Pillars and pathways: foundations of recovery in Irish forensic mental health care

Abstract

The Central Mental Hospital in Ireland is one of the oldest forensic mental health units in Europe. The hospital is currently in the process of transforming from a single inpatient site to a modern national forensic mental health service. Central to this transformation is the need to move from the traditional security‐focused model of care to a model of recovery. The challenge incumbent within this transformation is to incorporate a sophisticated amalgamation of the patients' needs while recognising the broad range of security requirements in a forensic setting. This paper considered that adopting an integrated care pathway (ICP) approach would provide the service with a vehicle to re‐engineer our principles and systems of care. Likewise we hypothesised that the ICP would enable us to consolidate best practices such as multi‐ disciplinary working, structured professional judgement and the involvement of the patient and their carers. Thus far it has afforded us the opportunity to examine many aspects of the care delivered within the service. It has provided a shared understanding of key standards among clinicians, service users and carers that are necessary to implement a quality care pathway. It has certainly not been a stagnant process, and the initial work often bears no resemblance to the current process. In turn, we expect that it will continue to change as the path travelled is as important as the outcome and the ICP becomes a dynamic part of the organisation.