Abstract
"Background: Therapeutic relationships within psychiatric settings are highlighted as important throughout the literature. Forensic mental health inpatient settings are tasked with balancing the provision of a therapeutic environment, whilst managing risk and ensuring safety. The restrictive and involuntary nature of these settings can cause the development of positive therapeutic relationships to be challenging. Despite being recognised as important, research from the forensic inpatient perspective is limited and studies of the forensic patient- staff relationships are often from the staff perspective. This research aims to address this gap in the literature by exploring the patient-staff relationships within forensic mental health inpatient services, from the patient’s perspective.
Method: Thirty adult male forensic inpatients were recruited from 12 wards across high, medium and low secure forensic mental health NHS hospitals within the UK. Participants were interviewed face to face within the hospital, about their experiences on the ward and their interactions with staff. Interviews were transcribed and interpreted using reflexive thematic analysis.
Findings: Analysis of the data generated four themes: ‘Respectful and reciprocal relationships between patients and staff’, ‘Working with and empowering patients within a restrictive environment’, ‘Keeping themselves to themselves, a disinterest in their patients’ and ‘Authoritarian relationships and the perceived over exertion of power’.
Conclusion: This study suggests that prioritising the development of therapeutic relationships within these services may effectively aid meeting patient needs. Additionally, it highlights the importance of forensic mental health services employing staff who are wanting to engage meaningfully, provide person-centred care and work collaboratively with patients, as these are valued by forensic inpatients."