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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

Emily Samuels (Department of Social Policy and Social Work, International Centre for Mental Health Social Research, York, University of York, UK)
Nicola Moran (Department of Social Policy and Social Work, International Centre for Mental Health Social Research, University of York, UK)

The Journal of Forensic Practice

ISSN: 2050-8794

Article publication date: 3 July 2021

Issue publication date: 27 July 2021

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Abstract

Purpose

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/approach

Face-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.

Findings

Four 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 implications

Interventions 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/value

This study highlights some of the unique challenges in forensics around improving physical health outcomes for individuals with SMI.

Keywords

Acknowledgements

The authors wish to thank all those who took part in and supported the study. The study was unfunded.Disclosure statement: No conflict of interest is reported by the authors.

Citation

Samuels, E. and Moran, N. (2021), "Accessing and engaging with primary health care services following discharge from forensic secure services: the perspectives of service users and mental health practitioners", The Journal of Forensic Practice, Vol. 23 No. 2, pp. 117-131. https://doi.org/10.1108/JFP-12-2020-0049

Publisher

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Emerald Publishing Limited

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