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This article reports the findings of a qualitative study on the contribution of foster home caregivers for people with serious mental illness. Traditionally, social workers have played a key role in the supervision of foster homes. Little is known about how the help caregivers provide is similar to, or different from, that provided by mental health professionals. Twenty semistructured interviews were conducted with caregivers operating foster homes in Montreal, Canada. With no preset theoretical framework, data analysis was inductive and ongoing, involving the identification of categories and themes. Overall findings revealed that caregivers consider themselves the real frontline workers. They claim to be available 24 hours a day, seven days a week to combine egalitarian and affective relationships with their residents and to provide them with personalized care. Caregivers are well positioned to respond immediately to crises. Caregivers also believe that their intimate and thorough familiarity with their residents allows them to assess residents differently than could social workers. These findings have implications for mental health professionals. The combined skills and expertise of nonprofessional caregivers and social workers are essential in promoting the residents' reintegration into the community.

From the Real Frontline: The Unique Contributions of Mental Health Caregivers in Canadian Foster Homes