Forensic carers\u2019 perspectives on the nature and quality of forensic mental health care and treatment were variable.\u00a0 While secure environments were generally \u2018daunting\u2019, their descriptions of forensic mental health services highlighted positive features of these settings, including consistent and caring staff.\u00a0 Conversely, some were critical of what they perceived as inconsistent treatment that had a detrimental impact on their relatives:<\/p>\n
He\u2019s had lots of changes of treatment, so that\u2019s not been good.\u00a0 He\u2019s had five consultants in a year or so because they\u2019ve all been on three month contracts\u2026(mother)<\/em><\/p><\/blockquote>\n
A medium secure unit was felt by carers to be \u2018very modern in its approach\u2019 on account of its staff being \u2018empathetic and compassionate, just amazing\u2019.\u00a0 A forensic rehabilitation ward was described as a \u2018good setup\u2019, supporting patients to prepare for moving into independent living situations.\u00a0 Support from a CPN in a forensic community team was described as \u2018absolutely terrific\u2019 in supporting an individual with his community treatment.\u00a0 Comments about positive relationships with staff occurred across all levels of secure services, although specific criticism was reserved for what some felt were more restrictive regimes in the high secure setting:<\/p>\n
They\u2019re locked up and\u2026 in my experience treatment is minimal other than drugs. They\u2019re extremely short staffed so you know they spend days sitting. It\u2019s no different from the psychiatric institutions of the Edwardians as far as I can see except for better security (mother)<\/em><\/p><\/blockquote>\n
However, it was the understanding of another carer whose relative had been in high secure for two years that he was \u2018in the best place, he\u2019s getting the correct treatment\u2019.\u00a0 Some of the more negative experiences, especially of high secure, were located as historic rather than current experiences, and it was noted that there had been tangible improvements in recent years.\u00a0 In particular, the more comprehensive range of forensic mental health services across Scotland meant the appropriateness of care and treatment had improved dramatically, and the modernisation of the built environment at the State Hospital was commented upon favourably:<\/p>\n
A lot of my experience is more sort of historical than contemporary because my experience when I first went to the State Hospital were of being treated like a number, no support, no explanations and that wouldn\u2019t be the case if you were going there today\u2026 A lot of my experiences have changed and the nature of the State Hospital\u2019s changed now, I mean in those days there were 300 and something patents, now it\u2019s 100 and something\u2026 it\u2019s a high secure State Hospital, whereas before it was having to take people who really should have been in medium secure or low secure but there weren\u2019t the facilities for them (father) <\/em><\/p><\/blockquote>\n
Nonetheless, some felt there was still some way to go before forensic mental health services, especially high secure care, catered for the individual needs of their relatives.\u00a0 This was especially the case where patients had learning disabilities and\/or autistic spectrum condition (ASC).\u00a0 Positive change happened when their relative moved into ward regimes with staff operating \u2018less like security staff or prison guards\u2019.\u00a0 A move to smaller wards at the State Hospital was also positively regarded.\u00a0 In relation to this, one carer commented, \u2018it\u2019s opened up the place\u2019, and \u2018it does work better\u2019.<\/p>\n
Carers were critical of \u2018punishingly high doses of medication\u2019 and drug treatments that seemed to do nothing other than sedate and control patients.\u00a0 Positive changes were noted when drug treatments were changed to suit the individual, so much so that one carer likened the difference when a new medication was tried to \u2018turning on the light\u2019.\u00a0 In this case, the dramatic change in the person led clinicians to review the relevance of the prevailing level of security, and to consider a move to a medium secure facility.\u00a0 Moving from \u2018a level of intimidation\u2019 to openly being able to discuss clearly defined targets and aspirations for their relative, was how one interviewee contrasted past experience of high secure services at the State Hospital with a more recent experience of medium secure:<\/p>\n
You didn\u2019t feel \u2018oh if we say this or say that you\u2019ll be here for another two years\u2019 or whatever.\u00a0 It was just a much more positive experience at the [name of medium secure unit] and you felt much more positive about the whole place (father)<\/p><\/blockquote>\n","protected":false},"excerpt":{"rendered":"
Views on the quality of forensic mental health services Forensic carers\u2019 perspectives on the nature and quality of forensic mental health care and treatment were variable.\u00a0 While secure environments were generally \u2018daunting\u2019, their descriptions of forensic mental health services highlighted positive features of these settings, including consistent and caring staff.\u00a0 Conversely, some were critical of … Continue reading Views on quality<\/span><\/a><\/p>\n","protected":false},"author":4,"featured_media":0,"parent":114,"menu_order":0,"comment_status":"closed","ping_status":"open","template":"","meta":[],"categories":[],"tags":[],"amp_enabled":true,"_links":{"self":[{"href":"https:\/\/www.researchunbound.org.uk\/forensic-mental-health\/wp-json\/wp\/v2\/pages\/135"}],"collection":[{"href":"https:\/\/www.researchunbound.org.uk\/forensic-mental-health\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.researchunbound.org.uk\/forensic-mental-health\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.researchunbound.org.uk\/forensic-mental-health\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.researchunbound.org.uk\/forensic-mental-health\/wp-json\/wp\/v2\/comments?post=135"}],"version-history":[{"count":0,"href":"https:\/\/www.researchunbound.org.uk\/forensic-mental-health\/wp-json\/wp\/v2\/pages\/135\/revisions"}],"up":[{"embeddable":true,"href":"https:\/\/www.researchunbound.org.uk\/forensic-mental-health\/wp-json\/wp\/v2\/pages\/114"}],"wp:attachment":[{"href":"https:\/\/www.researchunbound.org.uk\/forensic-mental-health\/wp-json\/wp\/v2\/media?parent=135"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.researchunbound.org.uk\/forensic-mental-health\/wp-json\/wp\/v2\/categories?post=135"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.researchunbound.org.uk\/forensic-mental-health\/wp-json\/wp\/v2\/tags?post=135"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}