Caring for a violent relative with severe mental illness: a qualitative study

Abstract

Background: According to the literature reviewed, although families living with a mentally ill relative often face violence, this issue has been little studied in nursing. Methods: We conducted a qualitative research study to explore the experience of families dealing with this complex reality. We adopted Jacques Donzelot’s theory of the government of family as our theoretical framework and used grounded theory as our research methodology. In total, 14 participants who had been victims of violence perpetrated by relatives with severe mental illness were interviewed. Findings: Qualitative analysis led to the identification of five themes: (a) medico-legal apparatus; (b) experience of violence; (c) the family’s responsibility toward the violent relative; (d) exclusion and stigmatisation; and (e) suffering and resilience. The present paper focuses on the study’s central theme: the family’s responsibility toward the violent relative.

Voices to be heard: Understanding family perspectives in forensic care trajectories

“…Still, including family members as partners in care continues to be a challenge in forensic mental healthcare (23,24). Family inclusion or family interventions in treatment settings are often found to be limited from a family member perspective [e.g., (7,8,11)]. For instance, Canning et al [(25), p. 877] mention that support for carers "has not yet become a consistent or widespread part of forensic services practice."…”

“…As such, the focus has shifted from “illness” to a first person-centered perspective that emphasize the importance of the social resources of the user. This paradigm shift has increased the role and importance of informal carers, more specifically family members, in the (forensic) service users' care trajectory ( 6 – 8 ).…”

“…In general, caring for a PNCR can place a burden on family members [e.g., ( 9 , 10 )], mainly on mothers, who feel restricted by professionals in their caring role, while at the same time being regarded as a major resource for their child, specifically in the social (re)integration process ( 6 , 8 ). Family members explain that taking on a primary care role (where they are often forced into by professionals), challenges and burdens them (i.e., socially, financially and emotionally), because they lack knowledge, skills or professional guidance and support to cope with the situation of their relative ( 8 , 11 – 13 ). In addition, family members of PNCR are confronted with a double stigma as their relative is not only seen as a “patient” but also as a “criminal” ( 14 , 15 ).…”

“…Still, including family members as partners in care continues to be a challenge in forensic mental healthcare ( 23 , 24 ). Family inclusion or family interventions in treatment settings are often found to be limited from a family member perspective [e.g., ( 7 , 8 , 11 )]. For instance, Canning et al [( 25 ), p. 877] mention that support for carers “ has not yet become a consistent or widespread part of forensic services practice .” Family members of PNCR tend to describe the relationship with professionals as a “terrible battle,” because they feel not listened to and experience no effective partnership ( 7 , 16 , 26 ).…”

Experiences of family caregivers in forensic mental health care—A qualitative evidence synthesis

“…However, most parents held strong negative perceptions regarding the use of MR, and quality and safety of care provision. It is apparent that parents believed that should be involved in the care in situations associated with the use of MR, because they considered this could reduce its use.16 TA B L E 2 (Continued) Finlay-Carruthers et al, 2018; Lavhelani et al, 2020; Paradis-Gagné, Holmes, & Jacob, 2020; Paradis-Gagné, Holmes, & Perron, 2020).Because of their experiences, the caregivers reported anxiety, fear, hypervigilance and exhaustion(Chemerynska et al, 2020;Finlay- Carruthers et al, 2018;Paradis-Gagné, Holmes, & Jacob, 2020). One caregiver referred to the impact on a sibling of the actions of a service user, described as: "(Violence), it stays for life, afterwards.…”