Entering a forensic clinic is a difficult step for relatives of mentally ill people. Uncertainty accompanies entering these hospitals. It is difficult to deal with the requirements placed on a relative by an institution. The expectations on a person admitted there are high due to the special nature of the institution.
The “Initiative Forensik”, forensic initiative, in the Federal Association of families of mentally ill people (BApK) wants to encourage and help relatives of mentally ill people admitted to forensic-psychiatric hospitals on their way to these institutions. It’s clear for the campaigners in the psychiatric self help movement that this is not an easy thing.
Even before the first visit to a forensic-psychiatric hospital emerge the first obstacles. What has to be clarified before someone can be visited in the facility? Is a judicial visit permit required? What must be brought there and what is allowed to be brought? The list of possible reflections is long and the possibility of getting tangled up in springes, likewise.
The “Initiative Forensik“ in the BApK wants to support people to deal with the uncertainty and fear. It wants relatives of mentally ill people, who are accommodated in forensic-psychiatric hospitals, to have contact persons when there are questions about the forensic-psychiatric care.
• What does the accomodation order in forensic-psychiatric hosptals mean? (Duration, treatment, visits, ...)
• How do we deal with the situation in the family and the social environment? (Children, friends ...)
• How do people who are accommodated in the forensic-psychiatric hospital actually live? What are they doing all day?
• What does the social reception area mean after a conditional dismissal forensic treatment? How does it proceed after the treatment?
• How can one deal with the fact that one’s own child or one’s own partner is accommodated in a forensic-psychiatric hospital?
The “Initiative Forensik” in the BApK is a nationwide, independent working group of relatives of the mentally ill who are accommodated in the hospitals. The „Initiative Forensik“ is mainly concerned with information and exchange of experience on the different experiences with the system and the people who are concerned with it.
Situation of affected families
Families who have come into contact with forensic institutions are also in self-help associations and groups in a special situation:
• they constitute a minority
• they are hardly informed about the legal situation
• these families are scattered across the country
• they often have no means of contact with other affected families
Dr. Gerald Meesmann gives an initial insight into the strange world of the execution of the forensic treatment. The jurist Meesmann is a long-time companion of the „Initiative Forensik”.
How would you, Dr. Meesmann, describe the situation of the relatives in the forensic treatment?
In short, they are overburdened and left alone in their misery! The relatives are faced with helplessness towards the institution of forensic treatment, but by the professionals they are perceived in their anamnesis, but with their burdens and worries they are allegorical. This experience, as well as the need for information and exchange of experience, brought together some relatives of the „Initiative Forensik”.
What are the perspectives of people with mental illness who are accompanied by forensic counseling on a forensic-psychiatric hospital?
The first encounter with the forensic clinic is a shock. They are awaiting a clinic and are facing a high security complex. The structural conditions (NATO-wired walls, security sluices) and other security measures (handing over of identity card and mobile phone, pocket- and possibly also person control) unsettle and shy the visitor. The forensic treatment remains a “black box” for the relatives. They do not learn what happens behind the wall with the patients, what competences exist within the institution, and between the judiciary and the clinic. All this, combined with the permanent duration of the accommodation (§ 63 Criminal Code), leads to the impression: “Worse than prison”!
How did you, as a relative, experience the professionally active staff in the clinic?
From my own experience in two clinics and the experiences of other relatives, I would like to warn you of generalizations - here as everywhere where people meet there are “such and such”! However, what is the main topic of all experiences is a reciprocal inhibition threshold, which hinders an open, unimpeded exchange between relatives and employees of the clinic. The employees are under pressure, fear legal risks (medical confidentiality), have had bad experiences with relatives. The relatives are hampered by feelings of shame and guilt, unsettled by the oppressive circumstances of a forensic clinic or the behavior of the employees. It takes more mutual understanding to overcome these obstacles, which in turn requires more knowledge from each other and the attempt to move into the position of the other.
What do you think psychiatric professionals can do to improve the relationship with their relatives?
It is very important for the relationship how the employees encounter the relatives at the first contact or visit. For relatives it is important that they feel like being welcome (and not annoying). This includes the awareness of the difficult emotional situation of the relatives who are encountered by the professionals in their everyday routine. It must become an integral part of the company’s mission statement. Standards for dealing with relatives have to be developed.
What are the self-imposed tasks has the "Initiative Forensics" in the BApK?
The primary objective of the initiative is to provide information and discussion opportunities for relatives, as well as to organize contacts and meetings for relatives at hospitals. This is connected with the desire for cooperation with the clinics, in order to create offers for relatives and to bring them closer to them on the one hand and on the other hand to do the work with the relatives on the subject training and further education of the employees.
Also in the family movement, it is necessary for the relatives of forensic patients to provide more understanding and support. For whether we like it or not, forensics shapes the image of psychiatry in society. No relative can be sure not to deal with the hospital order treatment one day. As part of the BApK, we therefore have a commissioner for forensic treatment. The national associations have appointed contact persons for questions of the forensic treatment. These are all measures which can contribute to a prejudice-free understanding of the treatment of persons with a mental illness who have been convicted.
Thank you very much for the conversation.