Perceptions of procedural justice and coercion among forensic psychiatric patients: a study protocol for a prospective, mixed-methods investigation
Abstract Background The risk and recovery paradigms are the dominant frameworks informing forensic mental health services and have been the focus of increasing research interest. Despite this, there are significant gaps in our understanding of the nature of mental health recovery in forensic setting...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-05-01
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| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12888-020-02629-6 |
| _version_ | 1819056946755403776 |
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| author | Alexander I. F. Simpson Irene Boldt Stephanie Penney Roland Jones Sean Kidd Arash Nakhost Treena Wilkie |
| author_facet | Alexander I. F. Simpson Irene Boldt Stephanie Penney Roland Jones Sean Kidd Arash Nakhost Treena Wilkie |
| author_sort | Alexander I. F. Simpson |
| collection | DOAJ |
| description | Abstract Background The risk and recovery paradigms are the dominant frameworks informing forensic mental health services and have been the focus of increasing research interest. Despite this, there are significant gaps in our understanding of the nature of mental health recovery in forensic settings (i.e., ‘secure recovery’), and specifically, the key elements of recovery as perceived by forensic patients and their treatment providers. Importantly, we know little about how patients perceive the forensic mental health system, to what extent they see it as fair and legitimate, and how these perceptions impact upon treatment engagement, risk for adversity, and progress in recovery. Methods In this prospective, mixed-methods study, we investigate patient perceptions of procedural justice and coercion within the context of the forensic mental health system in Ontario, Canada (final N = 120 forensic patients and their primary care providers). We elicit patient self-assessments of risk and progress in recovery, and assess the degree of concordance with clinician-rated estimates of these constructs. Both qualitative and quantitative methods are used to assess the degree to which patient perceptions of coercion, fairness and legitimacy impact upon their level of treatment engagement, risk for adversity and progress in recovery. A prospective, two-year follow-up will investigate the impact of patient and clinician perspectives on outcomes in the domains of forensic hospital readmission, criminal reoffending, and rate of progress through the forensic system. Discussion Results from this mixed-methods study will yield a rich and detailed account of patient perceptions of the forensic mental health system, and specifically whether perceptions of procedural fairness, justice and legitimacy, as well as perceived coercion, systematically influence patients’ risk for adversity, their ability to progress in their recovery, and ultimately, advance through the forensic system towards successful community living. Findings will provide conceptual clarity to the key elements of secure recovery, and illuminate areas of similarity and divergence with respect to how patients and clinicians assess risk and recovery needs. In doing so, knowledge from this study will provide a deep understanding of factors that promote patient safety and recovery, and provide a foundation for optimizing the forensic mental health system to improve patient outcomes. |
| first_indexed | 2024-12-21T13:31:30Z |
| format | Article |
| id | doaj.art-da47477d2c764eb4b93b852bcf6e7b74 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-12-21T13:31:30Z |
| publishDate | 2020-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-da47477d2c764eb4b93b852bcf6e7b742022-12-21T19:02:17ZengBMCBMC Psychiatry1471-244X2020-05-0120111010.1186/s12888-020-02629-6Perceptions of procedural justice and coercion among forensic psychiatric patients: a study protocol for a prospective, mixed-methods investigationAlexander I. F. Simpson0Irene Boldt1Stephanie Penney2Roland Jones3Sean Kidd4Arash Nakhost5Treena Wilkie6Complex Care and Recovery Program, Centre for Addiction and Mental HealthComplex Care and Recovery Program, Centre for Addiction and Mental HealthComplex Care and Recovery Program, Centre for Addiction and Mental HealthComplex Care and Recovery Program, Centre for Addiction and Mental HealthComplex Care and Recovery Program, Centre for Addiction and Mental HealthDepartment of Psychiatry, University of TorontoComplex Care and Recovery Program, Centre for Addiction and Mental HealthAbstract Background The risk and recovery paradigms are the dominant frameworks informing forensic mental health services and have been the focus of increasing research interest. Despite this, there are significant gaps in our understanding of the nature of mental health recovery in forensic settings (i.e., ‘secure recovery’), and specifically, the key elements of recovery as perceived by forensic patients and their treatment providers. Importantly, we know little about how patients perceive the forensic mental health system, to what extent they see it as fair and legitimate, and how these perceptions impact upon treatment engagement, risk for adversity, and progress in recovery. Methods In this prospective, mixed-methods study, we investigate patient perceptions of procedural justice and coercion within the context of the forensic mental health system in Ontario, Canada (final N = 120 forensic patients and their primary care providers). We elicit patient self-assessments of risk and progress in recovery, and assess the degree of concordance with clinician-rated estimates of these constructs. Both qualitative and quantitative methods are used to assess the degree to which patient perceptions of coercion, fairness and legitimacy impact upon their level of treatment engagement, risk for adversity and progress in recovery. A prospective, two-year follow-up will investigate the impact of patient and clinician perspectives on outcomes in the domains of forensic hospital readmission, criminal reoffending, and rate of progress through the forensic system. Discussion Results from this mixed-methods study will yield a rich and detailed account of patient perceptions of the forensic mental health system, and specifically whether perceptions of procedural fairness, justice and legitimacy, as well as perceived coercion, systematically influence patients’ risk for adversity, their ability to progress in their recovery, and ultimately, advance through the forensic system towards successful community living. Findings will provide conceptual clarity to the key elements of secure recovery, and illuminate areas of similarity and divergence with respect to how patients and clinicians assess risk and recovery needs. In doing so, knowledge from this study will provide a deep understanding of factors that promote patient safety and recovery, and provide a foundation for optimizing the forensic mental health system to improve patient outcomes.http://link.springer.com/article/10.1186/s12888-020-02629-6Procedural justiceCoercionRecoveryRisk assessmentForensic mental healthViolence |
| spellingShingle | Alexander I. F. Simpson Irene Boldt Stephanie Penney Roland Jones Sean Kidd Arash Nakhost Treena Wilkie Perceptions of procedural justice and coercion among forensic psychiatric patients: a study protocol for a prospective, mixed-methods investigation BMC Psychiatry Procedural justice Coercion Recovery Risk assessment Forensic mental health Violence |
| title | Perceptions of procedural justice and coercion among forensic psychiatric patients: a study protocol for a prospective, mixed-methods investigation |
| title_full | Perceptions of procedural justice and coercion among forensic psychiatric patients: a study protocol for a prospective, mixed-methods investigation |
| title_fullStr | Perceptions of procedural justice and coercion among forensic psychiatric patients: a study protocol for a prospective, mixed-methods investigation |
| title_full_unstemmed | Perceptions of procedural justice and coercion among forensic psychiatric patients: a study protocol for a prospective, mixed-methods investigation |
| title_short | Perceptions of procedural justice and coercion among forensic psychiatric patients: a study protocol for a prospective, mixed-methods investigation |
| title_sort | perceptions of procedural justice and coercion among forensic psychiatric patients a study protocol for a prospective mixed methods investigation |
| topic | Procedural justice Coercion Recovery Risk assessment Forensic mental health Violence |
| url | http://link.springer.com/article/10.1186/s12888-020-02629-6 |
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