Negotiating identity transition when leaving forensic hospitals

Abstract

The transition from hospital patient to community resident is something which is far from straightforward. For those with multiple labels of disability, chronicity and criminal offending behaviours this transition is particularly complicated. This article reports on a study of accounts provided by a hard-to-reach group of patients and their workers in one region of the UK. Through the use of 59 in-depth interviews with conditionally discharged persons, community mental health nurses and social workers, everyday understandings of the process of discharge and reintegration were investigated. The primary focus was on how identity was handled in the talk of discharged persons and what workers said about this. Analysis focused upon the action-oriented nature of accounts related to discharge, community return and attempts to construct viable identities in the outside world. This study found that stories did the work of loosening previous labels. Illness as mitigation was deployed as an important resource for this purpose. Deviant labels signifying mental illness and criminality presented enduring identity-threats. It was found that as they adjust to return to the community, individuals deploy particular types of identity talk to neutralize ascriptions of continuing deviance and make claims to normality. Workers for their part supported illness as mitigation but continued to orient towards risk as an enduring identity label. In their day-to-day lives the accomplishment of ‘ordinary’ identities was a continuing task of discharged persons in maintaining community return.