Making sense of being recalled: a grounded theory
| Pages | 27-37 |
| DOI | https://doi.org/10.1108/JFP-10-2018-0042 |
| Date | 31 January 2019 |
| Published date | 31 January 2019 |
| Author | Owen Rye,Krysia Canvin,Suzi Harrison,Charlotte Couldrey,Clare Churchman |
| Subject Matter | Health & social care,Criminology & forensic psychology,Forensic practice,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice |
Making sense of being recalled:
a grounded theory
Owen Rye, Krysia Canvin, Suzi Harrison, Charlotte Couldrey and Clare Churchman
Abstract
Purpose –A high proportion of forensic mental health service users (FSUs) are recalled to secure hospitals
from conditional discharge in the community. The limited research on recall to date has preliminarily identified
why FSUs are recalled, but not how they make sense of the process. The purpose of this paper is to develop
a conceptual understanding of how FSUs make sense of being recalled to hospital.
Design/methodology/approach –A constructivist grounded theory approach was used. Semi-structured
interviews were carried out with 11 FSUs from different levels of forensic service security who had been
recalled varying numbers of times across a wide timeframe.
Findings –A theoretical model was constructed to illustrate the process of how FSUs make sense of being
recalled. FSUs appraise being recalled on a continuum from negative to positive, based on their experiences when
conditionally discharged and their reflections on the circumstances of being recalled. The nature of their appraisal
appears to reciprocally influence their subsequent attitudes towards and their engagement with forensic services.
Research limitations/implications –The proposed mechanism of how FSUs make sense of being
recalled, particularly their dynamic appraisal of it, should now be investigated longitudinally. Future qualitative
research could explore forensic service staff perspectives on recall.
Practical implications –Enhancing the positivity of FSUs’appraisals about being recalled may improve
their attitudes about and engagement with forensic services.
Originality/value –This is the first research study to construct a theoretical model of recall.
Keywords Qualitative, Grounded theory, Procedural justice, Forensic mental health,
Conditional discharge, Hospital recall
Paper type Research paper
Introduction
Thecarepathwaysofadultforensicmentalhealthservice users (FSUs) are complex: often, they are
characterised by transfers between different levels of inpatient security, and between secure
hospitals and the community (Centre for Mental Health, 2011). Explanations of this are multifactorial,
but include fluctuations in FSUs’mental health and presenting risks, with FSUs being moved to
services that are most able to care for them and manage them safely (Kennedy, 2002).
The movement between hospitals and the community is frequently observed in a significant
subpopulation of FSUs –those subject to hospital orders with restrictions (Mental Health Act
Section 37/41). This group of FSUs are admitted to secure hospitals for treatment, with
restrictions placed on them by the Crown Court or the Secretary of State in the interest of public
safety, such that only the Secretary of State or an appointed Mental Health Tribunal has the
ultimate authority to grant their discharge (Ministry of Justice, 2017).
The vast majority of discharges of restricted FSUs to the community are not absolute discharges;
instead, they are subject to conditions requiring these FSUs’continued engagement with
supervision and treatment provided by community services whilst there continues to be a
substantial risk of harm to public safety or the health of the FSU (85 per cent, n¼460 in 2017;
Ministry of Justice, 2018). If a restricted FSU’s mental health deteriorates whilst they are
conditionally discharged, or their presenting risks escalate to a level that is judged to be
unmanageable in the community, then it is likely that the FSU will be recalled to a secure hospital
Received 28 October 2018
Revised 5 January 2019
Accepted 7 January 2019
Owen Rye is Clinical
Psychologist at the Oxford
Institute of Clinical Psychology
Training, University of Oxford,
Oxford, UK.
Krysia Canvin is Research
Fellow at the School of
Healthcare, University of
Leeds, Leeds, UK.
Suzi Harrison is Clinical
Psychologist at the Department
of Forensic Mental Health
Services, Oxford Health NHS
Foundation Trust,
Oxford, UK.
Charlotte Couldrey is based at
the Department of Forensic
Mental Health Services, Oxford
Health NHS Foundation Trust,
Oxford, UK.
Clare Churchman is Clinical
Psychologist at the Department
of Forensic Mental Health
Services, Oxford Health NHS
Foundation Trust, Oxford, UK.
DOI 10.1108/JFP-10-2018-0042 VOL. 21 NO. 1 2019, pp. 27-37, © Emerald Publishing Limited, ISSN 2050-8794
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JOURNAL OF FORENSIC PRACTICE
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