Forensic Psychiatric Patients’ Perspectives on Their Care: A Narrative View

Askola, Riitta; Nikkonen, Merja; Paavilainen, Eija; Soininen, Päivi; Putkonen, Hanna; Louheranta, Olavi

doi:10.1111/ppc.12201

Cited by 33 publications

(45 citation statements)

References 32 publications

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“…This can be understood as a part of the dual-role dilemma between these two roles or sets of tasks, promoting public safety on the one hand and the wellbeing of individual patients on the other hand (Robertson & Walter, 2008;Ward, 2013). Askola et al (2018) argued that patients in forensic psychiatry often begin their time in psychiatric treatment feeling a sense of alienation. Sometimes patients start fighting against the forensic psychiatric institution, while at the same time being very vulnerable.…”

Section: Discussionmentioning

confidence: 99%

An Interview Study of Professional Carers’ Experiences of Supporting Patient Participation in a Maximum Security Forensic Psychiatric Setting

Söderberg

Wallinius

Hörberg

2019

Issues in Mental Health Nursing

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Patient participation in forensic psychiatric settings seems to be complex by nature, and previous studies show that patients rate their participation as lower in this context compared to general psychiatric contexts. Studies on caregivers' perspective could provide a clearer picture of the components and possibilities of patient participation in forensic psychiatry. The aim of the study is to describe carers' experiences in supporting patient participation in a maximum security forensic psychiatric care setting. Twelve psychiatric caregivers were interviewed about how they support patients' participation. The result shows that a complexity of patient participation emerges as a difficult act of balancing the paradoxical role of caring for the patient's interests and development, while simultaneously representing and adhering to the rules and regulations of the system in which one is employed. In conclusion, it is suggested that participation is comprehended as an umbrella term and that focus is directed to conceptualising what caregivers can do in order to create positive patient-carer relationships, as well as what constitutes such a relationship.

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Section: Discussionmentioning

confidence: 99%

An Interview Study of Professional Carers’ Experiences of Supporting Patient Participation in a Maximum Security Forensic Psychiatric Setting

Söderberg

Wallinius

Hörberg

2019

Issues in Mental Health Nursing

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“…Even during the twentyfirst century, research has shown that forensic psychiatric care is characterised by correction and discipline, with a caring care being overshadowed by a non-caring care. Several studies have shown that the care provided in forensic psychiatric settings can be characterised as behavioural modification and discipline (e.g., Askola et al, 2016;Barnao, Ward, & Casey, 2015;Gildberg, Bradley, Fristed, & Hounsgaard, 2012;Gildberg, Elverdam, & Hounsgaard, 2010;Holmes, 2002Holmes, , 2005H€ orberg & Dahlberg, 2015;H€ orberg et al, 2012;Jacob, 2012Jacob, , 2014Jacob & Foth, 2013). Care based on behavioural modification risks overshadowing both the patient as a person and their lifeworld.…”

Section: Forensic Psychiatric Care and Caringmentioning

confidence: 99%

‘The Art of Understanding in Forensic Psychiatric Care’ – From a Caring Science Perspective Based on a Lifeworld Approach

Hörberg

2018

Issues in Mental Health Nursing

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Patients in forensic psychiatric clinics are a vulnerable and exposed patient group due to suffering from a severe mental disorder, having committed a crime and being cared for against their will in an institutional environment with a high level of security. The art of understanding in forensic psychiatric care is discussed from a caring science perspective, based on a lifeworld approach. The aim is to contribute knowledge that can support staff, who daily meet patients on forensic psychiatric wards, in applying a caring attitude.

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“…Patients live with restrictions and confinement in an unhome‐like atmosphere where they ‘strive to convert the unfamiliar to the familiar and the impersonal to the personal’ (Olausson et al , p. 521). They may feel that they are subjected to humiliating attitudes in a prison‐like culture (Hörberg et al ) and that their opinions and rights are ignored by staff (Askola et al ; Olsson et al ). They might feel burdened by normative expectations of what recovery should look like and pressured to act adherent (Livingston ).…”

Section: Introductionmentioning

confidence: 99%

‘I know what I need to recover’: Patients’ experiences and perceptions of forensic psychiatric inpatient care

Marklund

Wahlroos

Looi

et al. 2019

Int J Mental Health Nurs

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Patients find forensic psychiatric care inadequate in that they are not treated as individuals and not involved in their own care. The purpose of this study was to describe patients’ experiences and perceptions of forensic psychiatric inpatient care. Semi‐structured interviews were conducted with 11 inpatients. A qualitative content analysis resulted in a recurring theme, ‘I know what I need to recover’, and three main categories: ‘A need for meaning in a meagre existence’, ‘A need to be a person in an impersonal context’, and ‘A need for empowerment in a restricted life’. Participants experienced and perceived forensic care as predominantly monotonous, predetermined, and not adapted to them as individuals, forcing them to fight and adapt to get through it and not lose themselves. Perceived needs were largely ignored or opposed by staff due to the content and structure of care. Findings suggest a need for reflective practices and patient involvement in order to develop and maintain a person‐centred and recovery‐oriented nursing practice. The study adds to previous research showing the importance of patients in forensic psychiatric inpatient care being listened to and involved in their care. The study is reported in accordance with the COREQ guidelines.

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Forensic Psychiatric Patients’ Perspectives on Their Care: A Narrative View

Abstract: The findings of the present study should direct the forensic psychiatric personnel's attention to the notion that forensic psychiatric patients' experiences of their treatment can improve the quality of patient-centered care and reduce bureaucracy.

Cited by 33 publications

References 32 publications

An Interview Study of Professional Carers’ Experiences of Supporting Patient Participation in a Maximum Security Forensic Psychiatric Setting

An Interview Study of Professional Carers’ Experiences of Supporting Patient Participation in a Maximum Security Forensic Psychiatric Setting

‘The Art of Understanding in Forensic Psychiatric Care’ – From a Caring Science Perspective Based on a Lifeworld Approach

‘I know what I need to recover’: Patients’ experiences and perceptions of forensic psychiatric inpatient care

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