Schwartz Centre Rounds: qualitative exploration of panel members’ experiences within a forensic mental health service

Schwartz Centre Rounds (SCRs) provide a structured forum for staff from all disciplines to meet and discuss the difficult emotional and social challenges that arise in caring for patients. Research into the implementation of SCRs has shown that staff who attend report increased insight into the emotional and social aspects of care; greater understanding of the roles of their colleagues; improved teamworking and decreased feelings of isolation and stress. However, little research has explored the implementation of SCRs within forensic settings, and no research has focused solely on the experiences of panel members. Three focus groups were facilitated with participants who had participated in a SCR panel within a forensic mental health service. Semi-structured interviews were carried out, audio-recorded and subsequently transcribed. Interpretive phenomenological analysis was utilised to analyse the transcripts, and four key themes were identified. These themes were: feeling vulnerable, the importance of validation, exposure to intense emotional experiences and improved understanding and connection. We conclude that SCRs can be an emotionally challenging but rewarding experience, with the potential to enhance teamworking and general well-being. Limitations and recommendations for future research are also discussed.

Virtual Reality and Forensic Mental Health

This chapter provides an overview of virtual reality (VR) treatment and rehabilitation for mentally ill patients who have committed a crime or are at risk of relapse. The authors focus on the forensic mental health field since this area relates to any individual dealing with a psychiatric condition that is in trouble with the law, whether they be inpatient offenders, outpatient offenders, or inmates at a regular prison. Virtual reality (VR) and its current uses, as well as its benefits and barriers, are presented as a successful and individualized eHealth treatment. In addition, some examples of VR studies that were recently done with these individuals will be presented to show the results of their current approaches, demonstrate their limitations, and figure out possible ways of improvement.

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

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.

Personal recovery and its challenges in forensic mental health: systematic review and thematic synthesis of the qualitative literature

Background There has been a call for a framework to guide recovery-oriented practices in forensic mental health services. Aims This study aims to examine personal recovery and its challenges in forensic mental health settings in relation to the established framework for personal recovery in mental illness: connectedness, hope, identity, meaning and empowerment (CHIME). Method This study is an updated and expanded systematic review and thematic synthesis of the qualitative literature. A systematic search of six electronic databases (Web of Science, Medline, PsycINFO, CINAHL, EMBASE and SocIndex) was carried out in January 2019, using the terms [Recover*] AND [Forensic OR Secure] AND [Patient* OR Offend* OR Service User*]. Only studies that included service user's own perceptions and were published from 2014 onward were included in the review. Data were examined with thematic synthesis and subsequently analysed in relation to the CHIME framework. Results Twenty-one studies were included in the review. Findings suggest that some adjustments to the original CHIME framework are needed for it to be more relevant to forensic populations, and that an additional recovery process regarding feeling safe and being secure (safety and security) could be added to CHIME, providing the CHIME-Secure framework (CHIME-S). Specific challenges and barriers for forensic recovery were identified and found to represent the opposite of the recovery processes defined by CHIME (e.g. hopelessness). Conclusions We present the CHIME-S as a framework for the personal recovery processes of forensic mental health service users. The CHIME-S may guide the recovery-oriented work of forensic mental health services.