Experiences of forensic mental health patients and professionals with shared violence risk assessment and management: A scoping review of qualitative studies
Bibliographic record
Abstract
Person-centered care and shared decision-making between inpatients and professionals have become guiding principles for mental health care, yet their integration in forensic services remains limited by security-driven and legal considerations. In this context, emerging models of shared risk assessment and risk management could transform forensic patients' experience of, engagement in, and satisfaction with care. However, little evidence informs how shared approaches can improve these experiences of care and be successfully implemented in the forensic context. A scoping review was conducted to understand the experiences of forensic patients and professionals in implementing shared approaches for violence risk assessment and management. MEDLINE, Embase, CINAHL, PsycINFO and ProQuest were searched for qualitative studies, restricting to inpatient adult settings and interventions targeting hetero-aggression or violence. Raters screened records, appraised quality, and charted findings for narrative synthesis and meta-aggregation. From 1325 non-duplicate records screened, four articles were selected featuring three multicomponent approaches and one risk assessment tool. Both patients and professionals reported benefits, such as improved therapeutic relationships and patient self-understanding. Participants outlined interpersonal-, intervention-, and organizational-level barriers for patients to effectively influence decision-making. Practice and research implications are discussed, including training needs, how to address and leverage disagreements, and developing organizational change strategies to support shared approaches. • Few qualitative studies inform shared approaches in forensic mental health. • Patients and professionals report multiple benefits to shared management approaches. • More research is needed to ensure opportunities for influential user involvement. • Implementation issues include transparent communication and organizational context. • Targeted organizational strategies and professional training should be developed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.050 | 0.111 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.013 | 0.017 |
| Science and technology studies | 0.003 | 0.003 |
| Scholarly communication | 0.004 | 0.006 |
| Open science | 0.002 | 0.005 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".