Living on a razor's edge: Experiences of mothers caring for a son on synthetic cannabinoids in Malta.

Various studies have explored collectively the experiences of carers of individuals using illicit substances. Yet such experiences vary by gender, by relationship status to the substance user, by type of drug taken and whether the substance user lives within the same household. A hermeneutic phenomenological design was undertaken with five mothers of sons on synthetic cannabinoids (SC). These sons were receiving community mental health care following admission to hospital for episodes of drug-induced psychosis. Interview data were collected between August and October 2019. The transcribed texts were analysed using interpretative phenomenological analysis and interpreted using the Common-sense model. The superordinate theme 'Living on a Razor's edge' was extracted and consisted of two themes: 'A living Calvary' and 'Fighting a Lone battle'. The findings highlight the intense psycho-emotional suffering of the mothers, who experienced anxiety and fear relating to their welfare and that of the family; helplessness at not being able to communicate their concerns to their son and shame triggered by the judgmental attitude of others. Carers primarily associated the effects of SC such as psychotic episodes, to their sons being vulnerable individuals with mental health challenges rather than due to their drug habit. The mothers expressed feeling isolated as they could not turn to any family member or friends for support. The highly volatile and impulsive nature of their son further introduced a wedge between the female carer and her spouse, children, extended family and friends. Caring for a son on SC has a significant psycho-emotional and social impact on the mothers as informal carers. Hence, there is a need for a person-centred care approach to be provided, in which the shared understandings of the mothers narratives are explored and where their needs and concerns are integrated and addressed within a care plan.