Deconstructing imposed recovery – clinical perceptions of the legal and administrative framework for managing restricted mental health patients – the experience of one hospital in the independent sector

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Abstract

Deconstructing imposed recovery – clinical perceptions of the legal and administrative framework for managing restricted mental health patients – the experience of one hospital in the independent sector

Aims and objectives.

This paper sets out to address the potentially important issue or issues relating to mental health professionals’ views on the arrangements for the management of patients subject to a restricted hospital order.

Background.

Less-than-optimal outcomes and escalating costs for chronic conditions including mental illness have prompted calls for innovative approaches to chronic illness management in the context of forensic mental health.

Design.

Report of a survey. A grounded theory approach was used for both ‘collecting’ and ‘analysing’ the data.

Method.

A total of 14 mental health practitioners were interviewed regarding the legal and administrative framework for managing restricted patients and their use of a patient-centred care model to assist restricted patients with serious mental illness to identify their self-management needs. The research interviews were conducted between 2008 and 2009.

Conclusions.

‘Imposed’ recovery and the systemic issues and the value assumptions that health professionals often bring to their interactions with clients need to be explored further. Not until we have serious debate about such issues as will health services fully translate the current rhetoric of collaborative partnership into reality for clinicians and the clients they serve.

Relevance to clinical practice.

Forensic practitioners must practice within a legal framework and carefully balance the needs and rights of patients against the need to protect the public from harm. Imposed recovery involves a high degree of skill and expertise in terms of risk assessment, risk decision-making and working interprofessionally and cooperatively with government agencies.

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