Intensive Home Treatment in Mental Health: A Qualitative Exploration of Carers' Experiences

Intensive Home Treatment for acute mental health crises has expanded internationally as a community-based alternative to inpatient admission. Despite its growing use, little is known about how informal carers experience supporting a relative during acute psychiatric decompensation at home-an emotionally demanding context marked by intensified responsibility and disruption of daily life. The aim of this study is to explore the lived experiences of informal caregivers providing support to a family member admitted to mental health Intensive Home Treatment using a reflexive thematic analysis within a constructivist orientation. The study adhered to the COREQ guidelines for qualitative research reporting. Data were collected using individual semi-structured interviews (n = 30) and one focus group (n = 8). The Stress Process Model informed the interview guide and acted as a sensitising lens; however, coding and theme development remained inductive. Three overarching themes and seven sub-themes captured the caregiving experience. Carers reported substantial physical, emotional, occupational and social consequences, including exhaustion, anxiety and marked disruption of daily routines. Their experiences combined distress with positive meaning making: strengthened bonds, feelings of usefulness and increased closeness coexisted with uncertainty, fear of relapse and difficulty managing unpredictable behaviours. Coping strategies included personal practices and external supports. All these findings suggest that caring during acute Intensive Home Treatment is meaningful yet highly demanding. Mental health professionals should systematically assess caregiver burden, support needs and coping resources, offering targeted interventions to enhance emotional well-being and sustain effective home-based psychiatric care.