Researching service user views in forensic mental health: A literature review

There is increasing emphasis being placed on gaining users' views of health service provision. Forensic mental health services are provided within the context of twin challenges presented by those receiving services and societal responses. Service user views, however, can inform professional responses to their complex needs. The aim of this review is to explore the methodological approaches used to access the perspectives of users of forensic mental health services, to critique these approaches, and explore the range of views of users of forensic mental health services. The primary method employed was a literature review of research papers explicitly accessing perspectives of those categorised as mentally disordered offenders or users of forensic services. The main findings were as follows. First, both the volume and breadth of studies exploring service users' views are limited and limiting. Second, studies demonstrate significant flaws in terms of the conduct, application, and reporting of the research process. Third, service users across studies indicate positive and negative aspects to their experiences of caring, and concern with restrictions on their liberty as inpatients and as community residents. Lastly, given the complexity of ethical issues with largely captive populations, there is a striking absence of discussion of ethical problems in forensic mental health research. The range of approaches to accessing service user perspectives in forensic mental health services requires expansion, both methodologically and theoretically. The application of quality criteria should be more consistent and applied rigorously. A consequence of this is that we still know relatively little of the experience and perspectives of people who use forensic mental health services, and may judge available findings as unreliable.