‘Knocking on the Door, Saying, “Can We Come in?”‘: Carers’ Experiences of Engagement With Healthcare Workers in Inpatient Mental Health Services

AI Summary

Carers often experience exclusion and tokenistic involvement in inpatient mental health services, limiting meaningful contribution to care and decision making.
A fractured, highly medicalised and risk averse system undermines recovery rhetoric, creating a disconnect between professionals and carers' experiential knowledge.
Occasional genuine collaboration can foster trust and hope, yet inconsistent practice leaves carers without reliable recognition or access to formal support pathways.

AI Summary

AIM: This study explores carers' experiences of engagement with mental healthcare workers in public inpatient mental health services to better understand how carers can be optimally supported to contribute to recovery-oriented care.

RESULTS: Three overarching themes were identified, including: Exclusion and tokenism, which captures carers' experiences of limited inclusion and superficial participation in inpatient mental health services; Fractured and medicalised system, which highlights the disconnect between the rhetoric of recovery and the reality of highly medicalised and risk-averse practice; and Occasional care, which describes genuine collaboration and shared understanding between carers and mental healthcare workers that are intermittently present, supporting trust and hope in some instances, but absent in others.

Basic summary

J Clin Nurs. 2026 Jul 3. doi: 10.1111/jocn.70423. Online ahead of print.

ABSTRACT

AIM: This study explores carers’ experiences of engagement with mental healthcare workers in public inpatient mental health services to better understand how carers can be optimally supported to contribute to recovery-oriented care.

DESIGN: An exploratory qualitative descriptive study.

METHOD: We conducted semi-structured interviews with ten carers using a reflexive thematic analysis that emphasised systematic coding and reflexivity to enhance rigour.

RESULTS: Three overarching themes were identified, including: Exclusion and tokenism, which captures carers’ experiences of limited inclusion and superficial participation in inpatient mental health services; Fractured and medicalised system, which highlights the disconnect between the rhetoric of recovery and the reality of highly medicalised and risk-averse practice; and Occasional care, which describes genuine collaboration and shared understanding between carers and mental healthcare workers that are intermittently present, supporting trust and hope in some instances, but absent in others.

CONCLUSION: Carers experience significant challenges when engaging with mental healthcare workers. The findings suggest the need for a genuine transformation of mental health systems and practice, with meaningful carer engagement central to relational recovery and recovery-oriented care.

RELEVANCE TO MENTAL HEALTH SERVICES: Findings from this study indicate that carers often lack consistent recognition and access to appropriate support, needed to fulfil their potential in supporting recovery. Strengthening formal support pathways for carers is therefore essential to promoting recovery that is relational, sustainable and shared.

PATIENT OR PUBLIC CONTRIBUTION: A professional carer peer worker was consulted on the development of the study design and questions. Carers participated through in-depth interviews.

PMID:42400179 | DOI:10.1111/jocn.70423

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