1. Template Presentation
This presentation has been developed to share key findings of Keeping Care Complete, an international survey of family caregivers of individuals living with schizophrenia, schizoaffective disorder and bipolar disorder. It was originally developed for a media briefing, but may also be used to educate healthcare professionals, legislators, advocates or families living with mental illness. The presentation should take approximately 45 minutes to complete but could run longer at the discretion of the moderator and presenters.

2. Welcome and Introduction
[Insert name and affiliation of presenter]
This introduction should be given by an individual who will serve as a moderator for the entire session. Ideally, this would be a representative of a local caregiver association, who would introduce himself/herself before outlining the presentation goals and agenda.

3. Today’s goal
Heighten awareness of the perspective of family caregivers
Increase understanding of how serious mental illnesses affect the entire family
Communicate the hopes, frustrations and experiences of caregivers with regard to their loved one’s mental health treatment
Recommended speaker: Moderator
This portion of presentation should briefly outline the overall goal of the presentation.

4. Today’s agenda Introduction and overview [local advocate - moderator]
WFMH mission/role of family caregiver [WFMH representative]
Caregiver survey findings [local advocate - moderator]
Family caregiver/advocate story [local caregiver]
Contexualizing the findings [psychiatrist]
Question & Answer session   [local advocate - moderator]
Closing remarks [local advocate - moderator]
Recommended speaker: Moderator
This portion of presentation should briefly outline the agenda and acknowledge the presentation participants. After explaining the agenda, the speaker should introduce the next speaker: WFMH representative.

5. Insert name of WFMH representative
Recommended speaker: Representative of WFMH
Ideally, this section of the presentation would be given by a WFMH representative who could speak about the WFMH mission and the relationship of the survey to that mission. If a WFMH representative is not available, slides referring to WFMH may be truncated to include only a brief overview of the work of WFMH and its enthusiasm for the survey.

6. Who we are
WFMH is an international NGO governed by an elected volunteer board of directors from 17 countries
WFMH represents all mental health professional disciplines, consumers/patients, family members/caregivers and citizen advocates from more than 100 countries
WFMH’s World Mental Health Day network is comprised of 4000 organizations and individuals in 180 countries
WFMH has NGO consultative status with the United Nations, World Health Organization, UNESCO, International Labor Office and the World Bank
Recommended speaker: Representative of WFMH
Ideally, this section of the presentation would be given by a WFMH representative who could speak about the WFMH mission and the relationship of the survey to that mission. If a WFMH representative is not available, slides referring to WFMH may be truncated to include only a brief overview of the work of WFMH and how the survey connects to its mission.

7. World Federation for Mental Health mission
Promote the advancement of mental health awareness, prevention, advocacy and best practice recovery
Improve the care, treatment and recovery of people with mental disorders
Heighten public awareness about the importance of mental health through gaining understanding and improving attitudes
Recommended speaker: Representative of WFMH
Ideally, this section of the presentation would be given by a WFMH representative who could speak about the WFMH mission and the relationship of the survey to that mission. If a WFMH representative is not available, slides referring to WFMH may be truncated to include only a brief overview of the work of WFMH and how the survey connects to its mission.

8. Keeping Care Complete
In 2005, in partnership with Eli Lilly, WFMH embarked on Keeping Care Complete, an extensive survey that captured the perspectives of close to 1,000 family caregivers in eight countries
Keeping Care Complete is the first survey of its scope to shed light on the relationship between family caregivers and individuals with serious mental illness in areas such as treatment and long-term wellness
Family caregivers have always been an important part of WFMH
We are excited to share our findings with you today and hope you can help increase the world’s understanding of the toll mental illness can take on families
Recommended speaker: Representative of WFMH
Ideally, this section of the presentation would be given by a WFMH representative who could speak about the WFMH mission and the relationship of the survey to that mission. If a WFMH representative is not available, slides referring to WFMH may be truncated to include only a brief overview of the work of WFMH and how the survey connects to its mission.

