Systematic Review of Forensic Mental Health Patients on Conditional Discharge: Part Two – Qualitative Findings Using a Desistance Lens

This paper describes the qualitative findings of a systematic literature review of research on patients on conditional discharge from forensic mental health services in England and Wales (part two of two). In total, 15 qualitative and five mixed-methods studies were included. A thematic synthesis of the findings produced familiar themes addressed in the wider desistance literature: tensions between agency and social structures; the importance of bonds to (in)formal social institutions and meaningful relationships; and the assessment of criminogenic risk factors such as substance use, antisocial peers and inadequate accommodation. We draw on the concepts of identity-desistance and relational-desistance and suggest that our findings encourage modifications or adaptations to desistance theories to better explain the experiences of forensic mental health patients (e.g., epistemic injustice, mental health stigma, shared decision-making). We discuss how insights from desistance theories can be used to support recovery in forensic mental health patients in practice.