title: Double deprivation: a phenomenological study into the experience of being a carer during a mental health crisis.
abstract: OBJECTIVE
  To explore carers' experience of caring during a mental health crisis.
  
  
  BACKGROUND
  Community mental health care including crisis care relies increasingly on carers. The relationship between carers and professionals is at times fraught due to issues of what constitutes a crisis, confidentiality and a perception of lack of empathy. The caring experience can lead carers to feel isolated and neglected.
  
  
  METHODS
  A qualitative study with a phenomenological approach. Eight carers participated and were interviewed individually using a semi-structured approach.
  
  
  METHODS
  Analysis used the Interpretive Phenomenological Analysis method including transcribing of interviews, initial noting, searching for connections and patterns across the transcripts and cases. The themes were checked with the participants for their views on the emerging themes. The data were collected from November 2011-May 2012.
  
  
  RESULTS
  Carers experienced 'double deprivation' by not receiving support from professionals and protecting their social network from the trauma of the crisis. The caring in crisis invoked complex feelings of guilt and loyalty which made discussing aggression difficult. Caring was described as a terrifying experience not just because of the aggression but also because of the perception of abandonment by professionals.
  
  
  CONCLUSIONS
  The experience was an overwhelmingly negative one with a wish for acknowledgement of the crisis and support from mental health services. For most of the participants the caring during crisis was traumatic which left the carer feeling isolated and unsupported. The study should be used to help educate professionals on the complexities of caring during a crisis.
authors.affiliation: East London NHS Foundation Trust, London, UK.
authors.forename: Rikke
authors.initials: R
authors.lastname: Albert
authors.affiliation: East London NHS Foundation Trust, London, UK.|City University London, London, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Simpson
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003153:Community Health Services; D003419:Crisis Intervention; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000451:nursing*; D008875:Middle Aged; D036301:Qualitative Research; D012944:Social Support; D013315:Stress, Psychological / Q000451:nursing*
keywords: abandonment; carers; deprivation; mental health crisis; nursing; support