Challenges and Improvements
Respondents to the survey were asked to indicate if they had experienced any particular challenges in the carer role, and were also able to identify additional challenges experienced but not listed on the questionnaire. Just 11% had not experienced any challenges. The proportion of forensic carers identifying with specific challenges are accounted for in the following table:
Table 11: Challenges for forensic carers in getting the support they needed identified by survey respondents
Table 11 shows that the most prevalent challenges identified by forensic carers relate to their involvement in the care and treatment of their relative, which includes being listened to and respected and getting information about the forensic mental health service. In addition, almost half had experienced challenges in getting the information and advice they needed about the MHCT Act, as well as in travelling to and from forensic mental health services. The challenges self-identified by survey respondents included funding issues and a perceived lack of meaningful activities for people within services. The long term nature of caring in this context was also emphasised:
There should be a recognition that family of patients will be involved for the rest of their lives as opposed to professionals who come and go and leave carers with consequences of any decisions they make.” (survey respondent)
Respondents reported a range of emotional impacts of caring for a relative detained in forensic mental health services, including feelings of guilt and responsibility or, at times, feeling powerless and helpless. One survey respondent expressed satisfaction with regard to all the areas suggested as possible challenges for carers, so clearly some forensic carers are having their needs fully met. Other responses imply there are inconsistencies in supporting carers, between different units and sectors of the forensic mental health services, and between different staff. It was not untypical for a transition between units to bring different, more or less supportive, practices into stark relief.
Forensic carers called for increased communication with them, and for staff in forensic mental health services to listen to, inform and consult carers more. They sought to build a relationship with the staff caring for their relatives, and to know where they fitted in. They wanted to know about the support within forensic mental health services, as well as about the support available for them as carers. They wanted to be involved in the care plan. They asked for ‘more caring staff’, ‘patients being treated as human beings’, ‘better food’, and also somewhere ‘more homely’ for visiting. One respondent to the survey suggested:
More involvement. More communication. More humanity. More transparency. (survey respondent)