New technologies in the management of risk and violence in forensic settings

Abstract

Novel technological interventions are increasingly used in mental health settings. In this article, we describe 3 novel technological strategies in use for management of risk and violence in 2 forensic psychiatry settings in the United Kingdom: electronic monitoring by GPS-based tracking devices of patients on leave from a medium secure service in London, and closed circuit television (CCTV) monitoring and motion sensor technology at Broadmoor high secure hospital. A common theme is the use of these technologies to improve the completeness and accuracy of data used by clinicians to make clinical decisions. Another common thread is that each of these strategies supports and improves current clinical approaches rather than drastically changing them. The technologies offer a broad range of benefits. These include less restrictive options for patients, improved accountability of both staff and patients, less invasive testing, improved automated record-keeping, and better assurance reporting. Services utilizing technologies need also be aware of limitations. Technologies may be seen as unduly restrictive by patients and advocates, and technical issues may reduce effectiveness. It is vital that the types of technological innovations described in this article should be subject to thorough evaluation that addresses cost effectiveness, qualitative analysis of patients' attitudes, safety, and ethical considerations.

The Feasibility of Using Body Worn Cameras in an Inpatient Mental Health Setting

“…This concurs with the views of the nurses wearing them in Broadmoor [6] and provides further evidence of their acceptability to mental health nurses.…”

“…Again, this aligns with the views of patients at Broadmoor who also judged them to be useful [6]. As this was a feasibility pilot, we were limited in the types of questions we could ask patients.…”

“…Each department or facility need to develop their own set of standards, roles and responsibilities, and policies and procedures to comply with governance requirements [1]. In a qualitative appraisal of the use of CCTV cameras in Broadmoor Hospital (a high-security psychiatric hospital in England), patients believed the absence of sound recording led to a lack of context when reviewing the images [6]. This was one of the reasons that BWCs were introduced.…”

“…It displays a red light when in use. The employment of the BWCs has been judged to be useful by both nursing staff and patients [6], but no report on their feasibility or effectiveness has been published to date.…”

Risk Assessment and Manage- ment of Violence in Patients with Mental Disorders: A Re- view

“…There are four primary methods of risk management: monitoring, supervision, treatment, and victim protection. Monitoring involves continuous observation of the subject to identify, as soon as possible, the triggers that could potentially lead to an incident [61,62]. Supervision includes detention, probation, and other restrictive orders by authorities [63].…”