Time, Trust and Participation: A Nationwide Quantitative Study of Person-Centred Care in Forensic Mental Health...

Person-centred care emphasises the uniqueness of individuals through partnerships, the co-creation of care plans and coordinated health care. Its implementation in forensic mental health services is challenged by legal coercion and restrictive practices. Person-centred principles are embedded in legislation; however, national data on patients' perspectives on person-centred care are lacking. This study aimed to map person-centred care as perceived by patients and to identify areas for improvement. A nationwide survey included 329 patients across 13 forensic psychiatric hospitals in Sweden using the Generic Person-Centred Care Questionnaire supplemented with contextual background questions. The median Generic Person-Centred Care Questionnaire score was 70 (range 19-95). Length of stay was associated with perceived person-centred care; patients hospitalised for 2-5 years reported higher total scores than those hospitalised for more than 10 years, although the pairwise difference did not remain significant after correction for multiple comparisons. Trust in staff differed by length of stay, with patients hospitalised for > 10 years reporting significantly lower trust than those hospitalised for 0-1 and 2-5 years. Communicative safety showed a similar pattern, although pairwise differences were not significant after correction. No significant differences in total scores were found by gender, age, ethnicity, diagnosis, or hospital type. Overall, patients reported positive experiences of respect and emotional support. Among those who reported having a written care plan, involvement in and understanding of the plan were rated positively, whereas broader involvement in decision-making, use of patients' own resources and relatives' participation received lower ratings, indicating areas for further improvement in person-centred practice.