Being detained in a secure psychiatric hospital often means decisions are made for you. Treatment plans, daily routines and even conversations can be structured around safety and risk. New research suggests that involving patients directly in mental health research may shift that experience, giving people a stronger sense of purpose and helping services understand them better.
The study examined participatory research in forensic mental health settings, where individuals have committed offences but also live with serious mental health issues. Instead of being passive subjects, patients worked alongside researchers to design studies, analyse findings and present results. The findings were published in BMC Psychiatry.
Researchers reviewed international evidence and found that collaboration changed how both staff and patients interacted. Relationships became less hierarchical and more cooperative, although building that trust took time in environments shaped by security rules and authority structures.
One key challenge was communication. Academic language often prevented engagement, so research teams simplified wording and adapted materials to everyday speech. This improved understanding and helped patients contribute meaningfully to discussions about mental health care.
Secure hospitals can be restrictive places where people rarely feel heard. The review found that participatory research created space for dialogue and mutual learning, allowing patients to influence how knowledge about forensic psychiatry is produced.
The impact extended beyond the research itself. Many participants developed presentation, social and research skills, while also reporting higher self esteem and a clearer sense of identity. Some even gained accredited training that could support employment after discharge.
Mental health recovery appeared to benefit as well. Working in a group encouraged reflection on personal experiences and future goals, which supported well being and hope during treatment.
Clinicians also learned from the process. Staff reported seeing patients as capable collaborators rather than only service users, which improved communication and professional relationships.
The research suggests wider advantages for mental health services. Studies involving patients produced richer and more trustworthy findings because they included perspectives normally missing from clinical research.
However, the approach is not simple to implement. Security rules, confidentiality concerns and power imbalances can limit participation, and staff sometimes control recruitment for safety reasons.
Despite these barriers, the evidence indicates that involving patients in research can strengthen both treatment environments and scientific knowledge. The approach may help forensic psychiatry move towards care that balances safety with autonomy.