LAUSR

According to the Global Burden of Disease Study, schizophrenia causes a high degree of disability, which accounts for 1.1% of the total DALYs (disability-adjusted life years) and 2.8% of YLDs (years lived with disability). In the World Health Report [The WHO World Health Report: new understanding, new hope, 2001. Geneva]. In addition to the direct burden, there is considerable burden on the relatives who care for the sufferers. The workshop aimed to present and discuss different facets of what could be done for these persons and their families’ members in the light of what has been done in some European countries, which have conducted reforms. The round table will be introduced by presentations from two countries very much involved in psychiatric reforms which will present their attempts and results: first Italy with its emblematic radical deinstitutionalization model setting up a law to close down the psychiatric hospitals. The to-day situation will be presented underlying the huge diversity across Italian provinces and the dramatic lack of resources in some of them. Second the Portuguese reform will be described with a shift of psychiatric care toward general hospitals and its complete integration into health care catchment areas resulting in a increase of out patient acts among them home visits and a decrease of full time hospital admissions. Then a French three-year research program that focused on themes that aims to improve the every day well-being of people living with schizophrenia will be presented. This program aimed to provid new insights on their integration from different angles: information about the disease by doctors at diagnostic annoucement, on internet and actions to take on health administrator training against stigmatisation that could be extended to a larger public. Lastly the program allowed to interviewed face to face up to 67 people: 20 persons with schizophrenia, 20 person with bipolar disorders and 27 close ones to schizophrenic patients. A semi-structured interview collected information on the different aspects of care experiences plus “The Brief Illness Perception Questionnaire” allowed to measure and compare perceptions of the disease. This will allow to present the very positive effects of a program toward family members and patients themselves: “psychoeducation” that is a structured educationnal intervention which provides information and guidelines on how to react with their family member and influences positively the patient’s outcome as the well being of both patient and family members. Each presentation will extensively be discussed with the attendance and followed by some recommandations Although schizophrenia is a severe disorder much could be done to alleviate the burden on the patients and their family members. Reorganising the care systems trough adequate policies, setting up policies against stigmatisation and providing educational intervention should promote patients and families empowerment.