Abstract

Older forensic mental health patients have complex needs and requirements; service provision is required to address mental health, offending risk and issues associated with aging (geriatric care). This study aimed to identify the systems and processes that enable valued progress (in terms of quality of life, health, wellbeing, recovery and reduced risk) for older forensic mental health patients. Interviews were conducted with 48 members of staff working with these patients in secure hospitals or the community. Thematic analysis was used to analyze the data. Four overarching themes were identified regarding what facilitated or acted as a barrier in relation to quality of life, health, wellbeing and recovery. Multidisciplinary input, an individualized approach and implementing holistic and needs-led care was found to facilitate progress. However, lack of resources, excluding the patients in care planning, gaps in expertise and knowledge, and a lack of specialized units that could address mental health, forensic and elderly needs were found to be barriers. Extensive, multilevel and wide-ranging support is required specifically for older forensic mental health patients. Joint working is required between older adult and forensic mental health services incorporating geriatric medicine expertise in order to implement co-produced care and treatment plans.

摘要

老年法医心理健康患者有复杂的需求和要求；需要提供服务来解决心理健康、犯罪风险和与老龄化相关的问题（老年护理）。本研究旨在确定能够为老年法医心理健康患者带来有价值的进步（在生活质量、健康、福祉、康复和降低风险方面）的系统和过程。对 48 名在安全医院或社区为这些患者工作的工作人员进行了访谈。主题分析用于分析数据。确定了四个总体主题，关于什么促进或充当与生活质量、健康、福祉和康复相关的障碍。发现多学科投入、个性化方法和实施整体和以需求为导向的护理可以促进进展。然而，缺乏资源，将患者排除在护理计划之外，专业知识和知识方面的差距，以及缺乏可以解决心理健康、法医和老年人需求的专门单位被认为是障碍。老年法医心理健康患者尤其需要广泛、多层次和广泛的支持。老年人和结合老年医学专业知识的法医心理健康服务需要联合工作，以实施共同制定的护理和治疗计划。