Recovery in forensic mental health services: a review and meta-ethnography of reported accounts of service user experiences

The ‘Recovery Approach’ is widely regarded as the guiding principle for mental health service delivery in the UK. Forensic services face unique challenges in applying this approach. Numerous studies have explored themes associated with recovery in these settings but it is currently unclear how themes relate to each other. This study set out to build a theoretical model of service user experiences of recovery in forensic mental health settings. Semi-structured interviews were conducted with sixteen service users about their experience of recovery. Grounded Theory methodology, with a constructivist epistemology, was used to analyse the interview data. A cyclical model was developed, with five core recovery processes that inter-related; these were: the environment, connectedness, hope for the future, who I am and empowerment. These occurred in three phases of 1) feeling safe and secure, 2) moving forwards, and 3) empowerment. These processes were encompassed by two additional themes of arriving at hospital and changes over time. This study is the first to provide a clear model of service user experiences of recovery in this setting. Clinical and research implications are discussed