Söderberg Andreas, Wallinius Märta, Munthe Christian, Rask Mikael, Hörberg Ulrica
Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden.
Centre for Ethics, Law and Mental Health, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Front Psychiatry. 2023 Mar 16;14:1151554. doi: 10.3389/fpsyt.2023.1151554. eCollection 2023.
Previous studies show that both staff and patients describe patient participation as a challenge in forensic psychiatry. One reason may be that the forensic psychiatric process is difficult to understand and is experienced as being slow and complex. The proceedings in an administrative court are a core element in forensic psychiatric care as it constitutes the legal authority that legitimizes the deprivation of liberty. A better understanding about how patients experience these proceedings can contribute with important knowledge about how forensic psychiatric care can be understood from a patient perspective. The aim of the study was to describe patients' lived experiences of participating in oral hearings in an administrative court concerning the continuation of their forensic psychiatric care.
This is a phenomenological study performed in a Swedish context with a total of 20 interviews conducted with a Reflective Lifeworld Research (RLR) approach.
The results reveal three themes; A significant, correct but meaningless formality; An imbalance of power within the hearings; and Existential and practical disorientation.
The findings show how these court proceedings concerning the continuation of forensic psychiatric care are often experienced as challenging. This is partly due to the care structure in forensic psychiatry and that the purpose of the hearings is difficult to comprehend and is perceived as unjust by patients. Another challenge is of a more existential dimension, where the main character in a hearing is most likely in a situation that would be stressful for anyone. However, the focus on danger can make this experience even more intense. An increased transparency on this legal process along with more discussion and education for both patients and staff is called for based on the results.
先前的研究表明，工作人员和患者都认为患者参与是法医精神病学中的一项挑战。一个原因可能是法医精神病学过程难以理解，且被认为缓慢而复杂。行政法庭的程序是法医精神病护理的核心要素，因为它构成了使剥夺自由合法化的法律权威。更好地了解患者如何体验这些程序，可以提供有关从患者角度理解法医精神病护理的重要知识。本研究的目的是描述患者在行政法庭参与关于其法医精神病护理延续的口头听证会的生活经历。
这是一项在瑞典进行的现象学研究，采用反思性生活世界研究（RLR）方法共进行了20次访谈。
结果揭示了三个主题；一个重要、正确但无意义的形式；听证会上的权力失衡；以及存在性和实际性的迷失方向。
研究结果表明，这些关于法医精神病护理延续的法庭程序往往被视为具有挑战性。部分原因在于法医精神病学的护理结构，以及听证会的目的难以理解，患者认为其不公正。另一个挑战具有更强的存在主义层面，听证会上的主要人物很可能处于对任何人来说都有压力的境地。然而，对危险的关注会使这种体验更加强烈。基于研究结果，呼吁提高这一法律程序的透明度，并为患者和工作人员开展更多的讨论与教育。