9. About the illnesses
Keeping Care Complete surveyed family members of individuals with schizophrenia, schizoaffective disorder and bipolar disorder
These are debilitating biological disorders of the brain
They know no cultural, racial or economic boundaries
They are devastating—one in ten individuals with these illnesses will die by suicide
These mental illnesses currently do not have a cure, but there are treatments available that can help people live with their illnesses
People with serious mental illnesses can, and do, live productive and fulfilling lives
Recommended speaker: Representative of WFMH
As with the WFMH-specific slides, ideally these slides would be presented by a representative of WFMH. However, they may also be presented by the event moderator. Depending upon the knowledge base of the audience, the speaker may want to expand upon or limit the information provided about schizophrenia, schizoaffective disorder and bipolar disorder. For example, if the presentation is given to a group of psychiatrists, it may not be necessary to spend time addressing the symptoms and prevalence of the illnesses, and may be best to move ahead to the slide titled “The shadow of mental illness.” However, if it were presented to legislators, even more time may be needed to convey the impact of these illnesses to a group less familiar with the subject.

10. Twenty-four million people suffer from schizophrenia worldwide
About schizophrenia
Schizophrenia is characterized by
Acute episodes of delusions (false beliefs that cannot be corrected by reason)
Hallucinations (usually in the form of voices)
Long-term impairments, such as diminished emotion, lack of interest and other depressive symptoms
Recommended speaker: Representative of WFMH
As with the WFMH-specific slides, ideally these slides would be presented by a representative of WFMH. However, they may also be presented by the event moderator. Depending upon the knowledge base of the audience, the speaker may want to expand upon or limit the information provided about schizophrenia, schizoaffective disorder and bipolar disorder. For example, if the presentation is given to a group of psychiatrists, it may not be necessary to spend time addressing the symptoms and prevalence of the illnesses, and may be best to move ahead to the slide titled “The shadow of mental illness.” However, if it were presented to legislators, even more time may be needed to convey the impact of these illnesses to a group less familiar with the subject.
Twenty-four million people suffer from schizophrenia worldwide

11. About bipolar disorder
Bipolar disorder is characterized by debilitating mood swings, which fall into broad categories of mania and depression
Signs of mania include euphoric or extremely irritable mood, distractibility, accelerated or disorganized thinking, decreased inhibitions and increased physical activities and risky behaviors
Signs of depression include severe feelings of emptiness, guilt and self-hatred, impaired thinking, inability to experience joy, diminished energy and preoccupation with death
Recommended speaker: Representative of WFMH
As with the WFMH-specific slides, ideally these slides would be presented by a representative of WFMH. However, they may also be presented by the event moderator. Depending upon the knowledge base of the audience, the speaker may want to expand upon or limit the information provided about schizophrenia, schizoaffective disorder and bipolar disorder. For example, if the presentation is given to a group of psychiatrists, it may not be necessary to spend time addressing the symptoms and prevalence of the illnesses, and may be best to move ahead to the slide titled “The shadow of mental illness.” However, if it were presented to legislators, even more time may be needed to convey the impact of these illnesses to a group less familiar with the subject.
Twenty-seven million people suffer from bipolar disorder worldwide

12. About schizoaffective disorder
Schizoaffective disorder is characterized by a combination of symptoms of schizophrenia and an affective (mood) disorder
To be diagnosed with schizoaffective disorder an individual needs to exhibit:
primary symptoms of schizophrenia such as delusions, hallucinations and disorganized behavior
a period of time when he or she also has had symptoms of major depression or mania
Recommended speaker: Representative of WFMH
As with the WFMH-specific slides, ideally these slides would be presented by a representative of WFMH. However, they may also be presented by the event moderator. Depending upon the knowledge base of the audience, the speaker may want to expand upon or limit the information provided about schizophrenia, schizoaffective disorder and bipolar disorder. For example, if the presentation is given to a group of psychiatrists, it may not be necessary to spend time addressing the symptoms and prevalence of the illnesses, and may be best to move ahead to the slide titled “The shadow of mental illness.” However, if it were presented to legislators, even more time may be needed to convey the impact of these illnesses to a group less familiar with the subject.
Schizoaffective disorder may range from 0.2% to 0.5% of the population
and may account for 25% or 30% of all individuals with schizophrenia

13. The shadow of mental illness
More than 50 million people suffer from serious mental illness worldwide
These are parents, brothers, sisters, children, spouses and grandparents
Recommended speaker: Representative of WFMH
The key point of this slide is to visually convey how far the shadow of mental illness is cast, and to demonstrate that mental illnesses do not discriminate according to age, race, nationality or economic status.
It may be helpful here to point out that as the audience is taken through the survey findings they should try to think about the many ways these unpredictable, devastating illnesses can impact families.

