scholarly journals The omnipresence of risk and associated harms in secure and forensic mental health services in England and Wales

2021 ◽  
Author(s):  
Sarah Markham
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Forensic Mental Health ◽  
England And Wales

scholarly journals The Totalising Nature of Secure and Forensic Mental Health Services in England and Wales

2021 ◽  
Vol 12 ◽  
Author(s):  
Sarah Markham
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Research Literature ◽  
Forensic Mental Health ◽  
Mentally Disordered Offenders ◽  
England And Wales ◽  
Mentally Disordered ◽  
Practitioner Attitudes ◽  
Recovery Potential

This evidence-based opinion piece explores the totalising risk averse nature of secure and forensic mental health services and associated iatrogenic harms in England and Wales. Drawing on the research literature I consider the various influences, both external and internal which impact on the provision of such services and how both the therapeutic alliance and recovery potential for patients may be improved. Especial attention is paid to the deployment of restrictive practise, practitioner attitudes, the potential for non-thinking, and how these may impact on decision-making and the care and treatment of mentally disordered offenders.

Advancing research in adult secure mental health services in England

2021 ◽  
pp. 002580242110669
Author(s):  
Howard Ryland ◽  
Louise Davies ◽  
Jeremy Kenney-Herbert ◽  
Michael Kingham ◽  
Mayura Deshpande
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Learning Disability ◽  
Personality Disorders ◽  
Forensic Mental Health ◽  
Policy Makers ◽  
People With Mental Illness ◽  
Low Volume

Forensic mental health services in high income countries are typically high cost and low volume, providing care to people with mental illness, personality disorders, learning disability and autism deemed to pose a risk to others. Research into how forensic mental health services work as a whole system is limited. Such research is urgently needed to guide policy makers and ensure that services operate effectively.

The designated forensic professional program: A state government-university partnership to improve forensic mental health services

1991 ◽  
Vol 18 (3) ◽  
pp. 223-230 ◽  
Author(s):  
Robert A. Fein ◽  
Kenneth L. Appelbaum ◽  
Richard Barnum ◽  
Prudence Baxter ◽  
Thomas Grisso ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
State Government ◽  
Forensic Mental Health ◽  
University Partnership

Job creation through income generation: an evaluation of Re-Cover, a decorating project developed with forensic mental health service users

2018 ◽  
Vol 13 (3) ◽  
pp. 148-156
Author(s):  
Sarah McDonald ◽  
Mark Bertram
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Job Creation ◽  
Operating Costs ◽  
Service Users ◽  
Income Generation ◽  
Forensic Mental Health ◽  
Commercial Activity ◽  
Content Type

Purpose The purpose of this paper is to explore and describe the effectiveness, achievements and challenges of a job creation project that was developed with people in contact with forensic mental health services. Design/methodology/approach This evaluation (case study) used a mixed methods approach: a range of quantitative and qualitative data were gathered, analysed and interpreted. Findings There were economic and health benefits. The income generation was sufficient to fund a large chunk of the projects operating costs. Service users reported improvements in mental health, wellbeing, confidence, skill development and earning capacity. Research limitations/implications The sample size was too small to be generalised and no validated measures were used. Further research is required into the long-term benefits of job creation in mental health services and providing a continuum of employment support. Practical implications A range of commercial activity can form the basis for job creation and work training projects in mental health services. Substantial operating costs can be generated, to re-invest in job creation/enterprises. Social implications Social value can be enhanced within NHS public sector procurement procedures. Agreement between a range of internal NHS departments is necessary: finance, commercial, estates and facilities, and procurement. Originality/value Public sector procurement has the potential to act as a catalyst to support the inclusion agenda by funding commercial activity that job creation projects can undertake.

scholarly journals Security needs among patients referred for high secure care in Broadmoor Hospital England

BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Hannah Kate Williams ◽  
Madhri Senanayke ◽  
Callum C. Ross ◽  
Rob Bates ◽  
Mary Davoren
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Cohort Study ◽  
Personality Disorder ◽  
Mental Health Services ◽  
Health Services ◽  
Final Decision ◽  
Forensic Mental Health ◽  
Vulnerable Group ◽  
Secure Care

Background Security needs among patients referred to forensic mental health services have rarely been systematically studied. Aims To ascertain security needs among patients referred to a high secure hospital, Broadmoor High Secure Hospital, England. We also aimed to compare the security needs for those referred to mental illness services with those referred to personality disorder services in the hospital. Method A retrospective complete cohort study of all referrals to Broadmoor Hospital over a 2-year period was conducted. All referred patients (n = 204) were assessed for need for high secure care by two Broadmoor clinicians. The final decision on need for admission was taken by a multidisciplinary admission panel. Independent of the panel, researchers rated need for security using the DUNDRUM-1 triage security scale. Results Those admitted to Broadmoor Hospital had higher triage security scores than those declined (F = 4.209, d.f. = 1, P = 0.042). Referrals to the personality disorder pathway had higher security needs than those referred to the mental illness pathway high secure service (F = 6.9835, d.f. = 1, P = 0.0089). Overall security needs among referrals to Broadmoor were extremely high, both by comparison with previous needs identified in UK medium secure services and international medium and high secure services. Conclusions High secure patient cohorts represent a uniquely vulnerable group within mental health services, with extremely high security needs identified in this study. This has significant implications for services given the high levels of resources needed to provide therapeutically safe and secure care and treatment to this group.

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