Mental Health Nurses’ Experiences of Risk Assessments for Care Planning in Forensic Psychiatry

Abstract

The risk of patients committing violence implies major challenges throughout the care process in forensic psychiatry and brings risk assessments to the fore. The aim was to explore nurses’ experiences of risk assessments for their care planning and risk management in forensic psychiatry. Data were collected through focus groups with 15 nurses. The qualitative content analysis followed a deductive approach guided by the person-centered philosophy. When exploring nurses’ reasoning on risk assessment, units related to person-centered principles were identified. The findings showed that nurses made great efforts to confirm the unique person behind the patient, even when challenged by patients’ life histories of violence. They also regarded therapeutic alliance as crucial, although this needed to be balanced between caring and restricting actions. A fruitful strategy to preserve therapeutic alliance may be to increase the use of a structured focus on protective factors in treatment plans towards promoting recovery-oriented policies and practices.

Keywords:

• Person-centered care
• forensic psychiatry
• risk assessment
• care planning
• qualitative content analysis