Initial Assessment in Forensic Psychiatry: The Forensic Assessment Format as a boundary object

Abstract

This research project offers initial assessment in forensic psychiatry a new assessment guideline, the Forensic Assessment Format, (Carey 2006) which is a development from Jane Ussher’s material-discursive-intrapsychic model of critical realism, (Ussher 2000a). It presents a review of the technical and theoretical literature looking at the development of assessment methods in forensic psychiatry and discusses current practice and how a critical realist perspective could inform the assessment process. It is a qualitative study using both an empirical and an analytic auto-ethnographic approaches, (Anderson 2006). The research project presents data from 19 semi-structured interviews and a focus group analysed using grounded theory, (Glaser and Strauss 1967) to aid both deductive and abductive approaches, (Timmermans and Tavory 2012). Service users were involved from the beginning of the project to inform the themes that developed into the interview questions.

The outcomes of the study offer support for the potential of this critical method of initial assessment to be collaborative, holistic and inclusive and that it could act as a boundary object, (Star and Griesemer 1989), between different social worlds providing a bridge for information to flow. This encourages cooperation in completing the assessment and then formulating and meeting the identified needs. It explores and provides an insight into the initial assessment process in forensic psychiatry from the perspective of the service user, referrer and assessor. Further suggestions are offered in associated areas such as how plural realities can be understood and how the assessment process in forensic psychiatry could be further improved.