A qualitative study of service user experiences of occupation in forensic mental health

TLDR

The study examines how legal and institutional restrictions on occupation affect the health and wellbeing of individuals detained in forensic mental health units. Twenty‑six forensic mental health service users were interviewed in five focus groups, with recordings transcribed and analyzed using constant comparative methods. Participants described past and present occupations, aspirations, and emphasized control, motivation, and support, concluding that overcoming institutional barriers requires balancing risk management with mental‑health promotion through occupation.

Abstract

Background/aim: This qualitative study explored occupational engagement of those detained in forensic units. Legal and institutional restrictions on occupation have implications for their health and wellbeing. Method: Twenty‐six current forensic mental health service users participated in five focus groups, which were audio‐recorded, transcribed verbatim and subjected to constant comparative analysis. Findings: The participants highlighted previous occupations, current occupations and hopes. Key aspects were control over decision‐making, motivation and support, generating suggestions alongside positive experiences of occupational therapy. Conclusions: Institutional barriers could be overcome with a dynamic balance between risk management and mental health promotion through occupation. This demands a sustained focus on occupation for everyone involved in providing care and treatment in these settings.