Patient perspectives on general practitioners in forensic psychiatric wards

Area of Science:

• Forensic Psychiatry
• Primary Care Integration
• Patient Experience

Background:

• Forensic psychiatric patients face significant rates of preventable physical illnesses.
• Integrating primary care into forensic settings is a potential solution, but patient experiences are understudied.

Purpose of the Study:

• To explore forensic psychiatric patients' experiences with an on-ward general practitioner (GP) service.
• To understand how these experiences influenced engagement with integrated primary care.

Main Methods:

• Qualitative interview study with 14 patients in Danish medium-secure forensic psychiatric wards.
• Semi-structured interviews analyzed using reflexive thematic analysis.

Main Results:

• Patients valued the GP service's somatic focus, countering neglect of physical symptoms by psychiatric staff.
• Accessibility and the GP's 'outsider' role facilitated engagement, but barriers included limited continuity and discomfort during examinations.
• Engagement was conditional, relying on trust and privacy.

Conclusions:

• Integrated GP services are broadly welcomed but require attention to relational continuity and sensitive examination practices.
• Future models should focus on enhancing preventive somatic care within forensic settings.