Meta-aggregative systematic review of the needs of caregivers for individuals with mental illness who have offended and are involved in secure forensic services

This review presents a meta-aggregation of qualitative studies exploring the needs of caregivers for individuals with mental illness who have offended and are in secure forensic services. While much research has examined carers’ experiences and burdens, few studies focus specifically on their needs. To address this gap, this review systematically synthesised qualitative evidence to develop a comprehensive understanding of forensic carers’ perspectives. A systematic search was conducted across five databases (Web of Science, PsycINFO, ProQuest, CINAHL Plus, and Scopus), supplemented by grey literature and manual reference screening. Following quality appraisal, five studies met inclusion criteria, with quality scores ranging from 65% to 81%. Data extraction and synthesis were undertaken using a structured meta-aggregation approach. Six interrelated themes emerged: (1) Emotional responses, (2) Coping strategies, (3) Carers’ need for guidance: Navigating the mental health system and accessing information, (4) The need for support in managing family dynamics and the practical burden of caregiving, (5) Collaborative partnerships: Moving from exclusion to transparent inclusion, and (6) Relational stability as a buffer against isolation. Findings indicate that carers face significant emotional distress and require reassurance, guidance, and inclusion to sustain resilience, reflecting challenges that extend beyond those identified in general mental health caregiving.