Hospital environments

Hospital environments

The facilities available for visiting were important and affected carers’ perceptions of forensic mental health care.  Having a relaxing atmosphere, some flexibility in visiting times, and good staff support were vital components of a ‘good experience’.  Equally important was feeling that there was a comfortable space for visiting with facilities for visitors, like the ability to have a ‘real cup of tea’, especially after a long journey.

For some, the particular forensic mental health service environment, if coupled with a detached attitude of the nursing staff, was off-putting.  Some forensic environments seemed more prison-like than health or therapeutic environments.  In the words of one forensic carer, the secure care setting was ‘a strange, strange environment’.  Many forensic carers reported feeling intimidated by early (and sometimes subsequent) visits, especially to high secure units:

Even for myself, to be fair, the first couple of times in fact the very first time… it’s really intimidating having never been in that environment. Extremely intimidating for me and, you know, I’m no’ really a lily-livered character, I’m quite a strong person… (sister)

It’s just a feeling, but you always felt you were visiting a prison rather than a hospital and I suppose you know the sort of high fences and the razor wire didn’t quite fit in with a hospital image. (father)

One interviewee kept referring to the nurses and staff as prison guards, and then would correct herself, but she was not unique in making this reference:

Everybody goes about wi keys, you know, like, they’re like gaolers, and that is how it feels. That is how it feels. And sometimes [name of patient] still refers to it as ‘I’m still in jail’, you know.  (sister)

We used to feel we were like a criminal yourself… although all the security is understandable, the staff behave like prison wardens… you don’t experience courtesy.  My stomach used to be in knots, my mouth bone dry – it was a hugely difficult and unpleasant experience every time we went.  (sister)

Walking in wasn’t a very friendly atmosphere, it was all locked doors, it was you were left waiting in the waiting room before you could get in, there was just… there was no kind of welcoming, it wasn’t that welcoming a feeling and it felt quite charged.” (mother)

Views about experiences of visiting someone at the State Hospital were repeatedly contrasted with those of visiting medium secure units, usually making the comparison that it was more relaxed in the latter:

The [name of medium secure unit] is far better you know, it’s far better… it’s just a better feeling about it you know. (father)

It was much more a case of you know between the hours of… and you know you didn’t feel you were racing to get there [name of medium secure unit] because you might be 10 minutes late and miss the bus and things like that, so that was a lot more relaxed. (father)

That said, there were reports from carers of positive visiting experiences at the State Hospital’s Visitors Centre

Skye Centre because that’s like a communal lounge area and there’s a big TV and there’s a little shop that the patients can go to and there’s sort of a tea and coffee area and you’re not so… you’re still supervised but it’s not so in your face you know it’s a bigger area so you’re more spread out and the nurses are further away so they’re not like in your face.  (sister)

[Name of person] likes to go to the Skye Centre.  He identified it’s a nice place with comfortable chairs and real teacups. (friend)

Interviewees identified the importance of visiting areas being welcoming for families and friends.  Carers felt that many of the places where visits took place were overly restrictive and unsatisfactory, even taking into account appreciation of the need for security.  Places that were lacking as far as the carers were concerned had ‘hard wooden dining chairs’, no or poor tea and coffee facilities, felt like ‘goldfish bowls’, lacked privacy and were generally clinical environments that inhibited interactions between carers and their relatives:

There was no kind of visiting area, there was no tea or coffees, toilet, there was nothing and I’ve travelled an hour and a half up the road.  (mother)

There is nowhere that the family can walk outside the wards with their relative.  This should have been planned for. Visitors have to go to the ward and sit in the dining room.  (father)

An ability to be flexible around when visits take place was also identified by forensic carers as important in determining the quality of their visit.  As 44% of survey respondents identified not being able to visit when it suited them, this is clearly an area of importance for forensic carers.  There were positive examples of such flexibility:

Basically the arrangement is that you know you decide or you say when you want to come and visit and provided there’s no… you know they’ll look in the diary and I mean obviously if he had… if either of them had got something else at that time they would say so and if I’m booked in for a visit then presumably they would manage it, but they have managed. (father)

I’m allowed to stay longer than normal if, for example, I have to travel back on say a Monday… I’ll be allowed to see my daughter whenever.  They [name of medium secure unit] always say `yes no problem’ once I ask, I say `look I’m going back tomorrow can I come in the morning?’ `yes it’s no problem’ (mother)

Leave a Reply

Your email address will not be published. Required fields are marked *