Abstract Body

Early life trauma (ELT) refers to various types of adversity that occur during the early years (usually defined as the first 5 years) of a person’s life. It is a key determinant of mental health and well-being throughout the life course.

A series of three workshops on early life trauma and mental health care were conducted in Belarus and Ukraine in 2018-2019 to support stakeholders and service providers to better understand and respond to ELT, and to support the development of a network of ELT specialists dedicated to finding common goals, pooling cross-disciplinary data and sharing experiences and good practice across countries.

The workshops found that different attitudes, expectations and experiences amongst stakeholders and service providers could hinder the development of consistent, effective and empowering care in Belarus and Ukraine. However, opportunities for more protective and health-enhancing responses were also identified, including the need for: evidence-based education and training; clear roles and communication pathways across sectors; and inter-sectoral partnerships and networks to leverage resources, mitigate practitioner burnout, and build a continuum of support within communities. Findings have been disseminated through a directory of resources in Belarus, a project webpage (www.earlylifetrauma.info) and a report on ELT in Belarus and Ukraine published by WHO Europe.

Introduction

Belarus is undergoing legislative shifts towards community-based mental health care. Responding effectively to support this process requires an understanding of the experiences and challenges facing families caring for a relative affected by mental illness.

Objectives

To identify how caring for a person with severe mental illness impacts on family carers, and what carers identify as their support needs.

Methods

Semi-structured interviews were undertaken with 17 caregivers of people affected by severe mental illness (diagnosis of F06.8, F20, F25, F7, and/or F 84) in Belarus between March - June 2019.

Results

Care-giving for a family member was usually undertaken on a full time basis with no option for respite. Whilst caring did, in cases, strengthen family solidarity, it also resulted in intensive stress and burnout, financial pressures, and high levels of family tension, exacerbated when the person living with mental illness was perceived as a potential safety risk. High levels of societal stigma meant that care-givers commonly felt unable to discuss their circumstances, travel in public spaces, or participate in community activities. Stigma also deterred carers from seeking professional support. Priorities for support amongst carers included better information, public awareness raising and sensitization, advocacy to support patient integration into social and economic life, peer support and respite for family carers, and an increase in mental health specialists.

Conclusions

Caregiving affected family carers on multiple levels with predominantly negative consequences. Priorities identified by carers need to be considered and acted upon if community-based care is to become an effective option.