14. Introduction to Keeping Care Complete and survey findings
[Insert name and affiliation of presenter]

15. Why survey family members?
In recent decades, the trend away from long-term institutional care for people with mental illnesses has led to the transferring of care out of inpatient hospitals and into communities
Recommended speaker: Moderator
This portion of presentation should briefly outline the rationale for surveying family members, highlighting the trend in recent decades away from long-term institutional care, and the shift of care out of inpatient hospitals and into communities and homes.
In presenting this slide, the speaker should convey the shifting landscape of care, and how this has resulted in family members playing a greater role in the everyday wellbeing of their loved ones.
With this shift—largely made possible by more effective medications and increased community-based mental health services— family members are playing a greater role in day-to-day care

16. Fulfilling an unmet need
The profound impact on the families of individuals with these illnesses may be comparable to that of family members of persons with illnesses such as Alzheimer’s disease or cancer
To date, there has not been much research conducted that captures the feedback of family members
Employers, the broader public, and even caregivers themselves may not consider the enormity of the challenges faced on a daily basis by family caregivers, especially when relapse occurs
Recommended speaker: Moderator
This portion of the presentation should make the point that the stress of mental illness on families may be comparable in level to the stress experienced by family members of persons with illnesses such as Alzheimer’s disease or cancer. And that Keeping Care Complete was the first international survey quantify the perspectives of family members of individuals with schizophrenia, schizoaffective disorder and bipolar disorder.
Keeping Care Complete was created to help fill this unmet need for information

17. Combined findings across countries
Keeping Care Complete International Findings
The percentages in the following slides represent answers across all countries surveyed and a total number of respondents (982), unless noted otherwise.
Recommended speaker: Moderator
The goal of this slide is to acknowledge the eight countries that were involved in the survey.

18. About the caregivers surveyed
The caregivers represented a wide range of family roles:
31% of caregivers are the mother or father of the individual living with mental illness
24% are the son or daughter
17% are the husband or wife
16% are the brother or sister
These caregivers are very involved in their family member’s treatment:
69% accompany their family member during visits with doctors
58% say they are the primary caregiver
56% are involved in treatment decisions
30% administer medication
53% spend more than 10 hours per week caregiving
Recommended speaker: Moderator
The goal of this slide is to emphasize the fact that the caregivers surveyed represent a wide range of family roles (parent, child, spouse and sibling), and that they are very involved in their loved ones day-to-day care.

19. About their family members
Their family members’ diagnosis was broken down into the following:
49% of caregivers said the diagnosis of their family member had schizophrenia
45% answered bipolar disorder
6% answered schizoaffective disorder
48% say that their family member has been diagnosed for more than 10 years
The family members’ living situation
46% live with the surveyed caregiver and 30% live in their own apartment or house
Recommended speaker: Moderator
The goal of this slide is to show the percentage of participants’ family members affected by each illness; to show that almost half of the family members had been diagnosed for more than 10 years; and to shed light on the living situation of the family members.

20. Their thoughts on stigma
62%
22% 6% 7% 3%
Strongly agree
Somewhat agree
Neither agree nor
disagree
Somewhat disagree
Strongly disagree
84%
Stigma is still a barrier.
84% of caregivers say that stigma and discrimination make it harder for their family member to be well
Recommended speaker: Moderator
The goal of this slide is to highlight the reality that stigma is still a barrier for families living with mental illness. In acknowledging this point, it may be helpful to elaborate how stigma manifests in your community and note that audience members can play a key role in eradicating stigma by educating the public about mental illnesses.
QH7. To what extent do you agree that stigma or discrimination against people with mental illnesses make it harder for your family member to be well?
Base: All respondents (982)

21. Their thoughts on stigma (cont.)
63%
63% agree that stigma in society about mental illnesses may influence relative's decision to stop taking his/her medication
Recommended speaker: Moderator
The goal of this slide is to highlight the reality that stigma is still a barrier for families living with mental illness. In acknowledge this point, it may be helpful to elaborate on how stigma manifests in your community and note that audience members can play a key role in eradicating stigma by educating the public about mental illnesses.
QD4. To what extent do you agree that stigma in society about mental illnesses may influence your relative's decision to stop taking his/her medication?
Base: Caregivers whose relatives stopped taking medication (502)

