Looking back, looking forward: Recovery journeys in a high secure hospital

Abstract

A qualitative study of staff and service users' views of recovery was undertaken in a UK high secure hospital working to implement recovery practices. 30 staff and 25 service users participated in semi-structured interviews or focus groups. Thematic analysis identified four broad accounts of how recovery was made sense of in the high secure environment: the importance of meaningful occupation; valuing relationships; recovery journeys and dialogue with the past; and recovery as personal responsibility. These themes are discussed with an emphasis on service user strategies of cooperation or resistance, respectively advancing or impeding progress through the system. In this context the notion of cooperation is, for many, commensurate with compliance with a dominant medical model. The policy framing of recovery opens up contemplation of treatment alternatives, more participatory approaches to risk management, and emphasise the value of relational skills, but may not elude the overarching bio-psychiatric episteme.

Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice

“…A shift in autonomy and responsibility for care is needed not only for reducing blame placed on those we are purporting to treat, but also for supporting autonomy itself as a therapeutic intervention. While mandated treatment poses a challenge to nurses promoting autonomy in the inpatient setting, all nurses can utilize a strengths‐based approach in patient care and centre freedom of choice (McKeown, Jones, Wright, Paxton, & Blackmon, ). Doyal et al.…”

How Best to Engage Users of Forensic Services in Research: Literature Review and Recommendations

“…Two documents summarised studies exploring professionals' experience of involving service users in research in a prison setting (Byrne, 2005;Patenaude, 2004); four were studies involving service users at each stage of the research (Livingston, Nijdam-Jones & Team P.E.E.R., 2013a;Livingston, Nijdam-Jones, Lapsley, Calderwood & Brink, 2013b;McKeown et al, 2014;McKeown et al, 2016), one was a study on communication between researchers and service users (Davidson, Espie & Lammie, 2011), and one was an evaluation of peer support in secure mental health settings carried out by people with personal experience of mental distress (Shaw, 2014). In summary, five articles focussed mainly on providing guidance for good practice (CLINKS, 2013;Faulkner, 2004;NSUN/WISH, 2011;SURGE, 2005/6), eleven were qualitative or empirical studies (Banongo et al, 2006;Davidson et al, 2011;Godin et al, 2007;Livingston et al, 2013a;Livingston et al, 2013b;McKeown et al, 2014;McKeown et al, 2016;MacInnes et al, 2011;Martin et al, 2009;Patenaude, 2004;Shaw, 2014), and seven were overviews or discussion documents (Byrne, 2005;CLINKS, 2011;Faulkner, 2007;Faulkner & Morris, 2003;INVOLVE, 2009;Sainsbury Centre, 2008;Spiers et al, 2005).…”

StreetWise: developing a serious game to support forensic mental health service users' preparation for discharge: a feasibility study

“…Although using Serious Gaming as a participatory approach for risk assessment and to promote recovery may enable movement away from compliance and a reliance of mental health nurses on bio‐medical approaches to care within FMH services (McKeown et al . ).…”

“…, Dickens , McKeown et al . ). A commonality in these is the development of safe communicative spaces to enable open and honest dialogue between users and practitioners (Godin et al .…”