Forensic mental health service users’ experience of hospital recall under the Mental Health Act

This thesis aims to add to the body of literature on forensic service users (FSUs). Literature around forensic service users focuses heavily on the prevalence and reoffending rates. It has been widely accepted within forensic services that FSUs developing empathy reduces the likelihood to re-offend and return to services. Coupled with this, the ‘lived experience’ of FSUs is less often the focus of research with this population. Three papers are presented within this thesis.
Paper one is an overview of the current literature on the effectiveness of enhancing empathy within interventions for intellectually disabled service users who have engaged in sexually abusive behaviour. A total of 12 studies were reviewed and critically appraised. A synthesis of the findings is provided within this paper. The findings of the review indicated group Cognitive-Behavioural Therapy interventions enhance empathy for this population. The results can provide support to clinicians in delivering effective interventions for this population.
Paper two is the empirical research which was completed due to gaps in the literature. Three FSUs having experienced recall under the Mental Health Act (1983 as amended 2007) were interviewed to better understand their experiences of recall. Thematic analysis was utilised to analyse the data. Four themes were identified; ‘managing expectations’, ‘others doing to them’, ‘rebelling and taking control’, and ‘trusting relationships’. This research suggests FSU inclusion in the discharge process might lead to better outcomes.
Paper three is an executive summary of the research. This has been written in an accessible manner for FSUs with and without intellectual disability. This paper outlines FSUs experiences of recall and provides recommendations on how best to support FSUs through the discharge process