22. The quest for the right medication
Finding the right medication can be a difficult and lengthy process
Many people try different medications for years before they find the one that works
Of the 756 caregivers who say that their relative is satisfied with their current medication:
56% say it took two years to find a medication that works
85% say that their relative tried more than two different medications before finding the one that works
36% say their relative had to try more than five medications
Recommended speaker: Moderator
The goal of this slide is to share caregivers’ perspectives on the process of finding a medication that works, noting that it is often a trial and error process that can take many years.

23. Treatment priorities
Caregivers view effective medication as a top treatment priority.
91% of caregivers say that efficacy is their primary concern when considering treatment options for their family member.
Recommended speaker: Moderator
The goal of this slide is to demonstrate that caregivers view effective medication as a top treatment priority, and that caregivers want treatment teams to pay more attention to the physical health of their loved ones.
QF10. How much do you agree or disagree that efficacy defined as symptom control and management that enables one to move forward with their life is your primary concern when considering treatment options for your family member?
Base: All respondents (982)

24. Treatment priorities (cont.)
90% say that an effective medication is needed to control the symptoms of the family member's condition before the patient’s overall well-being can be properly addressed
Caregivers also want treatment teams to pay more attention to the physical health of their loved ones
58% of caregivers said that their loved one’s healthcare treatment team has never made them aware that people with severe mental illness are more susceptible than the general population to physical illnesses
Recommended speaker: Moderator
The goal of this slide is to demonstrate that caregivers view effective medication as a top treatment priority, and that caregivers want treatment teams to pay more attention to the physical health of their loved ones.

25. Consequences of Relapse – patient
Relapse can lead to hospitalization, suicide and imprisonment of the individuals with severe mental illness.
Recommended speaker: Moderator
The goal of this slide is to show the devastating, real life consequences of relapse on the individual experiencing the relapse firsthand.
QF4. Which of the following have happened as the result of your family member experiencing a relapse?
Base: Caregivers whose family members experienced relapse (838)

26. Consequences of Relapse — caregiver
Relapse can have devastating consequences for caregivers as well.
Recommended speaker: Moderator
The goal of this slide is to show how relapse can affect a caregiver.
QF5. How did your family member's relapse impact you personally?
Base: Experienced relapse

27. Relapse and treatment disruption
Treatment disruption due to change in medication and discontinuation are major causes of relapse.
Of the 502 caregivers who say their family member stopped taking his/her medication despite his/her doctor’s advice, as a result 91% say their loved ones experienced relapse (cont. on second slide)
Recommended speaker: Moderator
The goal of this slide is to show what can happen when a family member stops taking their medication despite his or her doctor’s advice.
QD2. Did medication discontinuation ever lead to relapse, defined as worsening of symptoms and/or acute return of symptoms after apparent and/or partial recovery?
Base: Caregivers whose family members stopped taking medication (502)

28. Relapse and treatment disruption (cont.)
Treatment disruption due to change in medication and discontinuation are major causes of relapse (cont.).
Of the 455 caregivers who say their family member’s medication was changed based on a decision made in cooperation with a doctor, as a result 56% say that this led to relapse.
Recommended speaker: Moderator
The goal of this slide is to show what can happen when a family member changes their medication.
QE2. Did change in medication ever lead to relapse, defined as worsening of symptoms and/or acute return of symptoms after apparent and/or partial recovery?
Base: Caregivers whose family members’ medication was changed (455)

29. Relapse and treatment disruption (cont.)
Of the 502 caregivers who say their family member stopped taking his/her medication despite his/her doctor’s advice, as a result:
71% say their loved ones had to be hospitalized .
71% strongly agree that their family life was disrupted
Recommended speaker: Moderator
The goal of this slide is to show what can happen when a family member stops taking their medication despite his or her doctor’s advice.

30. Relapse and treatment disruption (cont.)
Of the 455 caregivers who say their family member’s medication was changed based on a decision made in cooperation with a doctor, as a result:
64% say that family life
was disrupted
53% say that their family member
seemed even less
like their old self
Recommended speaker: Moderator
The goal of this slide is to show what can happen when a family member changes their medication.

