It is claimed that family or other carers provide support equivalent in scale to that delivered by the employed staff of the mental health and associated care services –“we have to be available for our relative when the professional staff are not available”. That invites mutual respect between the two. Carers cannot be expected to know much about, or therefore to deliver, clinical interventions. However, as they know their friend or relative when s/he is well, as well as when ill, carers can offer a ‘holistic’ perspective sometimes not available to mainstream staff. Knowledge arising from familiarity with the particular service user can be extremely useful for the treatment offered to that individual. The equivalent experience, when combined across a number of carers, should be invaluable to the service when addressing perceived weaknesses in service delivery, or when considering broader service redesign.
That can pose difficulties. Many carers see themselves as a David facing the Goliath of the service. The need for success is to create a partnership of equals. For the two to tango successfully, there is a parallel need for the carer to stand tall and for the service to lead. There can be apprehension in the other direction. Input from carers can be unpredictable and sometimes hurtfully critical. Their input may be tinged with frustration from situations that have not gone well for their family. CiP is conscious of these sensitivities and deploys means of minimising their adverse effects. At best, the carer contribution can be both positive and useful for both parties. CiP co-ordinated carer participation in the peer-review of West Midlands MH trusts by the NHS Quality Review Service during 2011. Opportunities are currently being sought to work with certain provider trusts on services identified as examples of good practice. CiP has also been invited to work with a couple of trusts on the implementation of the Triangle of Care.
A project recently concluded was concerned with issues particular to carers living in rural areas. Recently started is a project aimed at carer participation towards the gaining of paid employment of service users, covering also job retention by carers whose ability to continue working is put at risk by their caring role.