Staff perspectives on barriers to and facilitators of quality of life, health, wellbeing, recovery and reduced risk for older forensic mental-health patients: A qualitative interview study

Walker, Kate; Yates, Jen; Dening, Tom; Völlm, Birgit; Tomlin, Jack; Griffiths, Chris

Abstract

Objectives: There is a lack of research informing service delivery for older forensic mental health patients. This study explored service provision in forensic mental health inpatient and community services in England, investigating what is required for progress in terms of quality of life, health, wellbeing, recovery and reduced risk, and the barriers and facilitators associated with this. Methods: Semi-structured interviews were undertaken with 48 members of staff working with older forensic mental health patients in secure inpatient units or the community in England. Data were analysed using thematic analysis. Results: Two global themes ‘What works’ and ‘What doesn’t work’ were identified comprising themes representing environmental, interpersonal and individual factors. ‘What works’ included: positive social support and relationships; individualised holistic patient-centred care; hub and spoke approach to patient care; and suitable environments. ‘What doesn’t work’ included: absence of/or maladaptive relationships with family and friends; gaps in service provision; and unsuitable environments. Conclusions: For older patients to progress to improved quality of life, health, wellbeing and reduced risk, multilevel and comprehensive support is required, comprising a range of services, interventions, and multidisciplinary input, and individualised to each patient’s needs. The physical environment needs to be adapted for older patients and provide a social environment that seeks to include supportive families, friends and expert professional input. A clear patient progression pathway is required; this must be reflected in policy and provision.

Citation

Walker, K., Yates, J., Dening, T., Völlm, B., Tomlin, J., & Griffiths, C. (2022). Staff perspectives on barriers to and facilitators of quality of life, health, wellbeing, recovery and reduced risk for older forensic mental-health patients: A qualitative interview study. Journal of Health Services Research and Policy, 27(4), 287-300. https://doi.org/10.1177/13558196221094512

• Journal Article Type: Article
• Acceptance Date: Apr 27, 2022
• Online Publication Date: May 18, 2022
• Publication Date: 2022-10
• Deposit Date: May 30, 2022
• Publicly Available Date: May 30, 2022
• Journal: Journal of Health Services Research and Policy
• Print ISSN: 1355-8196
• Electronic ISSN: 1758-1060
• Publisher: SAGE Publications
• Peer Reviewed: Peer Reviewed
• Volume: 27
• Issue: 4
• Pages: 287-300
• DOI: https://doi.org/10.1177/13558196221094512
• Keywords: Public Health, Environmental and Occupational Health; Health Policy
• Public URL: https://nottingham-repository.worktribe.com/output/8138867
• Publisher URL: https://journals.sagepub.com/doi/abs/10.1177/13558196221094512?journalCode=hsrb