Compelled to interact: forensic community mental health nurses’ and service users’ relationships

Abstract

This is the first of two papers reporting community forensic mental health nurses' experiences of restriction orders and supervised discharge mechanisms. Service user/nurse relationships and risk are addressed in this initial paper. A mixed method/approach was used. A piloted 15-item questionnaire sought quantitative and qualitative data from 122 nurses throughout England and Wales; 57 questionnaires were returned. Limitations applying to gaining qualitative data via written questionnaire are overtly acknowledged. Quantitative data were analysed using the SPSS program. Content analysis and reflexive appraisal of qualitative data led to production of critically appraised conclusions. Findings are illustrative of complexity. Increased understanding of relevant issues, rather than definitive conclusions, is claimed as an outcome. Reductionist approaches are insufficient in illustrating relevant complexities; nurses offer considered, contextualized responses; diametrically opposed opinions exist about the value of interpersonal relationships and balances between care, control and risk assessment.

Power and control: forensic community mental health nurses’ perceptions of team‐working, legal sanction and compliance

“…Response rates, demographic details of respondents and findings related to nurse–patient relationships are reported elsewhere (Jenkins & Coffey 2002). Responses to the quantitative elements of this portion of the study are presented in Table 1.…”

“…Study design, data analysis, research methodology and its limitations are detailed elsewhere (Jenkins & Coffey 2002) and are further discussed in Coffey & Jenkins (2001).…”

Expanding roles within mental health legislation: an opportunity for professional growth or a missed opportunity?

“…Indeed, within a comparative paucity of evidence for either position, our findings suggest of an overall positive impact on therapeutic relationships should motivate more active participation. Study findings by Jenkins & Coffey (2002) exploring the relationship between forensic users and their nurses also indicated that many community forensic nurses felt the therapeutic relationship was unaffected by coercive legislation. Consequently, both the legitimacy of statutory roles and the robustness of therapeutic relationships to resist negative consequences from those roles, can be argued as having being at least partially established, from both research and practice‐based sources.…”

Community treatment orders: the ethical balancing act in community mental health

“…2006). Nurses have identified CTOs’ potential in facilitating medication compliance (Coffey & Jenkins 2002), reducing neglect and managing harmful behaviour (Jenkins & Coffey 2002). Concern exists with suggestions of using CTOs for all chronically mentally ill clients and not just those in the judicial system (Coffey & Jenkins 2002).…”

“…There is a valid fear that this negatively influences the therapeutic relationship between the health professional and the client (Canadian Mental Health Association 1998, Haque et al. 2002, Jenkins & Coffey 2002, O'Reilly et al. 2006).…”