Purpose – The purpose of this paper is to derive from an on-going, innovative, project to explore the concept, and application, of “recovery” in the care and clinical management of patients detained in one UK high-security hospital. Design/methodology/approach – Utilising a qualitative, action research, methodology the aim was to involve forensic mental health nurses in a collaborative, client-centred approach to identification and resolution of dilemmas in the process of planning care for offender-patients. Findings – In this context the authors identify constraints and contradictions involved in employing recovery principles in institutions critics refer to as part of the disciplinary apparatus of psychiatric and social control; where the taken for granted lives, and relations, of an incarcerated population are measured by the calendar, not the clock. Research limitations/implications – Protective practices remain highly relevant in high-secure practice. Safety, an important value for all can by and large be achieved through recovery approaches. The humanistic elements of recovery can offer up safe and useful methods of deploying the mental health nurse on the ward. Many nurses have the prerequisite approach but there remains a wide scope to enhance those skills. Many see the approach as axiomatic though nurse education often prepares nurses with a biomedical view of the ward. Practical implications – Currently, philosophical tenets of recovery are enshrined in contemporary health policy and professional directives but, as yet, have not been translated into high-secure settings. Drawing on preliminary findings, attention is given to the value of socially situated approaches in challenging historic dominance of a medical model. Social implications – It is concluded that recovery could be a forerunner of reforms necessary for the continued relevance of high-secure care into the twenty-first century. Originality/value – This research is located in high-secure setting. The social situation is marked by the extent of the isolation involved. A value is in this situation. First it is akin to the isolation of the tribe utilised by many anthropologists for their ability to adopt the “social laboratory” status to test out theories of behaviour in industrial society. The authors urge others to utilise this research in this way. Second, the situation represents the locus of so many of societies dilemmas, paradoxes and fears that moral issues morph from what is the mundane in wider society. In this way humanistic approaches are tested via action research with nurses in some rigouous ways.

Models of care from the general field of nursing applied in special hospitals appears to be unworkable in this type of environment in terms of their inability to affect patient care. It is argued that these external models, adopted due to a crisis of confidence in special hospitals, fail because their fundamental constructs clash with that of the institution's particular sociology. A historical analysis of the development of special hospitals and nursing models reveals a dichotomy of emergent values, highly complex in nature, which conflict from the notion of Parsonian role-adoption. From this position, it is suggested that the strength of value systems are such that this leads to a non-negotiable stalemate of forensic elements of client and institution, and the 'treatment' ethic as prescribed by the medicalization of criminology. This article critically analyses the six most commonly-used nursing models in special hospitals and pinpoints the areas of breakdown within this type of environment from a sociological perspective. Finally, it argues for a new direction away from 'generalist' ideals of nursing towards a theoretical construction of 'specialism' in forensic care.

Purpose – The authors offer up an example of recovery in a high-secure setting. The purpose of this paper is to highlight how an individual account of recovery and the academic literature offer up related and important perspectives that have serious clinical utility. Design/methodology/approach – First the context is outlined. The biographical account is then deployed to describe the experience of being detained in an English high-secure facility using recovery as a framework for elucidation. This is often referred to in recovery as accessing the views of the “expert by experience”. In a thematic way this author details his understanding of recovery, what worked and what did not. This account is then contrasted with the academic literature and research at the same site. Social anthropology acts as the theoretical backdrop. This debate informs some clinical implications and issues for practice. Findings – Recovery can be a highly relevant concept in a high-secure context. The author found that the biographical account of the “patient” can offer the observer some insights for practice. The authors noted that the collective themes of previous research where consistent to this account. The authors found the use of recovery principles helped the person receiving care fulfil his potential. Nevertheless, forensic recovery implies a forensic past. This complicates recovery and placed limits on the own use of the principles. Social implications – The authors argue that recovery is highly relevant to the context and particularly important to people who are often stigmatized for multiple reasons including their, “illness”, their “crime”, and their social situation. The paper implies that forensic recovery is more problematic than mainstream recovery. Key events mark out issues. Originality/value – This is the first co-produced paper surrounding recovery in high-secure care.

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