Partners in care?: views and experiences of carers from a cohort study of the early implementation of the Mental Health (Care & Treatment) (Scotland) Act 2003

Abstract

Carers are seen as legitimate stakeholders in wider policy processes and increasingly as 'co-producers' and key providers of care. Mental health carers, however, especially those caring for relatives subject to compulsory care and treatment, often feel overlooked and marginalised, caring in complex circumstances with little or no professional support. The Mental Health (Care & Treatment) (Scotland) Act 2003 (MHCT Act) implemented in 2005 aspired to change this for the better. This article focuses specifically on findings from seven focus groups and 10 individual interviews with 33 carers from three Health Board areas and the State Hospital in Scotland. Interviews were conducted at two stages during 2007 and 2008 as part of a wider study. Participating carers were supporting relatives who were under different compulsory measures and so had experience of new procedures under the MHCT Act. The data were gathered as part of a cohort study exploring service users', carers' and professionals' early experiences of the Act's implementation. A topic guide was used to explore the impact of compulsion on carers; the 'Named Person' role; Mental Health Tribunals; the principles underpinning the MHCT Act; and suggestions for improving the law. The study found that new provisions, in particular the Named Person role and Mental Health Tribunals, had resulted in positive change. However, many carers still felt isolated and unsupported. They remained critical of the lack of consultation and involvement at both individual and collective levels. Few were aware of their right to a carer's assessment and many were sceptical that this would make any difference. Acknowledging the study's limitations, we discuss the implications for practice in light of broader policy agendas of personalisation, recovery, recognition for carers and promotion of more community-based mental health services.

Double deprivation: a phenomenological study into the experience of being a carer during a mental health crisis

“…However, research and anecdotal evidence suggests that the role is fraught and continues to lack meaningful support from professional services (Ridley et al 2010). Some literature (Schneider et al 2001, Oyebode 2003 suggests that professionals' views of the caring experience are mainly negative, which is not a full reflection of the caring role.…”

The Bond We Share: Experiences of Caring for a Person with Mental and Physical Health Conditions

“…The current study supports and builds on the view that 'carer' is an ambivalent term that "fails to do justice to the complexity of interpersonal relationships in the context of mental health problems"(pp.475-476) [34]. Wong uses the term 'chronic stressors' to denote the complex and ongoing nature of the difficulties mental health carers face [29].…”

Care planning for consumers on community treatment orders: an integrative literature review

“…In practice however there was a lack of evidence of supporting consumers in these areas [42]. Instead, care plans were reported to be ‘formal records of deficits, professionally assessed needs, and allocated services’ (p.517) [25].…”

“…Some carers reported their involvement in care planning as infrequent, which was seen as contradictory given the high level of care they provided [42]. Others reported having an increased voice subsequent to the CTO process and feeling that their caring role was more recognised [36].…”

“…Conversely, references to engaging with families were made in the majority of studies, with family members often study participants. Family members were aware of potential dilemmas and tensions that came with CTO use including differing opinions between them and their relative [42, 54], though often reported positive benefits of CTOs, such as increased stability for their relatives and increased connection with services and support for them and their family member [6, 7, 48]. Whilst the CTO gave carers evidence that their relatives illness was being taken seriously by services, they remained the primary caregiver with the major responsibility for care.…”