, which grew and evolved hand in hand with the community mental health movement.[3,7] This was essentially a two-stroke engine: deinstitutionalization – the closing down of psychiatric asylums – was the first stroke and building alternative community resources for the mentally ill was the other.[8] Families and family therapy along with all the other approaches to supporting the mentally ill in their communities was an intimate partner of the community mental health movement. This intimate relationship between family therapy and social psychiatry is clearly articulated in a feature of World Social Psychiatry called “Luminaries in Social Psychiatry” with a spotlight on a world leader of family therapy today, Maurizio Andolfi in dialogue with Vincenzo Di Nicola. Finally, social psychiatry is represented by all four editors of this special issue being deeply involved with WASP: Saïd Fattah and Yann Hodé of the WASP Family Intervention Programs Section and Olga Garcia Falceto as Chair of the newly-formed WASP Women’s Section, and Vincenzo Di Nicola as WASP President. Those of us who work with children and youth have long understood the importance of family, community, and cultural and social contexts.[9,10] As our colleagues stated in their editorial to a previous special issue of this journal on child and adolescent psychiatry, “All along its short history,” child and adolescent psychiatry and mental health, “recognized from early on how family and community strengths and supports are essential components of the healing environment for effective treatment and have incorporated those in some of our most advanced treatment models, like community systems of care.”[10] This recognition of the sociocultural context of child development and family life is now firmly supported by the WHO Study on the Social Determinants of Health[11] and the pioneering work on adverse childhood experiences.[12] This special issue brings together these three communities of practice with contributions from around the world. Our contributors range from Mexico and Brazil to Morocco and France, including family and patient peer caregivers, and from Canada to Sweden, and finally, further East to Japan. From the francophone world of Morocco and France, we have these original pioneering contributions: Special Editorial: “Are we obliged to involve the family in the care of people suffering from psychiatric disorders?” by Saïd Fattah, a Moroccan psychiatrist working in Mulhouse, France “How to become an efficient family caregiver for a loved one with schizophrenia?” by Jean-Michel Piat and Saïd Fattah, from France Fatah Senadla and Saïd Fattah from Mulhouse, France, both with origins in the Maghreb: “The Peer Health Mediator, a new recovery-oriented paradigm” Yann Hodé, a Frenchman from Châtenois, France: “With just one family member and without the patient, can multifamily psychoeducation produce markedly positive overall effects on the whole family?” “Impact of a Family Educational Program on Moroccan and French caregivers of patients with schizophrenia: A comparative analysis of prevalence and severity of depressive symptoms” by Wydad Hikmat and her associates from Morocco. From Japan, we have a leader in social work and family therapy: “Working with Families in an Aging Society” by Tazuko Shibusawa from Tokyo, Japan, presents global aging trends and discusses the importance of supporting families based on a relational and multisystemic framework. Latin and South America are represented by Raúl Medina from Mexico and Olga Garcia Falceto and her associates from Southern Brazil: “Rethinking Psychiatry: Toward a third-order ecology for a more humane and contextual clinical practice” by Raúl Medina Centeno, Guadalajara, Mexico, is a critique of psychiatry and family therapy that does not take into account the larger social system in the origin and maintenance of symptoms and offers “third-order ecology” as a new model Olga Garcia Falceto and her group write about the experience of reinventing communication with the patient’s families during the COVID-19 pandemic in an intensive care unit in Porto Alegre in Southern Brazil José Ovidio Copstein Waldemar writes about a “Program of Mindfulness and Social Emotional Learning as part of a systemic multidimensional approach to reduce violence in Brazilian cities.” Two special features conclude this issue: Maurizio Andolfi, who straddles Italy and Australia, is this special issue’s “luminary” of family therapy and social psychiatry in a “relational dialogue” with Vincenzo Di Nicola.[13] And finally, Saïd Fattah reviews a book of poetry called Attractions by Wafa Ibrahimi, a Moroccan woman who uses poetry to express and transcend her mental illness. Fattah’s review offers a brief glimpse into her suffering and recovery through her poetry.

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