Linking the past and the present: service users’ perspectives of how adverse experiences relate to their admission to forensic mental health services

Abstract

Purpose This study aimed to explore how forensic mental health service users make sense of their past adverse experiences. Secondly, it aimed to explore whether service users considered their adverse experiences to be related to their current stay in a forensic mental health setting. Design/methodology/approach Interpretative phenomenological analysis was used to analyse interviews with eight service users in low and medium secure care. Six of the participants were male and two were female. Findings Four super-ordinate themes emerged from the data: “Living amongst adversity”; “Managing adverse experiences”; “Making sense of going into secure care”; and “Coping with the past in the present”. All participants referred to multiple adverse experiences throughout their lives and used harmful coping strategies to manage these. Individual differences in how they related their past experiences to their detention in secure care were evident. Practical implications Author guidelines state that this section is optional. Implications for clinical practice are discussed at length in the discussion section. Originality/value This study offers an insight into the way in which forensic mental health service users make sense of their past traumas in relation to their current admission to secure services. To the best of the authors’ knowledge, no research has previously addressed this from the perspective of service users.

An Interpretative Phenomenological Analysis of the Experience of the Therapeutic Relationship between Service Users and Staff after Physical Restraint in a Secure Mental Health Service

“…Ongoing support with the repairing of the therapeutic relationship when ruptures have occurred is also required. Principles of Procedural Justice, Safewards, and trauma informed approaches have been applied on a limited basis in UK secure mental health services to date, but have all been recognised as having potential benefits in these areas for such services (Cartwright et al, 2021b;Maguire et al, 2022;Simpson et al, 2020). Based on our findings we recommend that secure service providers and future research should aim to explore these approaches further.…”

Facilitating a safe and caring atmosphere in everyday life in forensic mental health wards - a qualitative study

“…Forensic psychiatry is a speciality within the mental healthcare system and emphasizes providing care to patients with severe mental disorders with a focus on creating a safe and secure environment (Seppänen et al, 2018 ; Söderberg et al, 2022 ; Tomlin et al, 2018 ). Patients in forensic psychiatry wards are vulnerable and exposed because they suffer from severe mental disorders, have committed serious crimes and are being cared for against their will in a secure hospital environments with a high level of security (Cartwright et al, 2022 ; Hörberg, 2018 ).…”