Experiences of Consumer Recovery in a Forensic Step-Down Rehabilitation Unit

Abstract

ABSTRACT Forensic mental health settings are complex, influenced by legal, clinical and policy paradigms. Patients are generally subject to mandatory detention, psychiatric treatment and supervision. Social reform has resulted in implementation of the recovery paradigm in mental health services, which advocates least-restrictive practice, empowerment, hope and collaborative decision-making. However, there is tension between the recovery paradigm and risk management in forensic mental health settings. Eight forensic residents of a forensic step-down rehabilitation unit (FSDRU) were interviewed about their experiences in and attitudes towards the unit. Thematic analysis identified five main themes: two associated with the treatment context of Mental Health Recovery (Mental Health Management, Relationships) and three associated with the Forensic Setting (Court Influence, Resident Journeys and FSDRU). The FSDRU model was regarded as adaptive, supportive, well-considered and multi-faceted, owing to the FSDRU setting, risk management approach and fostering of positive peer and staff relationships. Resident perspectives indicated that the recovery model had been implemented effectively and was feasible for forensic residents, although many aspects were affected by the judicial system.