Patient participation in forensic psychiatric care: Mental health professionals' perspective.
Mikael Selvin, Kjerstin Almqvist, Lars Kjellin and 1 others
PMID 33098186WHAT IT FOUND
Staff in forensic care describe balancing patient involvement with legal and safety duties.
They adjust communication to match the patient's insight, using small steps to build independence while acknowledging that full autonomy is often impossible in coercive settings.
Key findings
01Professionals describe a hierarchy of participation: creating prerequisites through communication, adapting to forensic conditions by assessing ability, and progressing toward independence.
02Staff feel responsible for adjusting their approach based on the patient's current insight and motivation, sometimes making decisions against the patient's will to manage risk.
03Encouraging gradual independence through feedback on small successes is seen as a way to improve adherence and support discharge planning.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study only includes staff perspectives, not patients' experiences. Findings are from two clinics in Sweden, so legal and service structures may differ elsewhere. The small sample size (19 people) limits the generalisability of the themes. The first author had prior experience in forensic nursing, which may have influenced the interview and analysis process.
Declared interests
No funding was received for this study.
The easy way to misread this
Do not interpret these themes as evidence that specific interventions improve patient outcomes. This is a descriptive study of staff perceptions, not a trial of efficacy.