Perceptions, experiences and meanings of recovery in forensic psychiatric patients

The 'Recovery Approach' is widely regarded as the guiding principle for mental health service delivery in the UK. However, it is not clear whether this approach has any relevance, or is applicable to mentally disordered offender patients, who are almost invariably detained against their will and whose capacity to exert choice and control over their treatment must therefore be severely restricted. This study set out to explore definitions, experiences, and perceptions of recovery in patients with severe mental illness, currently detained in medium secure psychiatric provision. Most patients defined recovery as getting rid of symptoms and feeling better about themselves. Medication and psychological work, relationships with staff and patients and being in a secure setting were all cited as being important in bringing about recovery. The stigma associated with being an offender, as well as having a serious mental illness, was perceived as a factor holding back recovery, particularly in relation to discharge and independent living in the community. Core recovery concepts of hope, self-acceptance, and autonomy are more problematic and appear to be less meaningful to individuals, who are detained for serious and violent offences. The recovery approach may need to be modified for use in forensic psychiatric services.