Service Users' Experiences and Perceptions of Carer Support and Involvement in Care and Treatment in Adult Mental Health Inpatient Settings: A Qualitative Evidence Synthesis

Over the past decade, research has increasingly addressed the support needs of carers in mental health settings and their involvement in care and treatment. However, service users' perspectives have received comparatively limited attention, despite the importance of their preferences as a key starting point for carer involvement. Furthermore, existing evidence remains scattered across smaller qualitative studies. The aim of this qualitative evidence synthesis of adult mental health inpatient service users' experiences and perceptions of carer support and involvement in care and treatment. Systematic searches were conducted in CINAHL, PubMed, APA PsycINFO and Scopus for literature published between January 1, 2000 and January 3, 2025. Grey literature was identified through OpenGrey, GreyGuide, ProQuest Dissertations & Theses Global, Google, Google Scholar and relevant websites. Eligible studies underwent quality appraisal and were analysed using a thematic approach. Fourteen studies were included, encompassing findings from 632 service users. Five themes were developed: (1) eagerness versus hesitations towards involvement of carers in care planning, care and treatment; (2) the significance of receiving support from carers in coping with mental illness; (3) the necessity of supporting carers-recognising needs and burdens; and (4) institutional barriers to carer support and involvement. These four themes are interrelated with an overarching theme five: (5) relationship between service users and carers. The overarching theme reveals that service users' perceptions of whether carer involvement and support were meaningful depended on the significance and quality of the relationship, which in turn was shaped by carers' knowledge and understanding of mental illness.