31. Impact of Successful Treatment - patient
Caregivers believe that effective treatment has enabled their family members to perform daily tasks more independently among other tasks.
Recommended speaker: Moderator
The goal of this slide is to show the positive things that can happen when a family member finds a medication that works for them.
QB5. What was your family member able to accomplish while being treated successfully?
Base: Caregivers whose family members are satisfied with medication (756)

32. Impact of Successful Treatment - caregiver
The improvement of the family member’s symptoms improved the quality of life of the caregiver
How did your loved one’s ability to find an effective treatment affect your own life?
76% Decreased my stress levels
Recommended speaker: Moderator
The goal of this slide is to show the additional benefit to the quality of life of a caregiver that results from a family member finding an effective medication.
71%
Increased quality time spent with family
72% Decreased my interpersonal tension

33. Raising the bar
76% of caregivers say doctors should focus on long-term care rather than managing crisis situations
Recommended speaker: Moderator
The goal of this slide is to highlight caregivers’ views on wellness and their desire for physicians to focus more on achieving long-term stability, instead of managing an illness from crisis to crisis. In terms of wellness, it should be emphasized that caregivers believe that wellness programs can help their family members manage their symptoms. (Depending upon the audience, it may be useful to identify specific wellness programs that are available in your community.)
QG3. Is the following statement true or false for you? 'I would like my family member's doctor to focus more on long-term care rather than managing crisis situations.'
Base: All respondents (982)

34. Raising the bar (cont.)
98% of caregivers say that the goal of treatment should be to maintain wellness, defined as the condition of both good physical and mental health
84% of caregivers agree that wellness programs are valuable in helping their family member manage their symptoms
Recommended speaker: Moderator
The goal of this slide is to highlight caregivers’ views on wellness and their desire for physicians to focus more on achieving long-term stability, instead of managing an illness from crisis to crisis. In terms of wellness, it should be emphasized that caregivers believe that wellness programs can help their family members manage their symptoms. (Depending upon the audience, it may be useful to identify specific wellness programs that are available in your community.)

35. Caregiver Story [local caregiver] Recommended speaker: Moderator
Introduce caregiver who will share their personal story and place the survey findings into context.

36. [local advocacy group] introduction if appropriate
Recommended speaker: Moderator
If the local caregiver is also a mental health/caregiver rights advocate, then it would be appropriate to introduce his/her advocacy group at this point. Include such information as mission statement, objectives, when it was founded, a description of its constituency and contact information (telephone, Web site). If the local caregiver is not affiliated with a local advocacy association, this slide can be ommitted.

37. Insert a quote from a family member that represents how that
caregiver feels about the task of
caregiving.
Insert a photograph of caregiver
and a family member.
Please consult local rules and
regulations for sharing personal
information with the public.
Recommended speaker: Caregiver
The caregiver should provide some information about his or her life in order to paint a real life picture of how one family has been affected by a mental illness. Note that any photographs of consumers used will require the consent of the consumer.
Following are some questions the caregiver may want to answer:
What area/region does she/he come from?
Is he/she affiliated with a local advocacy group?
What is her/his occupation?
What is her/his relationship with the family member with severe mental illness? What is the diagnosis of the family member? How long has this family member been suffering from this illness?
How does the caregiver feel about her/his caregiving role and the effect that the family member’s mental illness had on the caregiver?

38. Why is this survey important?
Recommended speaker: Caregiver
The point of this slide is to give the caregiver an opportunity to explain in her/his own words why the Keeping Care Complete survey is important.

39. Relapse Recommended speaker: Caregiver
The point of this slide is to give the caregiver an opportunity to explain in his/her own words the impact of relapse on the whole family. As a thought-starter, below are a few comments from a caregiver who shared her story at a recent Keeping Care Complete media briefing. However, it is important that the caregiver speak from his/her personal experience.
In my experience, I’ve seen how relapse can have devastating consequences for the whole family: The marital relationship is under high pressure and siblings may suffer from tremendous stress
Relapse, or the threat of relapse, significantly impacts family members’ long-term and short-term plans, such as vacations, business travels, even causes fear of unexpected visits by friends
For example, fear and panic arise when doctors are not accessible because they are on vacation

