Key findings (ch 2)

In summary, the survey of forensic mental health services’ perspectives of carer support found:

  • Most forensic mental health services report that they identify carers when a patient is admitted to the ward or service, or as soon as possible thereafter.
  • Levels of patient/carer contact were thought to vary, although it was estimated that an average of 69% of patients were in contact with their relatives.  This was mainly by telephone or when their relatives visited.
  • Services reported wide-ranging of levels of carer engagement in CPA meetings – from as little as 10% to 99% – with an average across forensic mental health services of 53% carer involvement.
  • Services reported providing at least one form of support to carers, although this might simply be providing general information leaflets.
  • The most common form of support reported by services was a link with the named key worker or nurse for the relative.  Carer support groups and behavioural family therapy were less frequently available.
  • Carer support is promoted mainly through direct communication, but staff also highlighted that they provide information leaflets, posters, and write out to carers about the support available.
  • The decision to provide support to carers was most strongly associated with specific service drivers, such as legislation and policies.
  • Face-to face consultation with forensic carers about what support they wanted was mostly non-existent, and a fifth of services had no mechanism for monitoring or evaluating the support they offered to carers.  There were exceptions such as the State Hospital’s annual survey of carers.
  • Staff in services estimated that an average of 43% of carers engaged with the support they provide, with variations ranging from zero to 100% carer engagement.
  • Half of the services reported experiencing some difficulty in providing carer support, which included low or no involvement in carer support groups they had initiated.
  • Staff thought that many carers were not interested in engaging or were not in contact with their relatives or friends, thus complicating services’ attempts to engage with carers.
  • Low uptake was therefore primarily explained in terms of carers’ choices or circumstances and/or the stigma associated with caring for a relative in forensic services.  Having to travel long distances to forensic mental health services was another main reason why they thought carers did not engage with the support provided.

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