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Accessing and engaging with primary health care services following discharge from forensic secure services: the perspectives of service users and mental health practitioners

Accessing and engaging with primary health care services following discharge from forensic secure... Physical health inequalities and mortality rates are higher amongst individuals with severe mental illness (SMI), including among forensic populations, than the general population. This paper aims to explore the experiences of individuals accessing primary health care following discharge from secure services, and the practitioners who support them.Design/methodology/approachFace-to-face qualitative interviews were conducted with service users (n = 4) and mental health practitioners (n = 4) within a forensic community mental health team in one NHS Trust in England in 2019. Data were analysed using the Interpretative Phenomenological Analysis.FindingsFour super-ordinate themes emerged: perceived importance of physical health, agency, responsibility and relationships. Service users mostly saw themselves as passive recipients of health care and prioritised their mental health over their physical health. Close working relationships meant that mental health practitioners were often the first contact for service users with any health issue and thus felt a sense of responsibility for their physical health care. Service users who did access primary care reported that consistency of professional, feeling understood and listened to without judgement or stigma were important.Practical implicationsInterventions for service users that include practicalities and strategies to facilitate independence in physical health care, and collaborative working between primary care and forensic mental health services, are encouraged.Originality/valueThis study highlights some of the unique challenges in forensics around improving physical health outcomes for individuals with SMI. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Forensic Practice Emerald Publishing

Accessing and engaging with primary health care services following discharge from forensic secure services: the perspectives of service users and mental health practitioners

Journal of Forensic Practice , Volume 23 (2): 15 – Jul 27, 2021

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Publisher
Emerald Publishing
Copyright
© Emerald Publishing Limited
ISSN
2050-8794
DOI
10.1108/jfp-12-2020-0049
Publisher site
See Article on Publisher Site

Abstract

Physical health inequalities and mortality rates are higher amongst individuals with severe mental illness (SMI), including among forensic populations, than the general population. This paper aims to explore the experiences of individuals accessing primary health care following discharge from secure services, and the practitioners who support them.Design/methodology/approachFace-to-face qualitative interviews were conducted with service users (n = 4) and mental health practitioners (n = 4) within a forensic community mental health team in one NHS Trust in England in 2019. Data were analysed using the Interpretative Phenomenological Analysis.FindingsFour super-ordinate themes emerged: perceived importance of physical health, agency, responsibility and relationships. Service users mostly saw themselves as passive recipients of health care and prioritised their mental health over their physical health. Close working relationships meant that mental health practitioners were often the first contact for service users with any health issue and thus felt a sense of responsibility for their physical health care. Service users who did access primary care reported that consistency of professional, feeling understood and listened to without judgement or stigma were important.Practical implicationsInterventions for service users that include practicalities and strategies to facilitate independence in physical health care, and collaborative working between primary care and forensic mental health services, are encouraged.Originality/valueThis study highlights some of the unique challenges in forensics around improving physical health outcomes for individuals with SMI.

Journal

Journal of Forensic PracticeEmerald Publishing

Published: Jul 27, 2021

Keywords: Service user; Practitioner; Physical health; Forensic mental health; Accessing primary health care; SMI

References