Abstract:
The primary focus of this study was to explore how patients that had been found Not Guilty by Reason of Insanity (NGRI) for homicide, and their Responsible Clinicians (RCs), viewed the patients’ recovery processes. Ten patient participants and their RCs were interviewed independently using semi-structured interviews. The transcripts were analysed using thematic analysis. The researcher was able to study people in their natural settings. This allowed for an in-depth exploration of patient and RC experiences without the restraints of testing a hypothesis. A four stage recovery process was identified. The stages are: Numb/Psychotic, Early Awareness, Rebuilding Sense of Self, and Re-entry into Community Life. Participants also talked about Aspirations of Autonomy and a life beyond the Forensic Services. Each stage of recovery has specific tasks to master and require particular resources to help achieve stage goals. In the Numb/Psychotic stage the main task is to resolve psychotic thinking. In the Early Awareness Stage the recovery task is dealing with guilt, despair, depression and suicidality. In the Rebuilding Sense of Self Stage the tasks were being able to forgive self, accept self for committing the homicide and to come to terms with this. In the fourth stage, Re-entry into Community Life, participants live with psychosis and homicide whilst working towards re-entry and acceptance in the community. Participants describe this process of recovery as non-linear. For some, making sense of the event and the place it has in their lives has been important in their reintegration into the community. For others, this process appears to be more difficult and to survive they appear to seal-over the event to cope with its enormity. No single variable explains violent acts by people with psychotic symptoms. A combination of multiple stressors and disadvantages provide vulnerability to triggering factors. Recovery from psychosis and making sense of having committed homicide whilst psychotic is a complex process. An understanding
Of the stages of recovery and their components could facilitate more effective treatment for those found NGRI for homicide and so enable them to re-integrate in the community with a decreased risk of re-offending.