What Happens after Discharge from a Forensic Psychiatric Hospital?: An Analysis of Causally Complex Patterns of Recovery among People Found Non-criminally Responsible on Account of Mental Disorder

Abstract

In this article, we explore which configurations of risk and protective factors explain recovery in a sample of 60 forensic psychiatric patients 6 months after they have been discharged from a psychiatric institution. In line with the recovery-oriented paradigm that emerged in psychiatry, we focus on the role dynamic risk factors and dynamic protective factors play in recovery. Using fuzzy set qualitative comparative analysis, we explore which configurations of conditions explain recovery in conjunction with each other. This entails that the configurations of conditions are codependent sets of conditions, in the sense that the conditions in the configuration explain recovery only in the presence of the other conditions in the configuration, with important implications for research and practice. Our results suggest that the absence of dynamic risk factors is a necessary condition for recovery, and that both the absence of dynamic risk factors and the presence of dynamic protective factors play a pivotal role in recovery, often in combination with other factors, such as absence of symptoms, absence of historical risk factors, and absence of alcohol dependence. We conclude by stressing the important role dynamic risk and protective factors play in recovery, and underline their co-dependence on other factors.

Keywords:

• Qualitative comparative analysis
• recovery
• risk factors
• protective factors
• dynamic factors

Conflict of interest

The authors have no conflicts of interest to report.

Additional information

Funding

This work was supported by Canadian Institutes of Health Research.