Mad and/or bad?: Structural violence and the experiences of forensic mental health patients in NSW

Forensic mental health patients detained within the New South Wales, Australia prison system are a marginalised sector of society. Issues of disempowerment increase as they progress through the criminal justice and medical systems. People in these prison systems are excluded, ignored and largely voiceless, and the dearth of research in this field is evidence of this. People who are cast into the criminal justice and medical systems and who have a serious mental illness form a unique sociological group. The experiences of forensic patients are hidden from the public gaze and the prison experience has been found to exacerbate mental illness. This exploratory study analyses four case studies to show how system failures impact forensic patients. Policy and legislation are found to have gaps and contradictions between what is written and how it is implemented. These were found to have significant implications for forensic patients’ wellbeing. Documents from court cases, coronial inquests, parliamentary investigations, personal correspondence with state departments and official reports were analysed. Analysis uncovered how structures within the system violate forensic patients. Power is held and used within the systems that surround forensic patients in ways that further punish them. It is crucial to understand how these violations are affecting those within the prison systems if violations are to be addressed. This study examines the experiences of people held within the criminal justice and medical systems and how structural and symbolic violations are occurring. This is important for improving services towards reform.