Throughout my career, I have met many family members of people who have been detained in inpatient units. I have talked to people who have had their son or daughter ‘placed’ in various services, not just forensic units, for many different reasons. Yet there was a common feeling amongst all of them: they felt bewildered about the process that led to this placement, and they didn’t feel involved or consulted enough. When their family member was detained in the unit, they spent a lot of time worrying about them and how they were being looked after. Things like even getting their family member to ring them or see a family pet were seen as breakthroughs.
Laughing Boy’s Mum, Sara Ryan [see JusticeforLB.org and @justiceforLB] told me that if services worked together with families more, it might have stopped her son, Connor, being taken to an ATU (Assessment and Treatment Unit). Sara said:
When the crisis started in Nov/Dec and escalated quite quickly, it would have been good for someone to sit down with Connor (us and school), explore what made him happy (or least unhappy) and arranged for him to just do this for a few months.
It is extremely important to involve family and friends. In my opinion, the whole point of services should be to support and restore positive relationships as far as possible.
Most importantly, not involving parents can be a matter of life and death – after LB had been detained in the ATU, Sara was ignored when she voiced her concerns to the staff about LB’s epilepsy. After 107 days in the unit, he was left in a bath alone until he drowned.
Family members know the person best; they know what makes the person tick, how to keep them safe, and what will cause them distress. This is crucial information.
When I did an ethnographic research project in 2012 at an inpatient unit, spending time on the women’s wards, I found that many of the women thought the lack of family contact was the worst thing about being locked up. One woman, Sarah, told me,
‘[The worst thing is…] being away from your family, at Christmas time, locked away.’
She was worried about her sister’s domestic situation and she wanted to be at home to help. They had both been abused at the hands of their father and they had been emotional supports for each other in the past.
Other women were worried about the health of one of their family members and whether they would pass away without them, like Marion:
‘I do hope if I do move, sooner or later, that I’ll be back before anything happened to my Mum.’
Two of my participants talked about their mum being ill. Bella said she was ‘just waiting for the phonecall’ to say that her mum had passed away. Being away from family at such a distressing time must be heartbreaking.
Some of the parents found it difficult to come and see their daughter due to the distance from home. For example, Katrina’s Mum lived two hours away and therefore Katrina had to wait for approval to visit her home with two staff (a difficult arrangement). She said about the service
‘The only thing that’s good is that I see my Mum.’
I found that staff helped women with family contact and writing letters to family, even supporting them in dealing with some difficult family dynamics. One of the many tasks that staff did was protecting women from abusive family members and helping them to deal with them. Most of the women had experienced abuse at the hands of one or more family members, but even though this was the case, all women had at least one family member that they wanted to keep in contact with.
As well as family contact, I asked about relationships with other women in the unit. I found that friendships (whilst widely accepted as helpful to people in psychiatric inpatient services) were also being regulated. Women had been told not to get too close to people, because the focus of the service was ‘moving on’ in the form of ‘progression’. Despite this, women made and kept friendships. Annie told me about her friendship with another woman on her ward,
‘We’ve managed to lean on each other and pick each other up. And when one’s down, the other one’s alright, so whoever’s alright manages to pick the other person up.’
The relationships we have are extremely important when it comes to mutual encouragement and assistance, and of course, networks of support are vital when people move back to the community. My view is that if someone is made to be away from home for (as short as possible) a period of time, then the building and maintaining of relationships should be the service’s fundamental focus.
- I wrote a journal article about this. The paper has just been published open access (free to read) in Disability and Society (2016 December issue) and is called ‘Friends and Family: Regulation and relationships on the locked ward’.