“It just felt like a rubber stamp”: Family experiences of mental health review board hearings in Ontario, Canada

Abstract

Involving families in the planning and delivery of care to relatives living with a mental health disorder is beneficial to achieve optimal recovery and medication adherence, and to reduce decompensation and hospital readmission rates. However, in the specific context of forensic mental health, the involvement of families in the planning and dispensation of care to relatives has been difficult. The purpose of our study, which was conducted in Ontario, Canada, was to better understand the interactions between families and the forensic mental health system. To meet this objective, we used a qualitative methodology, namely interpretive phenomenology. We collected data from 17 family members of persons in the forensic mental health system through semi-structured interviews. Interviews were analysed using a three-pronged approach with a particular attention paid to the spatial, temporal, and interpersonal dimensions of families' lived experiences. In this article, we present our findings related to families' experiences with the Review Board, a mental health tribunal responsible for the legal management of patients in the forensic mental health system. We regrouped the experiences of family members in four overarching, and occasionally overlapping, categories: (1) Preparation for Review Board hearings; (2) Review Board hearing processes; (3) Information Discussed during Review Board hearings; and (4) Format of Review Board hearings. Among other things, our findings highlight that Review Boards are experienced by families as rubber-stamping exercises, and that Review Board panels lack sociodemographic diversity. These findings have implications for healthcare professionals and mental health tribunals in Canada and abroad.