Supporting recovery by improving patient engagement in a forensic mental health hospital: results from a demonstration project

J Am Psychiatr Nurses Assoc. 2013 May-Jun;19(3):132-45. doi: 10.1177/1078390313489730. Epub 2013 May 20.

Abstract

Background: Mental health services are shifting toward approaches that promote patients' choices and acknowledge the value of their lived experiences.

Objective: To support patients' recovery and improve their experiences of care in a Canadian forensic mental health hospital, an intervention was launched to increase patient engagement by establishing a peer support program, strengthening a patient advisory committee, and creating a patient-led research team.

Design: The effect of the intervention on patient- and system-level outcomes was studied using a naturalistic, prospective, longitudinal approach. Quantitative and qualitative data were gathered from inpatients and service providers twice during the 19-month intervention.

Results: Despite succeeding in supporting patients' participation, the intervention had minimal impacts on internalized stigma, personal recovery, personal empowerment, service engagement, therapeutic milieu, and the recovery orientation of services. Peer support demonstrated positive effects on internalized stigma and personal recovery.

Conclusions: Strengthening patient engagement contributes toward improving experiences of care in a forensic hospital, but it may have limited effects on outcomes.

Keywords: forensic mental health; participatory action research; patient engagement; peer support; recovery.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advisory Committees / legislation & jurisprudence*
  • Advisory Committees / organization & administration*
  • Canada
  • Commitment of Mentally Ill / legislation & jurisprudence*
  • Cooperative Behavior
  • Female
  • Hospitals, Psychiatric / legislation & jurisprudence*
  • Hospitals, Psychiatric / organization & administration*
  • Humans
  • Insanity Defense*
  • Interdisciplinary Communication
  • Longitudinal Studies
  • Male
  • Mental Disorders / nursing*
  • Mental Disorders / rehabilitation*
  • Middle Aged
  • Outcome and Process Assessment, Health Care / methods
  • Patient Care Team / organization & administration
  • Patient Compliance / psychology*
  • Patient Participation / legislation & jurisprudence*
  • Patient Participation / psychology*
  • Patient Satisfaction
  • Peer Group*
  • Power, Psychological
  • Prospective Studies
  • Psychotic Disorders / nursing
  • Psychotic Disorders / rehabilitation
  • Research / legislation & jurisprudence*
  • Research / organization & administration*
  • Schizophrenia / nursing
  • Schizophrenia / rehabilitation
  • Social Support*
  • Substance-Related Disorders / nursing
  • Substance-Related Disorders / rehabilitation