Introduction: This article focuses on the meaning of being a family when a member of the family is cared for in forensic psychiatric care. The latter operates at the crossroads of psychiatric services and the legal system, making it a highly complex area of care. Families play a vital role in supporting recovery from mental illness, however, when a family member has committed a crime and suffers from severe mental illness, pressure and stress of a complex nature are felt by the family. The aim of this study was to describe the lived experiences of families when a member is in forensic psychiatric care. Material and methods: Seven family interviews (15 participants) were conducted and analyzed with a Reflective lifeworld approach in this phenomenological study. Results: The findings reveal four themes; Being constantly affected by uncertainty; A struggle to maintain family relations – overcoming barriers in the form of restrictions; Trying to help despite inherent powerlessness and It is not just the patient who needs to heal when the family is wounded. Conclusion: A family with a family member who is being cared for in forensic psychiatric care have support needs that are not fulfilled, even though these have been highlighted from several different perspectives. Healthcare professionals might be able to provide substantial support to the family by using simple yet effective methods, such as active listening and empathetic communication. By fostering an open dialogue and understanding, caregivers can help bridge gaps and facilitate better outcomes. A family-oriented practice should thus become a fundamental component of caregiving strategies in forensic psychiatric care.

Despite advancements in promoting family engagement in mental health settings, limited involvement of family members persists in forensic mental healthcare. Forensic mental healthcare professionals face various barriers in engaging families, including a patient-centered approach and resource constraints. However, limited understanding exists of professionals' experiences with family engagement, which is crucial for improving care practices in this setting. Consequently, this study investigates the evolution of professionals' experiences with family engagement from 2015 to 2021 in Flanders, Belgium. Qualitative methods were employed, including focus group interviews in 2015 and individual interviews in 2021 with 23 forensic mental healthcare professionals. Thematic analysis is employed to identify patterns and changes over time. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was utilised to report the study. The analysis revealed that while initial steps towards family engagement in forensic mental healthcare have been taken, full integration in organisational structures is still lacking. Future efforts should focus on involving family organisations and caregivers, addressing barriers like time and resource constraints, and fostering a cultural shift towards family engagement. Further research involving a broader range of stakeholders is needed to enhance family engagement initiatives in forensic mental healthcare settings.

Caring for women in compulsory psychiatric inpatient care entails having to make a number of different moral considerations. Using coercive measures leads to difficulties in creating a caring relationship and the care given to the women thus needs to be as ethical as possible. The aim was to describe healthcare staff’s experiences of caring for women in compulsory psychiatric inpatient care. Eleven healthcare staff were interviewed, and the material was analyzed with a Reflective Lifeworld Research approach. The results show that healthcare staff move between self-examination and examining their colleagues closely and are also careful about protecting the women’s privacy. An emotional rollercoaster is set in motion when the women’s life situation affects the healthcare staff. Bridges are built, both with the next of kin but also with other authorities. It can be challenging to include the next of kin in the care for women in compulsory care since they may have a different view to that of the healthcare staff. Providing the healthcare staff with professional support and a supportive care environment may enhance their ability to provide a personalized care for the women in compulsory care.

Purpose: The aim of the study was to describe how the care relationship in primary healthcare has contributed to the recovery of persons with stress-related disorders.

Methods: This study was based on the phenomenological approach, Reflective Lifeworld Research (RLR). Fifteen persons who had recovered from stress-related disorders and who had experience of being cared for in primary healthcare were included. Lifeworld interviews were conducted, and the data were analysed according to the RLR principles of openness, flexibility and bridling.

Results: The participants experienced that the care relationship in primary healthcare contributed to their recovery from stress-related disorder by enabling them to land and be embraced in a safe relationship. This opened up a space for rest and growth that included time, being listened to and a permitting space for existential reflection based on one’s life story. The results also showed that a sense of disharmony in the care encounter constitutes a threat to recovery and reinforces vulnerability.

Conclusions: Sensing security and hope is a crucial element in the care relationship in primary healthcare when recovering from stress-related disorders. This includes the importance of being treated with respect, being given space to tell one’s story, being listened to and being supported in an existential reflection of one’s life situation

Aims: To describe self-reported mental health, bonding with the infant, family wellbeing, and family functioning among mothers and non-birthing parents with children receiving neonatal intensive care and to explore factors associated with bonding with the child, family wellbeing, and family functioning. Methods: This cross-sectional study included families from three different units in Sweden. Parents received a questionnaire that included self-reported measures of the study variables. Results: In total, 75 mothers and 72 non-birthing parents were included. Nearly 40% of the parents reported anxiety symptoms, whereas depression and post-traumatic stress symptoms were uncommon. Mothers reported more mental health issues than non-birthing parents. In the regression analyses depression was associated with problems with bonding and family wellbeing, no other significant associations were identified. Conclusion: Symptoms of anxiety were common but might be a natural and transient reaction. Identifying depression is important to be able to provide targeted family support.

