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“It Had Only Been a Matter of Time Before I Had Relapsed Into Crime”

Aspects of Care and Personal Recovery in Forensic Mental Health

Pollak, Charlotte, RN1,2; Palmstierna, Tom, MD, PhD1–3; Kald, Magnus, PhD4; Ekstrand, Per, RN, PhD5

doi: 10.1097/JFN.0000000000000210
Original Articles

Introduction Forensic psychiatry has the dual task of focusing on the prevention of reoffending as well as maintaining psychiatric rehabilitation. No previous studies addressing the patients' own views on reducing their risk of serious reoffending were found.

Aim This study describes forensic psychiatric inpatients' own views on what aspects of care and personal recovery are important in reducing their risk of serious reoffending.

Methods A structured qualitative approach was used. Data were collected from semistructured interviews and analyzed with a systematic qualitative content analysis.

Results The results highlight aspects of care and personal recovery. Four themes emerged: “time: opportunity for change,” “trust: creating a context with meaningful relations,” “hope: to reach a future goal,” and “toolbox: tools needed for recovery.”

Discussion The themes present with a continuum. At one end, there are patients who appreciated possibilities to participate actively in care and treatment. At the other end, patients felt they had no use for their care. Interestingly, although patients in our study were asked for their opinion on how they could reduce their dangerousness, all themes fit into established personal recovery processes found in general psychiatric populations. The theme “time: opportunity for change” seems to have an overarching importance.

Implications for Practice By understanding the specific content along these themes, relevant to the individual patient, carers may be able to better support their personal recovery journey. Because time spent as inpatients in forensic psychiatry is an overarching issue, carers need to be persistent over time.

Author Affiliations:1Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet;

2Stockholm Health Care Services, Stockholm County Council;

3St. Olav's University Hospital, Center for Research and Education in Forensic Psychiatry, Norwegian University of Science and Technology;

4Economic Information Systems, Linköping University; and

5Department of Health Sciences, The Swedish Red Cross University College.

The authors declare no conflict of interest.

Correspondence: Charlotte Pollak, RN, Rättspsykiatri Vård Stockholm, Karolinska Universitetssjukhuset Huddinge, Röntgenvägen 3 Plan 6, S-141 52 Huddinge, Sweden. E-mail:

Received March 27, 2018; accepted for publication June 11, 2018.

© 2018 by the International Association of Forensic Nurses. All rights reserved.
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