# ‘We Are the Cornerstone of This Hospital’: First‐Hand Accounts of Expert‐By‐Experience Practices in Forensic Psychiatry in Finland

## TL;DR

This study explores how patients and former patients contribute to forensic psychiatric care in Finland by sharing their experiences and working alongside staff.

## Contribution

The study is the first to describe expert-by-experience practices in Finnish forensic psychiatry and identifies key themes from first-hand accounts.

## Key findings

- Experts-by-experience contribute through tasks like planning and evaluating care.
- Five main themes emerged: transformative effect, resource contribution, motivation, cooperation, and validation through identification.
- Experts-by-experience lack formal positions in most hospitals despite their contributions.

## Abstract

Experts‐by‐experience can help care personnel in planning, producing and evaluating care and promoting the patient perspective in care. Patients in forensic psychiatry rarely influence core processes in hospitals, but involving them as experts‐by‐experience in various assignments has become a desirable way of making forensic psychiatric services more patient‐centred. This is the first study to outline the forms that expert‐by‐experience work takes in Finnish forensic hospitals. It summarises experiences of such work from the perspectives of experts‐by‐experience themselves and the staff who work with them. We interviewed 19 experts‐by‐experience and 18 professionals who work with them to reveal the current situation of expert‐by‐experience activities in Finnish forensic psychiatric hospitals. We used inductive thematic analysis to explore their experiences. Our findings identify five main themes: a transformative effect, the resources as a contribution, motivation and achievement, interaction and co‐operation and identification as validation. The results from this study show that a wide range of expert‐by‐experience tasks are assigned to current and former patients in these hospitals, but experts‐by‐experience have not yet gained a formal position in most of them. We identified several benefits of expert‐by‐experience work for different stakeholders, along with challenges to the implementation of EBE practices. We hope that this study will promote the development of expert‐by‐experience work in forensic psychiatric hospitals. A COREQ Checklist was applied.