Ethical approval for the study was given by the PSYSOC Ethics Committee at the University of Central Lancashire. Advice was also taken from NHS South East Scotland Ethics Board on behalf of NRES, who advised that NHS ethical approval was not required since the study was service evaluation.
Research governance approvals were given from 10 Health Boards including the Research Committees at the State Hospital and Greater Glasgow & Clyde. Care has been taken not to identify individuals. Identifying features such as place and secure service have been changed or omitted in writing this report.
In order to address limitations of survey methods, the questionnaire of forensic mental health services was based on a modified measure that had been tested previously with forensic mental health services elsewhere in the UK (Canning et al, 2009). The initial draft questionnaire was checked for validity with the Working Group and Forensic Network, and was slightly amended.
The sample of forensic mental health services was identified through the Forensic Network and relevant contacts for each service were verified by the research team. This ensured the selection of the most relevant individual respondents. The study is a unique survey of forensic mental health services in Scotland.
While the questionnaire survey with forensic carers had some limitations, the method enabled us to reach a diverse range of carers across the country. The Working Group was consulted about the questions used and we piloted the survey with two carers who completed it online.
As a result of the pilot, slight word changes were made to ambiguously worded questions. Participation in the study was reliant on information being circulated on our behalf by services for data protection reasons, and because the commissioners wanted the study to be promoted to all forensic carers and not only those who had participated in past consultations. The findings in Chapter 3 and 4 demonstrate that this was achieved.
Reaching forensic carers via another party in a limited timeframe was a major limitation that impacted on levels of participation in both the survey and interviews. A longer timeframe and better resourced study might have been able to develop a more localised and tailored approach to working with services to recruit carers. For instance, word of mouth between carers in existing trusting relationships helped us to contact additional interviewees and with more time this approach could have been extended.
That there are generally low levels of carer engagement in some services currently meant that the pool of carers to invite for interview was small to begin with. To address this, we engaged with staff in a wider range of forensic services than initially planned for, including the State Hospital, to help recruit an interview sample. The study therefore adds to an area where there is limited knowledge in a specifically Scottish forensic context.