Purpose – Therapeutic relationships have been identified to be a key feature of staff working with patients within mental health settings and are widely referred to within research literature. The aim of this study is to explore the experiences of support staff within secure mental health services with regards to the formation and development of therapeutic relationships with patients.

Design/methodology/approach – Ten participants were interviewed, all of whom were unqualified support staff based within secure establishments and working directly with patients.

Findings – Interpretative phenomenological analysis of the data resulted in the identification of three themes: “Building bridges”: developing relationships with patients; “You do forget what they've done”: seeing the person and managing risk, and “Playing your cards close to our chest”: maintaining boundaries.

Originality/value – The themes are discussed and evaluated in terms of relationship formation and development, barriers that may prevent such relationships from being built and the implications for clinical practice.