Forensic carers’ role

The caring role in a forensic context was said to be ‘a difficult one to define’ according to some of those we interviewed.  This was on account of the nature of secure hospitals or living in the community under a restriction order, resulting in carers feeling ‘inadequate’ in their role, even ‘institutionalised and intimidated’.  Providing practical and emotional support were core elements of the role.  Commonly, forensic carers supporting their relative or friend in the community were giving practical help, offering emotional support including a check on reality, being a point of contact for services, accompanying their relative to appointments and being aware of triggers to ill-health.  Some felt burdened in this role and felt they ought to do less:

I’ve always been the one that went and did things for whoever I could but now I’ve got to take a wee back step and say to myself `how long am I going to last at this rate?’ (partner)

On entering a secure hospital setting it was often assumed by carers themselves and others that the caring role was suspended.  However, for forensic carers the reality was that they continued to support their relative, including practically through visits, taking food and other items into hospital, being involved emotionally, being a named person, offering support with rights, maintaining contact with other family members, and being a point of contact for services through phone calls and visits.

Thinking and worrying about someone who is away from home in this situation, as well as the circumstances of the index offence that may have led to admission to forensic mental health services, was a significant emotional burden.  The impact of the index offence on family members cannot be underestimated:

It broke my mum’s heart. (sister)

There’s no-one else, I’m the only person, me singularly and it’s hell on earth at times, it’s hell, it’s a living hell. (sister)

Forensic carers advocated for their relative, for instance, assisting with securing legal services and other information, writing letters to MPs and councils, being involved with the press, and securing accommodation when the person was discharged from hospital.  As one interviewee commented:

The good thing about being a carer is that you know at least that you can be there to speak for them when they can’t. (mother)

 

The forensic carers’ role was not constant or fixed.  It changed over years, with some interviewees acknowledging that this could be the work of a lifetime, although they may not have anticipated this at the start.  Their role was ‘reactive rather than proactive’, responding to whatever was needed by their relative:

Your experience as a carer is always influenced by your relative’s situation and experience. (sister)

Whereas services assumed that many people within forensic mental health services were no longer in touch with family and friends and had no-one they could call a ‘carer’, the participants in our study were all in regular contact and did not see that as ending:

I will never stop fighting for him. (father)