Abstract
There are long-standing concerns that forensic patients may be staying in high and medium secure care for too long. However, ‘long-stay’ remains undefined, and research on the determinants of long-stay has been limited and undertaken mainly from an institutional or staff perspective. Research that has investigated the patient’s perspectives of secure care has focused upon quality of life and desired service provision. This study aimed to explore patients’ perceptions and experiences of prolonged stay in secure care. Semi-structured interviews were conducted with a purposive sample of 40 patients from 8 high and medium secure hospitals. Thematic analysis was carried out using a framework approach. A narrative analysis approach was used to explore the relationship between emergent themes at an individual case level. Several key issues were discussed by participants in the context of their current situation, their reasons for long-stay and their potential to move on from secure care. A typology of four long-stay stances was developed in relation to these themes: dynamic acceptance, dynamic resistance, static acceptance and static resistance. These stances illustrated differences in the extent to which participants believed that being in secure care was helping them to get better and whether they were actively trying to progress to leave secure care. Service providers should be mindful of these stances to provide patients with individualised opportunities to progress through the secure care treatment pathway.
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References
Coffey M. Researching service user views in forensic mental health: a literature review. J Forensic Psychiatry Psychol. 2006;17(1):73–107.
Reed J. Risk assessment and clinical risk management: the lessons from recent inquiries. Br J Psychiatry. 1997;(Suppl 32):4.
Jacques J, Spencer SJ, Gilluley P. Long-term care needs in male medium security. Br J Forensic Pract. 2010;12(3):37–44.
Walker J, Gudjonsson G. The Lancashire Quality of Life Profile: data and experiences with 58 detained mentally disordered offenders. Crim Behav Ment Health. 2000;10(2):123–35.
Swinton M, Carlisle J, Oliver J. Quality of life for patients with a personality disorder—comparison of patients in two settings: an English special hospital and a Dutch TBS clinic. Crim Behav Ment Health. 2001;11(3):131–43.
Bressington D, Stewart B, Beer D, MacInnes D. Levels of service user satisfaction in secure settings—a survey of the association between perceived social climate, perceived therapeutic relationship and satisfaction with forensic services. Int J Nurs Stud. 2011;48(11):1349–56.
Ford K, Sweeney J, Farrington A. User views of regional secure unit: findings from a patient satisfaction survey. Int J Psychiatr Nurs Res. 1999;5(1):526–41.
Green T, Batson A, Gudjonsson G. The development and initial validation of a service-user led measure for recovery of mentally disordered offenders. J Forensic Psychiatry Psychol. 2011;22(2):252–65.
O’Neill C, Heffernan P, Goggins R, Corcoran C, Linehan S, Duffy D, et al. Long-stay forensic psychiatric inpatients in the republic of Ireland: aggregated needs assessment. Ir J Psychol Med. 2003;20(4):119–25.
Rankin JM. ‘Patient satisfaction’: knowledge for ruling hospital reform—an institutional ethnography. Nurs Inq. 2003;10:57–65.
Yorston G, Taylor PJ. Older patients in an English high security hospital: a qualitative study of the experiences and attitudes of patients aged 60 and over and their care staff in Broadmoor Hospital. J Forensic Psychiatry Psychol. 2009;20(2):255–67.
Clarke C, Tapp J, Lord A, Moore E. Group-work for offender patients on sex offending in a high security hospital: investigating aspects of impact via qualitative analysis. J Sex Aggress. 2013;19(1):50–65.
Farnworth L, Nikitin L, Fossey E. Being in a secure forensic psychiatric unit: every day is the same, killing time or making the most of it. Br J Occup Ther. 2004;67(10):430–8.
Helbig K. Perceptions of meaningful activity amongst male patients in a high secure forensic addictive behaviours unit. Ment Health Occup Ther. 2003;8(3):77–81.
O’Connell M, Farnworth L, Hanson EC. Time use in forensic psychiatry: a naturalistic inquiry into two forensic patients in Australia. Int J Forensic Ment Health. 2010;9(2):101–9.
Rollnick S, Miller WR. What is motivational interviewing? Behav Cogn Psychother. 1995;23(04):325–34.
Drennan G, Wooldridge J. Making recovery a reality in forensic services. Implementing Recovery through Organisational Change (ImROC) briefing paper. Centre for Mental Health and Mental Health Network NHS Confederation; 2014.
Repper J, Perkins R. The team recovery implementation plan: a framework for creating recovery-focused services. London: Implementing Recovery Through Organisational Change; 2013.
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Holley, J., Weaver, T. (2019). The Experience of Long-Stay in Secure Psychiatric Hospitals in the UK: The Patient Perspective. In: Völlm, B., Braun, P. (eds) Long-Term Forensic Psychiatric Care. Springer, Cham. https://doi.org/10.1007/978-3-030-12594-3_14
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DOI: https://doi.org/10.1007/978-3-030-12594-3_14
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