Healthcare assistants’ experiences on forensic mental health wards

Stacey Boardman (Stockton Hall Hospital, York, UK)
Jane Clarbour (Department of Psychology,University of York, York, UK)
Kelly Rayner (Tees, Esk and Wear Valleys NHS Foundation Trust, Harrogate, UK)

The Journal of Forensic Practice

ISSN: 2050-8794

Publication date: 13 August 2018



In forensic mental health wards, patients spend more time with healthcare assistants (HCAs) than qualified nurses. Despite this, there is no universally utilised standardised HCA training. The purpose of this paper is to assess the HCAs’ experiences in the HCA role in order to better understand how to build on the HCA role to ensure safe practice, and enhance staff well-being.


HCAs working on low and medium secure NHS forensic mental health units were recruited through purposive methods. HCAs engaged in a semi-structured interview, with questions surrounding their support needs, clinical decision making and perception of risks in the role. Template analysis was used, applying an a priori template based on the existing literature to interview transcripts.


The participants described the HCA experience to be defined by two master themes: “HCA factors” and “organisational factors”. HCAs valued a holistic patient view which prized patients’ experiences. The participants described a lack of role clarity which may be defined through ward expectations and professional experience.


HCAs seek a holistic view of the patient; however, some overlooked patient offences in order to do their job. Future research should address how looking past offences impacts security and HCAs’ well-being long term.



The authors’ sincere thanks goes to Dr Simon Reid Milligan for his support in facilitating data collection.


Boardman, S., Clarbour, J. and Rayner, K. (2018), "Healthcare assistants’ experiences on forensic mental health wards", The Journal of Forensic Practice, Vol. 20 No. 3, pp. 179-190.

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