Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes
Mental health professionals are tasked with making difficult clinical decisions in treatment settings. In the forensic system, decision making regarding staff supervised community outings (SSCOs) provides a significant challenge due to the need to balance patient liberties, mental health recovery, a...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1382676/full |
| _version_ | 1827299190187753472 |
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| author | Christian Farrell Christian Farrell Karen L. Petersen Peri Hanzouli Tonia L. Nicholls Tonia L. Nicholls Tonia L. Nicholls |
| author_facet | Christian Farrell Christian Farrell Karen L. Petersen Peri Hanzouli Tonia L. Nicholls Tonia L. Nicholls Tonia L. Nicholls |
| author_sort | Christian Farrell |
| collection | DOAJ |
| description | Mental health professionals are tasked with making difficult clinical decisions in treatment settings. In the forensic system, decision making regarding staff supervised community outings (SSCOs) provides a significant challenge due to the need to balance patient liberties, mental health recovery, and public safety. This study explored the characteristics and rehabilitative nature of SSCOs, characteristics of patients attending SSCOs, and any adverse events that occurred during the outings. Employing a cross-sectional design, 110 patients who participated in SSCOs over a one-year period from a Canadian Forensic Psychiatric Hospital were included. Clinical records were reviewed to capture patient and SSCO variables. Descriptive analyses were used to calculate participant, risk, SSCO, and adverse event characteristics. Qualitative analysis was used to explore the purpose of SSCOs and rehabilitative progress that occurred during the outings. Patients attending SSCOs were comprised of long-stay patients with over half having committed a violent index offence. Almost 75% of patients had a moderate/high risk for violence and 50% of the patients had a moderate/high risk of absconding. During the study period, 463 SSCOs were completed. Most outings focused on developing skills for daily living and staff comments suggested many patients developed skills in these areas. Despite considerable risk profiles and public concern regarding forensic patients having community access, there was a single occurrence of unauthorized leave and no instances of violence or substance use. This research can disrupt stigma, demonstrating that SSCOs support a specific rehabilitative intent, promote community reintegration, and maintain public safety. |
| first_indexed | 2024-04-24T15:29:48Z |
| format | Article |
| id | doaj.art-51b9050ca3934f71a9fd6ef96e50a1dd |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-24T15:29:48Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-51b9050ca3934f71a9fd6ef96e50a1dd2024-04-02T04:45:43ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402024-04-011510.3389/fpsyt.2024.13826761382676Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomesChristian Farrell0Christian Farrell1Karen L. Petersen2Peri Hanzouli3Tonia L. Nicholls4Tonia L. Nicholls5Tonia L. Nicholls6Department of Psychiatry, University of British Columbia, Vancouver, BC, CanadaDepartment of Psychiatry, University of Alberta, Edmonton, AB, CanadaDepartment of Psychiatry, University of British Columbia, Vancouver, BC, CanadaBC Mental Health and Substance Use Services, Provincial Health Services Authority, Coquitlam, BC, CanadaDepartment of Psychiatry, University of British Columbia, Vancouver, BC, CanadaBC Mental Health and Substance Use Services, Provincial Health Services Authority, Coquitlam, BC, CanadaDepartment of Psychology, Simon Fraser University, Burnaby, BC, CanadaMental health professionals are tasked with making difficult clinical decisions in treatment settings. In the forensic system, decision making regarding staff supervised community outings (SSCOs) provides a significant challenge due to the need to balance patient liberties, mental health recovery, and public safety. This study explored the characteristics and rehabilitative nature of SSCOs, characteristics of patients attending SSCOs, and any adverse events that occurred during the outings. Employing a cross-sectional design, 110 patients who participated in SSCOs over a one-year period from a Canadian Forensic Psychiatric Hospital were included. Clinical records were reviewed to capture patient and SSCO variables. Descriptive analyses were used to calculate participant, risk, SSCO, and adverse event characteristics. Qualitative analysis was used to explore the purpose of SSCOs and rehabilitative progress that occurred during the outings. Patients attending SSCOs were comprised of long-stay patients with over half having committed a violent index offence. Almost 75% of patients had a moderate/high risk for violence and 50% of the patients had a moderate/high risk of absconding. During the study period, 463 SSCOs were completed. Most outings focused on developing skills for daily living and staff comments suggested many patients developed skills in these areas. Despite considerable risk profiles and public concern regarding forensic patients having community access, there was a single occurrence of unauthorized leave and no instances of violence or substance use. This research can disrupt stigma, demonstrating that SSCOs support a specific rehabilitative intent, promote community reintegration, and maintain public safety.https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1382676/fullcommunity accessforensic psychiatric patientsrisk assessmentunauthorized leaveviolence |
| spellingShingle | Christian Farrell Christian Farrell Karen L. Petersen Peri Hanzouli Tonia L. Nicholls Tonia L. Nicholls Tonia L. Nicholls Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes Frontiers in Psychiatry community access forensic psychiatric patients risk assessment unauthorized leave violence |
| title | Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes |
| title_full | Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes |
| title_fullStr | Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes |
| title_full_unstemmed | Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes |
| title_short | Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes |
| title_sort | staff supported community outings among forensic mental health patients patient characteristics rehabilitative goals and the absence of adverse outcomes |
| topic | community access forensic psychiatric patients risk assessment unauthorized leave violence |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2024.1382676/full |
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