“It Had Only Been a Matter of Time Before I Had Relapsed Into Crime”: Aspects of Care and Personal Recovery in Forensic Mental Health

Pollak, Charlotte; Palmstierna, Tom; Kald, Magnus; Ekstrand, Per

doi:10.1097/jfn.0000000000000210

Cited by 16 publications

(34 citation statements)

References 17 publications

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“…The central factors supporting recovery as pointed towards by the informants in this study are in line with previous studies on recovery in forensic contexts [ 10 , 11 , 12 , 13 , 14 , 15 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ].…”

Section: Discussionsupporting

confidence: 91%

“…The central factors supporting recovery as pointed towards by the informants in this study are in line with previous studies on recovery in forensic contexts [10][11][12][13][14][15][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38].…”

Section: Discussionsupporting

confidence: 85%

“…Some of this insecurity as to how to react as a health professional and support recovery-oriented care might be reduced by increased knowledge on what patients consider as important and helpful ingredients in their recovery processes. The international literature on personal recovery has grown intensively, and there is also a substantial amount of literature on personal recovery processes and forensic psychiatry [ 7 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ]. There is a widespread consensus in the literature on the importance of focusing on and supporting recovery for patients struggling with mental disorder as well as offences, eventually even further complicated by substance use issues.…”

Section: Introductionmentioning

confidence: 99%

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Offender Recovery. Forensic Patient Perspectives on Long-Term Personal Recovery Processes

Møllerhøj

2021

IJERPH

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Knowledge on user experiences from mentally disordered offenders (MDOs) is still limited in a Danish context, especially regarding recovery from offences, severe mental illness, long-term admissions and often involuntarily contact with hospital psychiatry. The study is based on 34 semi-structured interviews with nine forensic patients exploring their experiences with personal recovery processes. The MDOs point out a significant number of elements and factors enhancing, supporting and limiting personal recovery processes. Long-term recovery processes for MDOs involve coming to terms with mental disorders as well as offences. Working with offender recovery implies addressing and understanding the index offence leading to psychiatric measurement as well as addressing risk and prevention of future crime. This coming to terms is an individual and deeply personal process and it often involves several and changing narratives. According to the informants, professionals play a crucial role in supporting recovery processes and maintaining hope and optimism over time. MDOs experience structural barriers limiting recovery potential, especially stigma or limited areas of participation. It is important not to focus solely on personal recovery as a one-dimensional individual process or responsibility, but as a process also marked by structural and organisational challenges.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

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Offender Recovery. Forensic Patient Perspectives on Long-Term Personal Recovery Processes

Møllerhøj

2021

IJERPH

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“…Furthermore, a recent qualitative study of FMH service users' own views on reducing their risk of serious offending found that the emerging themes fit into personal recovery processes described for general psychiatric populations. 14 Participants emphasised the importance of trust and creating a context with meaningful relations (connectedness), hope to reach a future goal (hope and optimism about the future) and being given the tools that they needed for their recovery (empowerment). Nevertheless, whether personal recovery processes for FMH service users are fully covered by the CHIME framework remains unclear.…”

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confidence: 99%

Personal recovery and its challenges in forensic mental health: systematic review and thematic synthesis of the qualitative literature

et al. 2021

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Background There has been a call for a framework to guide recovery-oriented practices in forensic mental health services. Aims This study aims to examine personal recovery and its challenges in forensic mental health settings in relation to the established framework for personal recovery in mental illness: connectedness, hope, identity, meaning and empowerment (CHIME). Method This study is an updated and expanded systematic review and thematic synthesis of the qualitative literature. A systematic search of six electronic databases (Web of Science, Medline, PsycINFO, CINAHL, EMBASE and SocIndex) was carried out in January 2019, using the terms [Recover*] AND [Forensic OR Secure] AND [Patient* OR Offend* OR Service User*]. Only studies that included service user's own perceptions and were published from 2014 onward were included in the review. Data were examined with thematic synthesis and subsequently analysed in relation to the CHIME framework. Results Twenty-one studies were included in the review. Findings suggest that some adjustments to the original CHIME framework are needed for it to be more relevant to forensic populations, and that an additional recovery process regarding feeling safe and being secure (safety and security) could be added to CHIME, providing the CHIME-Secure framework (CHIME-S). Specific challenges and barriers for forensic recovery were identified and found to represent the opposite of the recovery processes defined by CHIME (e.g. hopelessness). Conclusions We present the CHIME-S as a framework for the personal recovery processes of forensic mental health service users. The CHIME-S may guide the recovery-oriented work of forensic mental health services.

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“…Patients can experience good care that leads to change and recovery or poor care that leads to no changes or worse outcomes. (10) Although HCPs in forensic psychiatric care can help patients reconcile their situation and alleviate their suffering, these outcomes can be undermined by the actions of colleagues, leading to a more alienated and asymmetric relationship with patients (11). Hörberg and Dahlberg (12) found that patients experience insecure care when their care is contingent on the level of satisfaction of the HCPs rather than of the patients, suggesting that forensic psychiatric care should be guided by input from patients rather than the HCPs, a focus that requires the organisation and the care culture to support caregivers in developing a more caring attitude towards their patients (13).…”

Section: Introductionmentioning

confidence: 99%

The meaning of significant encounters in forensic care

Rytterström

Rydenlund

Ranheim

2020

Scandinavian Caring Sciences

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Background Research in forensic psychiatric care focusing on person‐oriented care is ambiguous about matters of quality. The encounters between a healthcare professional (HCP) and patient could influence how connections and relations emerge between the caregiver and the patient. Objectives To better understand caring aspects, this study explores significant encounters in forensic psychiatric care from the perspective of HCPs. Method This study is based on 34 written narratives from HCPs from two forensic psychiatric hospitals in Sweden. The narratives concern significant encounters with a patient. These narratives were analysed according to methodologies developed by phenomenological and reflective lifeworld research. Findings The essence of a significant encounter is a temporal extended phenomenon that both precedes as well as is a consequence of the actual encounter as it occurs. The encounter is unforeseeable and being open to an encounter also means to be vulnerable as it is not predetermined how someone will respond. The significant encounter is an act of sharing, and HCPs may come to understand more about their patients as well as about themselves. Moreover, these encounters seem to create repercussions and hope for the future care. Conclusions The everyday activities of forensic psychiatric care are not trivial activities. Rather, they are important aspects of health care as these everyday encounters can deepen the relationship between the HCPs and their patients and help both the HCPs and their patients develop a sense of hope for the future.

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“It Had Only Been a Matter of Time Before I Had Relapsed Into Crime”: Aspects of Care and Personal Recovery in Forensic Mental Health

Abstract: By understanding the specific content along these themes, relevant to the individual patient, carers may be able to better support their personal recovery journey. Because time spent as inpatients in forensic psychiatry is an overarching issue, carers need to be persistent over time.

Cited by 16 publications

References 17 publications

Offender Recovery. Forensic Patient Perspectives on Long-Term Personal Recovery Processes

Offender Recovery. Forensic Patient Perspectives on Long-Term Personal Recovery Processes

Personal recovery and its challenges in forensic mental health: systematic review and thematic synthesis of the qualitative literature

The meaning of significant encounters in forensic care

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