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A Qualitative Study Exploring the Experiences of Carers of Service Users With Complex Mental Health Needs

Published online by Cambridge University Press:  20 June 2022

Pooja Saini*
Affiliation:
Liverpool John Moores University, Liverpool, United Kingdom
Hana Roks
Affiliation:
Liverpool John Moores University, Liverpool, United Kingdom
Laura Sambrook
Affiliation:
Liverpool John Moores University, Liverpool, United Kingdom
Anna Balmer
Affiliation:
Liverpool John Moores University, Liverpool, United Kingdom
Jason McIntyre
Affiliation:
Liverpool John Moores University, Liverpool, United Kingdom
Antony Martin
Affiliation:
QC Medica LLP, York, United Kingdom
Jackie Tait
Affiliation:
Cheshire and Wirral Partnership NHS Foundation Trust, Chester, United Kingdom
Peter Ashley-Mudie
Affiliation:
Cheshire and Wirral Partnership NHS Foundation Trust, Chester, United Kingdom
Amrith Shetty
Affiliation:
Cheshire and Wirral Partnership NHS Foundation Trust, Chester, United Kingdom
Rajan Nathan
Affiliation:
Cheshire and Wirral Partnership NHS Foundation Trust, Chester, United Kingdom
*
*Presenting author.
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Abstract

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Aims

Carers of individuals presenting with complex behavioural and mental health needs report that service users may not receive the provision of care they require, particularly when presenting following suicide attempts and self-harm. Carers are an integral part of the care system and often feel ignored and marginalised by services; there is a lack of involvement of carers and paucity of their views of support needs to be explored. The aim of the study is to understand carers’ experiences of caring for service users with complex mental health needs who self-harm and/or attempt suicide, and the support received from mental health care services.

Methods

Ten carers of service users with complex mental health needs were interviewed about their views on the psychiatric admission, treatment and discharge process for the people they were caring for. Data were gathered during semi-structured, one-to-one interviews remotely over the phone or online platforms. Interviews were audio-recoded and transcribed verbatim. A transcript-based conceptual analysis was conducted to identify and explore emerging themes.

Results

Carers identified both positive and negative aspects of the psychiatric admission and care within community settings. The following key themes emerged from the interviews: lack of control and information from mental health services, the importance of support from staff, or conversely its absence; concerns about service users’ vulnerability, negative staff attitudes and opportunities for involvement; negative experiences of generic psychiatric settings; positive experiences were encountered when there were supportive and caring staff, good information sharing and satisfactory discharge arrangements.

Conclusion

Important areas for service improvements are highlighted. Recommendations included: the need for support; information about suicidal behaviour and advice on managing further incidents at home; more support in coping with regular and escalating self-harming and suicidal behaviours, particularly, severe consequences of staff safeguarding errors and inappropriate discharge, and the importance of supportive and adept staff. These findings identify the need for tailored support for carers regarding the management of self-harm and suicidal behaviours in the community.

Type
Research
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists
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