Supporting recovery by improving patient engagement in a forensic mental health hospital: results from a demonstration project

Abstract

Background: Mental health services are shifting toward approaches that promote patients' choices and acknowledge the value of their lived experiences.

Objective: To support patients' recovery and improve their experiences of care in a Canadian forensic mental health hospital, an intervention was launched to increase patient engagement by establishing a peer support program, strengthening a patient advisory committee, and creating a patient-led research team.

Design: The effect of the intervention on patient- and system-level outcomes was studied using a naturalistic, prospective, longitudinal approach. Quantitative and qualitative data were gathered from inpatients and service providers twice during the 19-month intervention.

Results: Despite succeeding in supporting patients' participation, the intervention had minimal impacts on internalized stigma, personal recovery, personal empowerment, service engagement, therapeutic milieu, and the recovery orientation of services. Peer support demonstrated positive effects on internalized stigma and personal recovery.

Conclusions: Strengthening patient engagement contributes toward improving experiences of care in a forensic hospital, but it may have limited effects on outcomes.

Keywords: forensic mental health; participatory action research; patient engagement; peer support; recovery.