Restorative Approaches Within Forensic Mental Health Systems

Restorative Approaches Within Forensic Mental Health Systems Background “All I want to do is be able to speak to my family, but they won’t answer my calls, it’s been two years” ‘Rosa’ who stabbed her two children to death whilst experiencing psychotic depression “He hasn’t contacted me, I just want to know if he’s sorry for what happened, and I want to see him again” ‘Joan”, who’s son seriously assaulted her whilst acutely unwell. “Restorative justice is a process to involve, to the extent possible, those who have a stake in a specific offence* and to collectively identify and address harms, needs and obligations, in order to heal and put things as right as possible”.(Zehr, 2002, p.37) Restorative justice has been practiced for a number of years in a range of settings, and is a set of principles which seeks to guide the comprehensive repair of harm committed by one person upon another (Cook, Drennan & Callanan, 2015). Restorative approaches have not been utilised within Forensic Mental Health Systems (FMHS) but would appear to have much to offer patients and those who have been harmed in some way through an act of violence. Although traditionally restorative justice has involved a face to face meeting between the ‘victim’ and the ‘offender’ (Ministry of Justice, 2011), as Daly (2008, p. 20) comments “it is not simply about a meeting for one or two hours (in a conference) or a guilty verdict and sentence imposed (in court). Like victimisation, justice is a process, not an event”. Indeed, the preparatory work, providing an opportunity to express emotion, and to develop a trauma narrative were of themselves found to be beneficial (Scott, Drennan, & Callanana, 2015). Restorative justice can thus involve mediation, conferencing and circles. As highlighted above, the ‘victim’ and ‘offender’ do not always have to meet face to face, for example, ‘shuttle mediation’ can occur, whereby the mediator meets separately with the two parties. Exchanges of information can also occur * Where the term ‘offender’ is used within this introduction, this is in relation to the restorative justice literature. through other mediums such as letters, emails, audio and video recordings, and telephone conferencing. There is significant evidence that restorative justice has produced positive outcomes, and in particular as a response to violent criminal offences. For example, a number of meta-analyses of restorative justice programmes for juveniles (Bradshaw & Roseborough, 2005; Latimer, Dowden & Muise, 2005; Sherman & Strand, 2007; Nugent, Umbreit & Williams, 2014;) have concluded that outcomes achieved by restorative justice approaches included increased “participant satisfaction, reduced recidivism and restitution, compliance for offenders, and reduced post-traumatic symptoms for victims” (Cook, Drennan, & Callanan, 2015, p. 511). In summary, the benefits for both ‘victims’ and ‘offenders’ include: 1. High levels of satisfaction with the restorative process expressed by both victim and offender; 2. Assisting offenders to express remorse and gain insight and responsibility for their actions; 3. A reduction in recidivism of offenders, for example, a 32% reduction in recidivism after one year compared to non-participants; this is also in contrast to incarcerated prisoners, for example, with more than 40% returning to prison within three years post-release; 4. Cost effectiveness when comparing the costs of crime prevented with the costs incurred in delivering restorative justice conferences; for example, at an aggregate level, the cost of running restorative justice conferences in London was £598,848 compared with £8,261,028 in the costs of crime prevented; 5. Allowing offenders to strengthen their support networks and re-enter their communities; 6. Allowing victims to feel a greater sense of procedural justice, restoring a sense of control and decision making for the victim; 7. Decreasing victim’s feelings of anxiety, fear and anger, and a desire for revenge, and enhancing their sense of dignity, self-respect and self-confidence; 8. Having particular success within Indigenous communities; Armour & Umbreit, 2007; Daly, 2008; Shapland et al., 2008; Quinn & Simpson, 2013; Hafemesiter, Garnett & Bath, 2012; Scott, Drennan & Callanan, 2015. There is a dearth of evidence about the impact of restorative practices within the forensic mental health population, in particular a lack of outcome studies (Cook, Drennan, & Callanan, 2015). A number of authors have stated that despite the shortfall of empirical evidence, theoretically restorative approaches within this population, with adequate assessment, planning and implementation, could provide a highly useful adjunct to current treatment (Garner & Hafemeister, 2003; Cook, Drennan & Callanan, 2015). For example, where an offence has been committed against a family member, a restorative approach could assist in re-establishing relationships with carers/ supports; where a staff member has been assaulted by a patient, a restorative approach could allow for repair of the care relationship. Research question Can restorative approaches enhance the recovery of both patients and victims within forensic mental health systems? Methodology A mixed methodology will be used to explore the process and effect of restorative approaches within a forensic mental health system. This will include: 1. A literature search. 2. A qualitative study to test an emerging model within an Australian context. Participants will be drawn from a cohort of forensic mental health staff and patients, victims of violent crimes committed by forensic mental health patients, and the broader community, including academic and clinical experts. Research will utilise oral interviews, and short surveys using open-ended questions. Thematic analysis will be used to analyse the data (Braun & Clarke, 2006). 3. A restorative approach will be developed and an outcome evaluation performed. Participants will be drawn from a cohort of forensic mental health patients and the victims of their offences. Ethical considerations Some of the key ethical considerations will include: - Safety of all participants; - Confidentiality of patients; - Timing in relation to patient’s mental health improving; - Capacity to consent; - Voluntary process. - Avoidance of stigmatisation;