Lack of privacy
The lack of privacy for visits at the State Hospital was repeatedly commented upon. Forensic carers found this challenging even if they understood in principle that there was a need for security measures at such facilities. This lack of privacy, for what can sometimes be quite fraught interactions, severely impacted on communications between carers and their relatives in secure services:
We go into the, it’s like the dining room that the patients eat for their meals, but we go in, our visit is from two till four so you’re in a dining area which is just a room… probably with maybe three or four tables and it’s all glass so all the other patients are in the lounge watching the TV. You feel as if you’re in a goldfish bowl because they’re looking in and I can see them out, because it’s all glass. There’s no privacy, no privacy at all. (sister)
The experience of visits to other forensic settings was often mentioned as a contrast to this. Staff at the medium secure units were said to be ‘discreet’ and afforded families a degree of privacy, which seemed to be largely absent from visits to people in high secure. In one medium secure unit visitors were able to see their relative in a private room – ‘they’re very accommodating towards leaving us on our own. That helps hugely’. In another medium secure unit:
The last time it was about four weeks ago we went into an interview room and just me, my other son and him and the male nurse just sat outside and gave us privacy so that was good yeah. (father)
Privacy is an interesting and complex issue in the context of secure services, however, raising issues about the boundaries on wards, which carers perceive as the home of their relative or friend. Forensic carers experienced frustrations with not being able to get to know more about the environment where their relative or friend lived, sometimes for many years, nor to meet the people they shared this environment with. They understood this to be because of concerns that the privacy of other patients would be compromised, though the practice of organising open days went some way to addressing this:
Well the big disappointment I think is that you know there’s no chance of meeting the ones that she’s associating with, you know her peers in those circumstances… (father)
Even though forensic carers understood the implications for confidentiality and protecting the interests of other residents/patients, they felt it would be beneficial, not just for their relative, to have opportunities to interact with people other than ward staff.