This thesis sought to explore how people talk about the care that they receive whilst detained within forensic mental health services and the use and effectiveness of compassion focused approaches within forensic and inpatient mental health services.
Chapter one presents a systematic literature review that synthesised twelve studies where compassion focused approaches were utilised within forensic and inpatient mental health services, delivered to both those in receipt of care and those delivering care. A narrative synthesis of the studies highlighted promising findings for the effectiveness of compassion focused approaches for the inpatient mental health population, inpatient mental health staff, adolescent offenders, and adult male offenders. Promising findings were identified across a range of mental health and criminogenic needs. Limitations included variable methodological quality of the studies reviewed and narrow population groups, resulting in difficulty in generalising findings to wider population groups.
Chapter two presents an empirical qualitative study that explored how seven males detained within forensic mental health services spoke about their experiences of receiving care under the Care and Treatment Planning approach. A Foucauldian Discourse Analysis methodology was utilised. Three main discourses emerged: “the power sits with them”, “tug-of-war”, and “it’s my care”. Alternative discourses to “the power sits with them” and “tug-of-war” were identified; “complex power systems”, and “a world removed from reality”. Power influenced the way in which care was perceived and received by the participants.
The final chapter, chapter three, considers the theoretical, research and clinical implications of both the systematic literature review and the empirical study, concluded with a personal reflection from the first author.