Making sense of being recalled: a grounded theory

Abstract

Purpose A high proportion of forensic mental health service users (FSUs) are recalled to secure hospitals from conditional discharge in the community. The limited research on recall to date has preliminarily identified why FSUs are recalled, but not how they make sense of the process. The purpose of this paper is to develop a conceptual understanding of how FSUs make sense of being recalled to hospital. Design/methodology/approach A constructivist grounded theory approach was used. Semi-structured interviews were carried out with 11 FSUs from different levels of forensic service security who had been recalled varying numbers of times across a wide timeframe. Findings A theoretical model was constructed to illustrate the process of how FSUs make sense of being recalled. FSUs appraise being recalled on a continuum from negative to positive, based on their experiences when conditionally discharged and their reflections on the circumstances of being recalled. The nature of their appraisal appears to reciprocally influence their subsequent attitudes towards and their engagement with forensic services. Research limitations/implications The proposed mechanism of how FSUs make sense of being recalled, particularly their dynamic appraisal of it, should now be investigated longitudinally. Future qualitative research could explore forensic service staff perspectives on recall. Practical implications Enhancing the positivity of FSUs’ appraisals about being recalled may improve their attitudes about and engagement with forensic services. Originality/value This is the first research study to construct a theoretical model of recall.

There and back again: staff and service user perspectives on readmission to a secure mental health hospital

“…The results of this study indicated that service users wanted more stability, structure and activity but it was difficult to achieve this for a variety of different reasons including availability, access and ability issues. This concurs with the grounded theory model proposed by Rye et al (2019) which suggests that the degree to which service users enjoy or struggle in their surrounding environments is a large factor in the likelihood of readmission. Service users reported not knowing how to develop the routines and interests which may have aided recovery, whereas destabilising activities such as substance misuse and gambling were more accessible.…”

“…Perhaps the most crucial findings were regarding the impact of identified factors on the relationship with the supporting team. The central role of the relationship between professional and client has been highlighted to the secure recovery process (Ashcraft and Anthony, 2006; Rye et al , 2019). Fear of readmission ironically can lead to behaviour which may actually increase the likelihood of readmission, as it can interfere with ability or willingness to maintain a cooperative relationship with the care team (O’Sullivan et al , 2013).…”

“…All the participants in these qualitative studies were male. One final study proposed a grounded theory model based on semi-structured interviews investigating how service users made sense of their experience of recall (Rye et al , 2019). This model posits that service users appraise their experience on a positive–negative continuum, which affects their engagement with subsequent care.…”

“…The use of case note analysis is believed by the authors to be original in this study, and the analysis of a qualitative staff perspective has been called for by other research (Rye et al , 2019). Researchers postulated that the themes that arose would overlap with those found in previous research but also strove to maintain an awareness and openness to novel results.…”