An exploration of coercion in a forensic inpatient unit. Version 0.1
Research type
Research Study
Full title
Title: ‘You need to meet with the psychologist before you have any leave’ – An exploration of coercion in a low secure forensic mental health service.
IRAS ID
221155
Contact name
Joel Harvey
Contact email
Sponsor organisation
Kings College London
Duration of Study in the UK
0 years, 6 months, 1 days
Research summary
Secure forensic settings provide specialist treatment for mentally disordered offenders. Such individuals have been detained under the Mental Health Act (1983, 2007) and require secure accommodation, due to the risk posed to themselves or others (Rutherford & Duggan 2008). Typically, they exhibit little desire to engage (Kaliski & de Clercq, 2012), yet may be required to undertake mandated or coerced-voluntary treatment in which, external reinforcements are used as leverage to encourage participation (Ross, Polaschek & Ward, 2008). For instance, early discharge or leave entitlement.
A range of coercive processes from explicit to implicit operate in secure forensic settings. In cases where psychological assessment or treatment have been mandated, Clinical and Forensic Psychologists often face systemic challenges around supporting their client's self-determination or obtaining informed consent (Miles, 2016). Research examining the impact of coerced interventions have focused predominantly on medical model compliance (Lowry, 1998) and positive outcomes remain unclear (Newton-Howes, 2010). However, there is no research exploring the impact of coercion for non-medical interventions in forensic mental health services.
To address this gap in the literature, there is need to explore service users’ understanding and experiences of coercion to engage in psychological assessment or treatment in secure forensic settings. This exploratory qualitative study will interview ten mentally disordered offenders detained within a low secure mental health in-patient unit. Using thematic analysis, key themes underlying participants’ experiences of coercion when undertaking psychological assessment and treatment, will be presented and discussed. The results will be disseminated in an appropriate format to Kent and Medway NHS and Social Care Partnership Trust and for peer-reviewed academic publications.
References:
Rutherford, M., & Duggan, S. (2008.) FMHS: facts and figures on current provision. The BritishJournal of Forensic Practice, 10 (4): 4-10
Ross, E.C., Polaschek, D.L.L., & Ward, T. (2008). The therapeutic alliance: A theoretical revision for offender rehabilitation. Aggression and Violent Behaviour, 13: 462-480.
Lowry, D. (1998). “Issues of non-compliance in mental health”. Journal of Advanced Nursing, 28:280-287.
Mental Health Act Commission (2007), Count Me In Census 2006. Available at. www.mhac.org.uk/census2006/2006Results.php
Newton-Howes, G., (2010). Coercion in psychiatric care: where are we now, what do we know, where do we go? The Psychiatrist 34(6), 217-220.
Miles, H., (2016). You need to meet with the psychologist before you can have any leave’: Reflections on ‘coercion’ in a secure forensic setting. Clinical Psychology Forum, Special Issue: Forensic Psychology. The British Psychological Society. Available at https://www.bps.org.uk/system/files/user-files/Division%20of%20Clinical%20Psychology/public/2016_06%20Ethics%20Column.pdf
Kaliski, S. Z., & De Clercq, H. G. (2012). When coercion meets hope: can forensic psychiatry adopt the recovery model? African Journal of Psychiatry, 15(3).
REC name
London - Camberwell St Giles Research Ethics Committee
REC reference
17/LO/0424
Date of REC Opinion
13 Apr 2017
REC opinion
Further Information Favourable Opinion