Background: Stress-related illnesses are increasing in society, impacting people’s abilities and well-being. The treatment for these in Sweden is provided in primary health care, but more treatment methods are needed. The newly developed individual health-promoting treatment ‘Photo-supported conversations about well-being’ (BeWell™) has shown improvements for this group. Occupational therapists have been positive about its use, but knowledge is also needed about how the patients perceive it.

Aim: To describe the participating patients’ experiences of the BeWell™ treatment.

Materials and methods: A qualitative approach was applied in the study, in which 35 patients (aged 29–62 years) in primary health care who were diagnosed with stress-related illness participated. The interviews focus on the participants’ experiences of BeWell™ and were conducted after completing the treatment. The data were analyzed using qualitative content analysis.

Findings: Three categories were identified, expressing the participants’ experiences of participating in BeWell™: ‘The combination of the core parts gives strength’, ‘Influences on the experience’, and ‘Contribution to enhanced everyday life’. Each category encompassed two or three sub-categories.

Conclusions and significance: BeWell™, provided by occupational therapists, was perceived to impact positively on the participants’ health, well-being, and everyday life. Combinations of the different components of the treatment generated value beyond that of each part on its own.

Introduction

Health-promotion approaches to address stress-related exhaustion disorders, reduce personal suffering, improve coping and participation in everyday life are needed in primary care. The aim of this study was to investigate self-reported health and well-being before and after an intervention focusing on well-being with photo-supported conversations (BeWellTM).

Material and methods

Eighty-one patients (69 women), 20–67 years old, with exhaustion disorders were recruited at Swedish primary health care centres (PHCC) to a controlled clinical study. The intervention group (n = 40) were offered BeWell™ by therapists in addition to care as usual. Controls (n = 41) received only care as usual. The primary outcome, self-rated symptoms of exhaustion (Karolinska exhaustion disorder scale, KEDS), and secondary outcomes, anxiety and depression, sense of coherence, quality of life, occupational balance, and work ability, were assessed by validated questionnaires. Non-parametric statistical analyses were used to compare data collected directly after the treatment period with baseline measures.

Results

Demographics and self-rated baseline measures of health and well-being were comparable between the groups, apart from sick leave being more common in the intervention group. Participants in the intervention group reduced their level of exhaustion more than the control group (median difference on KEDS −9.0 vs −4.0, p = .035). However, the size of the KEDS reduction was related to baseline KEDS and, not independently associated with group assignment. Both groups improved regarding secondary outcome measures.

Conclusion

Stress-related symptoms decreased considerably over the treatment period for both groups. The potential benefit of the BeWell™, which was intended to facilitate recovery, needs to be further evaluated.

Introduction: Studies suggest that experiences of patient participation, as described by both patients and staff, are associated with a significant caring relationship of high quality.

Aim: This study aimed to investigate staffs' and patients' self-reported perceptions on participation and the frequency and importance of verbal and social interactions in high security forensic psychiatry.

Method: The questionnaire Verbal and Social Interactions (VSI) was used together with the subscale Participation from Qualityin Psychiatric Care (QPC). The study was conducted at a large forensic psychiatric clinic in Sweden.

Results: Staff and patients rated the frequency of VSI differently while reporting the same perceived degree of patient participation. All categories of VSI were significantly correlated with perceived level of participation with medium or small effect size for the patients.

Discussion: Patients' perceived participation seems to depend on verbal and social interaction within the specific categories ‘Showing interest in the patients’ feelings, experiences, and behavior’ and ‘Helping the patients establish structure and routines in their everyday life’. There was, however, a negative association for the latter.

Implications for Practice: The results give a better understanding of what kind of interactions that affect patients' perceived level of participation.

Relevance Statement: Patient participant is a prioritised area for development in forensic psychiatry. The study contributes to a better understanding of what types of interactions that affect the perceived level of participation, while at the same time, it shows important similarities and differences between patient and staff perspectives