Forensic Carers and Secure Inpatient Services

The experience and role of carers are very different from that of many other groups when their relative is a long-stay patient in a secure unit. In this chapter, we seek an understanding of this experience as well as make some suggestions that we believe would improve the situation of forensic carers and the people they support and enable them to trust these services. Relatives are sometimes involved in the crisis that results in admission to secure care and often find that the process of admission, with its investigations, reports, unwanted media attention and court appearances, adds another layer of challenges. Often traumatised by events, they travel long distances to visit their relative. This could be the start of a tremendous partnership between family carers, workers and the person but is often characterised by despotic rules, intrusive supervision and shame. Official guidance has emphasised the importance of collaboration with carers in care planning and treatment, but forensic carers have reported being left in the dark, excluded from opportunities to contribute and sometimes blamed. Over the past 15 years, the recovery movement has helped to shift perspectives so that patients are more often empowered to take the lead, while forensic carers are rarely given information that enables them to understand the services and are seen as being in need of support. Partnership will only improve when forensic carers are proactively encouraged to build peer support structures, insist that secure services listen and receive simple and believable reassurances that their loved one is seen as a person and well cared for.