Authors (including presenting author) :
Lau KM(1), Yuen KK(1) , Liu ACY(1), Leung HW(1), Ng KK(1), Chan HS(1), Kong SK(1), Siu BWM(1)
Affiliation :
(1)Department of Forensic Psychiatry, Castle Peak Hospital
Introduction :
Forensic psychiatric patients are characterized by their complex needs of having both mental illness and criminal involvement. The Forensic Psychiatric (FP) Department of Castle Peak Hospital (CPH) is the only Department in Hong Kong that provides in-patient service to such special patient group.
CPH has followed the world-wide trend of recovery model and incorporated 10 recovery-oriented principles into its hospital policy. However, in forensic setting, there has been “inherent contradiction” between supporting patient’s autonomy while at the same time compulsorily detaining them (Davidson 2006; Frese 2001).
Here we describe our experience of applying recovery model to a forensic psychiatric in-patient in the FP Department of CPH.
Objectives :
To explore the feasibility of applying relevant recovery-oriented principles to a forensic psychiatric in-patient.
Methodology :
Tommy (fictitious name) is a long-stay patient who has been staying in FP Department for many years. He has multiple violent history of attacking co-patients and staff.
Jerry (fictitious name), Tommy’s elder brother, is the only family support to him. However, he is over-protective and prone to believe that Tommy was a victim rather than a perpetrator of violence.
1. Empowerment and choice:
Tommy’s perceptions about his hope and choice towards his daily life and future plan were explored. His choices were respected as far as they were within some well informed and agreed boundaries.
2. Individualized, holistic and strength-based approach
Tommy had volition to work and make change in his daily life. Therefore, a customized mobile Occupational Therapy (OT) training session was designed to provide training to him with careful considerations on the safety issues to others.
3. Partnership with patient and his carer
The detrimental blind support of Jerry to Tommy drastically changed on one day when Jerry was suddenly punched by Tommy on his face during visiting. Jerry started to understand the seriousness of Tommy’s violent risk and became willing to work as a partner with staff.
Result & Outcome :
Our experience proved that forensic psychiatric in-patient could be empowered to make choice within agreed boundaries. A safe and humane care plan could be developed by an individualized, holistic and strength-based approach. Seizing the opportunity at the right moment, partnership with patient’s carer could be built up.
