The Core Study



National Audit Office (2008) CRHT: The Service User and Carer Experience

Involving carers contributes positively to their experiences of the service

2.23 Carers unanimously emphasise the importance of carer involvement. They value being included in the treatment and care plan of the service user. The chief benefits of carer involvement are twofold. The carer is often the person most in tune with the service user and aware of their behaviours, their needs and their relative states of mental health. A carer can offer the CRHT team a great deal of knowledge based on this close understanding and experience, and carers feel that teams should make the most of this extra insight whenever they can:

'There should be much more co-operation between medical staff and carers, because carers can give information about the patient that's not available to them. I see my daughter sitting opposite her CPN. The CPN says, 'You're looking well today, how are you today?' She says, 'Fine', whereas I know she hasn't been fine at all.'

Sarah (carer)

Source: NAO carer focus group

'They take the word of the patient. What the patient thinks isn't always true […] But they listen to the patient and think the carer's trying to make trouble'

Catherine (carer)

Source: NAO carer focus group

'For me it was hard at the beginning […] They didn't want to talk to me. They just said, 'I won't talk to you without your son being present.' They didn't understand my son's illness, but he used to tell me every single thing […  Eventually they came to the understanding that we are partners in this, working together.'

Akram (carer)

Source: NAO carer focus group

2.24 The second reason why carer involvement is so important is because it allows the team to instruct and guide the key person responsible for the welfare of the service user about issues, side-effects or changes they should watch out for. This is especially important when the carer is new to the role, and may not have a great deal of understanding about their loved one's illness or how to deal with situations arising from it. If the carer is well informed and given basic guidance about what to expect or how to deal with certain situations, they are much better placed to work effectively with the team in managing more acute phases. Some carers, while acknowledging that they found home treatment a preferable option to admission, felt that more information and support was needed to help them manage their role:

'We would really welcome help on how to handle things like hearing voices; I've had no idea in the past. Do I say, 'That's rubbish!' or do I say, 'That must be very difficult for you'? I've learned over the years how to support her, but early on a bit of advice on how to respond would have been so helpful.'' (p.13-14)