Working towards a hopeful future with service users in a custodial setting is fraught with difficulty. Maxine Cromar-Hayes and Mark Chandley discuss how reflective practice helped to explore the principles involved

This article focuses on one of the three high secure hospitals in England. All the patients are male and all have a diagnosis of mental illness, personality disorder or dual diagnosis; they are nursed under the Mental Health Act 1983. Many of the patients have restrictions placed on them by the judicial system because of their propensity for violence and therefore present a risk to the public. The aim of this article is to explore an action research project that looked at how and if the recovery model can be embraced in high secure services.

Recovery is evident and tangible in high secure services, however, it differs from the recovery idea offered by Anthony (1993), who highlights that some of the core values are limited by the tension created by competing priorities; that is, care versus custody.

For staff to be able to offer recovery-orientated care they need to be valued. Recovery principles should apply to people, not simply to those who are prescribed the role of patient. Early findings of the study are detailed through a thematic analysis and practice changes are reported.