40. Effective medication/ Successful treatment
Recommended speaker: Caregiver
The point of this slide is to give the caregiver an opportunity to explain in his/her own words the importance and the impact of effective medication on the whole family. What does it mean for a caregiver? What does successful treatment enable the family member with severe mental illness to accomplish?
As a thought-starter, below are a few comments from a caregiver who shared her story at a recent Keeping Care Complete media briefing. However, it is important that the caregiver speak from his/her personal experience. Note, caregivers should only speak about specific medications if particularly relevant to their personal experience - they do not have to discuss specific medications at all.
Since my son is regularly taking his medication, his overall well-being has profoundly and positively changed
So from my personal experience, I consider effective medication as one of the top factors in treatment

41. What can we do? Recommended speaker: Caregiver
The point of this slide is to give the caregiver an opportunity to make a plea to the audience about how they can make a difference in improving the lives of families living with mental illness in their community. The specific plea that the caregiver makes will be dependent upon the speficic needs of the community.

42. Next on: [local psychiatrist]
Recommended speaker: Caregiver
Introduce local psychiatrist and his/her credentials. Highlight any research interest or relevant work dealing specifically with caregivers.

43. Contextualizing Keeping Care Complete Findings
[local psychiatrist]
Recommended speaker: Moderator
The moderator should introduce the physician speaker, who will offer his or her perspective of how the survey data reflects and can inform clinical practice.

44. Key findings: treatment disruption
Keeping Care Complete reveals the devastating consequences of relapse, which can occur due to treatment disruption
For individuals with severe mental illness, relapse can lead to hospitalization, attempted suicide, and/or incarceration
For caregivers, family members’ relapse can lead to deteriorated health and financial situation
Recommended speaker: psychiatrist
The psychiatrist should, in his/her own words, comment on the key findings of the survey in terms of treatment disruption and its potential to lead to relapse.

45. Consequences of relapse on caregiver
54% of the caregivers surveyed said that their physical and mental health worsened following a loved one’s relapse
Other studies have shown this link
Rates of caregiver depression have been estimated to range from 38% to 60%. Caregivers of persons with a higher number of symptoms and level of cognitive impairment experience more depression
Similarly, the more severe a loved one’s symptoms, the greater the number of infectious illnesses, such as respiratory illnesses, contracted by the caregiver
Recommended speaker: psychiatrist
The psychiatrist should, in his/her own words, comment on the key findings of the survey in terms of the consequences of relapse on caregivers. If appropriate, he or she can comment on other studies that have looked at similar topics, and may also offer anecdotal insight.

46. Reasons for treatment disruption
Caregivers say that relapse often occurs due to treatment disruption
Treatment disruption can be a result of:
Treatment discontinuation (when a patient decides to stop taking a medication)
Switching (when a physician decides to move a patient to a different medication)
Patients stop taking their medication because of poor response to treatment, poor tolerability or insufficient insight into their illness
Recommended speaker: Psychiatrist
The psychiatrist should, in his/her own words, comment on the key findings of the survey with regard to treatment disruption. Drawing on his or her professional expertise, the psychiatrist may offer insight into the link between treatment disruption and treatment discontinuation and switching.

47. Moving from relapses to stabilization
To reduce the chance of relapse, it is important for individuals to adhere to the treatment plan prescribed by their physician
However, doctors, patients and caregivers should closely monitor progress and recognize when changes to a treatment plan may be needed
Often caregivers feel that they are excluded from treatment decisions
Communication between the doctor, patient, and the caregiver – the therapeutic alliance – is critical to achieving the long-term wellness goals of the individual with severe mental illness
Caregivers need to be informed about each treatment option so that they may be in the best position to help their family members make best treatment decisions
Recommended speaker: Psychiatrist
The psychiatrist should, in his/her own words, explain how adherence, effective communication and the involvement of caregivers can help individuals move from relapse to stabilization.

