“You always remain that monster.” Challenges to recovery-oriented care in forensic mental health services

Purpose Few studies have investigated the complexity that arises when applying recovery-oriented principles, such as hope and autonomy, in the context of forensic treatment. This study aims to explore these complexities. Design/methodology/approach Semi-structured interviews were conducted with 11 professionals and 9 service users from six different organisations providing low, medium or high-secure forensic mental healthcare. The interview transcripts were analysed using Consensual Qualitative Research in a team of three researchers. Findings Several challenges were identified in the analysis. These challenges include the often implicit focus on recovery, the need to have hope to give hope and the delicate balance between care and control. Whereas most of the barriers to recovery can be placed within forensic mental health services, stigma is a major barrier that can hinder social recovery. Practical implications Drawing on the CHIME framework, this study outlines key dilemmas in promoting recovery-oriented work within forensic mental health services. Heightened awareness of these challenges can inform the development of explicit strategies to maintain recovery principles, even in complex or adverse situations. Originality/value While the principles of recovery-oriented care fit well within forensic settings, their application occasionally presents considerable challenges. Navigating these challenges requires a lot from professionals. Therefore, strategies aimed at enhancing the psychological resilience of service providers are essential to sustain a recovery-promoting attitude towards service users.