'My shared pathway': the experience of users of a low secure service

Abstract

Adoption of the recovery approach has proved contentious in forensic services, which has traditionally been dominated by the medical model and concepts of security and risk; nevertheless, there is currently a focus on embedding recovery principles in forensic services (Drennan & Alred, 2012). One advancement has been the development of ‘My Shared Pathway’, which was introduced to forensic services in 2011 (Esan, Pittaway, Nyamande, & Graham, 2012) with the aim of increasing transparency, promoting recovery and reducing admission times. The first part of this thesis is a systematic review and narrative synthesis of forensic mental health patients’ perceptions of recovery. Relevant databases were searched and a total of 11 studies that fit the inclusion criteria were identified. There was significant overlap of themes across the studies, these were subsequently organised into seven categories/superordinate themes: Connectedness, Treatment, Sense of Self, Past Experiences, Freedom, Hope and Health.

Two superordinate themes were particularly prevalent in 9/11 of the studies: Connectedness and a Sense of Self. It is argued that a focus on increasing opportunities for forensic mental health patients to develop a sense of self and connectedness could help improve recovery. The second part of this thesis is an empirical paper describing a study that explored the lived experience of ‘My Shared Pathway’ for six male patients who were detained in a low secure service. Interpretive Phenomenological Analysis (IPA) was used to capture the subjective meanings that patients ascribed to this process. Five superordinate themes were identified: It’s a Journey, We’re Vulnerable in Here, Relationships with Staff, Loss and Hope. These findings are consistent with those seen in the forensic recovery literature and suggest that ‘My Shared Pathway’ helps promote recovery in a number of ways. Clinical implications and suggestions for further research are given.

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