48. Finding and staying on effective treatment
As this survey shows, sometimes it takes years and numerous medications before finding the treatment that works
When considering switching a patient to a new medication, doctors have to weigh the risks and benefits of each treatment option before finding the one that is safe, efficacious and acceptable for an individual
Many patients forced to switch medications will fail by going into a psychiatric crisis and requiring emergency room admission followed by a lengthy hospitalization during this terrifying downward spiral
Restricting access is not in the interest of the individuals with severe mental illness, as this can ultimately lead to increased hospitalizations and utilizations of other services and can also negatively impact a patient’s quality of life.
Recommended speaker: Psychiatrist
The psychiatrist should offer commentary on the importance of finding and staying on effective treatment, and make a cautionary comment about the consequences of restricting access to newer medications.

49. Long-term wellness
Individuals with mental illnesses can lead productive and fulfilling lives and have successful relationships and meaningful jobs when these illnesses are effectively treated
Proper treatment can relieve symptoms, prevent or delay relapse and break the “revolving door” cycle
Proper treatment can also help reduce the frequency and severity of episodes and can help individuals maintain a good quality of life and achieve substantial stabilization of symptoms
Recommended speaker: Psychiatrist
The psychiatrist should speak to the positive outcomes that can occur when treatment is successful.

50. Efficacy matters
Nearly all caregivers surveyed agree that an effective medication is needed to manage psychiatric symptoms, before overall well-being and health can be properly tackled
Studies have shown that early effective treatment and social functioning is linked to long-term improvement of subjective well-being of patients with severe mental illness
Scientific advances have enabled us to develop effective medications and improve treatment practices compared to years ago, as well as to be able to move people from institutions into communities. This has become more evident in the past 10 years with the advent of newer drugs for the treatment of severe mental illness
Recommended speaker: Psychiatrist
The psychiatrist should offer commentary on the importance of finding and staying on effective treatment, and make a cautionary comment about the consequences of restricting access to newer medications.
Psychiatrist should add any personal insights he/she may have in addition to the above points focusing on the importance of effective medication.

51. Complete Care Medication cannot succeed in a vacuum
Family support and social support, talk therapy, exercise, having responsibilities and a stable schedule are among key factors that help keep their family member well
Doctors must recognize the importance of wellness as a whole, not just symptom-control
Doctors should help individuals with severe mental illness follow a healthy diet, avoid/reduce alcohol and street drugs, limit caffeine intake, exercise regularly with a gradual start, and go for regular medical check-ups
Caregivers can help make sure this happens
Recommended speaker: Psychiatrist
The psychiatrist should add any personal insights he/she may have in addition to the above points focusing on the importance of complete care – appropriate combination of effective medication, family support, social support, talk therapy, exercise, having responsibilities and a stable schedule – in achieving and maintaining wellness. Psychiatrist should also talk about the role of caregivers.

52. Questions and Answers Recommended speaker: Moderator
Moderator should field questions from the audience for a specified time. It is recommended that the Q&A session be at least 15 minutes.

53. Closing Remarks [moderator] Recommended speaker: Moderator
Closing remarks may vary according to the specific objectives of the presentation. The following slides offer some sample language you may wish to use to wrap up your program.

54. What’s next?
In order for family members to provide support to individuals with severe mental illness and help them become productive citizens
We must provide them with support
We must allow them the chance to be heard
Our hope is that, with increased awareness of the needs for access to psychiatric services, medications and wellness programs among legislators, medical professionals and the greater public, we will help alleviate the burden that these devastating illnesses can have on families

55. [local advocacy group] and caregiver survey
[local advocacy group] aims to actively support access to care and wide range of services for those with serious mental illness and their family members and promote the efforts of local advocacy associations across the world.
Keeping Care Complete serves as an important tool to help accomplish these goals by providing:
Mental health professionals, policy makers and the broader public with clearer picture of caregivers and their efforts, hopes and needs.
Advocacy associations with better information on how to support caregivers and fight for improved care and access.

56. What can you do?
Help us spread the word and fight against reduced access to treatment and support services by:
Reporting on the survey results
Encouraging people to bring mental illnesses out of the shadows
Visiting and [URL of local advocacy group, if appropriate] to view the survey materials online and learn more about efforts to improve the quality and accessibility of mental health services around the world

57. And finally, a word of thanks
Thank you to the many caregivers of individuals with bipolar disorder, schizophrenia or schizo-affective disorder who participated in this survey
Thank you to the approximately 50 associations around the globe that helped with recruitment for this survey
And thank you to you for attending this presentation and for helping us share the perspective of the caregiver with your audiences