Abstract
Forensic High and Intensive Care (FHIC) has recently been developed as a new care model in Dutch forensic psychiatry. FHIC aims to provide contact-based care. To support Dutch forensic care institutions in the implementation of the model, a model fidelity scale was developed called the FHIC monitor. The aim of this study was to assess the inter-rater reliability, content validity, and construct validity of the FHIC monitor. A multi-methods design was used, combining qualitative and quantitative research. To collect data, audits and focus group meetings were organized to score care at individual wards with the monitor and get feedback from auditors and audit receiving teams about the quality of the monitor. In total, fifteen forensic mental healthcare institutions participated. The instrument showed acceptable inter-rater reliability and content validity, and a significant difference between expected high and low scoring institutions, supporting construct validity. The instrument can be used as a valid instrument to measure the level of implementation of the FHIC model on forensic psychiatric wards in the Netherlands.
Highlights
In recent years, the reduction of coercive measures in forensic mental healthcare, especially concerning the use of seclusion, has received increasing attention (Laiho et al, 2016)
This study aims to assess the interrater reliability, the content validity, and the construct validity of the Forensic High and Intensive Care (FHIC) monitor
The precursor High and Intensive Care (HIC) monitor was used as a basis for formulating items, specifying them for the forensic setting and adjusting them based on the FHIC model
Summary
The reduction of coercive measures in forensic mental healthcare, especially concerning the use of seclusion, has received increasing attention (Laiho et al, 2016). Goulet, et al (2017) concluded that there is international consensus that seclusion should be reduced in (forensic) mental health care. A reduction of seclusion in forensic psychiatry is complicated by the explicit focus on safety (Goulet, et al, 2017). Care professionals in forensic psychiatry tend to focus on control for ensuring safety, especially in challenging situations such as a crisis. Instead of control-based care, contact-based care is suggested to contribute to less aggression, prevention of care disruption, and reduction of coercive measures as seclusion (Ros et al, 2013; van der Helm et al, 2011)
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