The Development of a UK Low Secure Service: Philosophy, Training, Supervision and Evaluation

Abstract

Within the UK, low secure mental health services provide care and treatment to individuals with a view to supporting their return to life within community settings. With the expansion of services in this area it is essential that effective models of care are articulated, delivered and evaluated. This paper describes the philosophical underpinnings of the Intensive Support and Intervention Service, a new low secure inpatient facility. The operationalization of the approach to recovery is described along with the role and impact of the initial staff training. Clinical supervision as a critical component to ongoing practice delivery and development is described. Finally, the methods being utilized to evaluate the service are outlined.

Patient characteristics and outcome measurement in a low secure forensic hospital

“…Low security hospital units were developed in England and Wales to bridge the gap between medium security hospital services and open settings (Dix, ; Davies et al, ; Prins, ; Dye et al, ). Approximately 2500 low security beds were commissioned across England; there are 2800 medium security beds in addition to 680 high security hospital places (The NHS Commissioning Board, ).The Department of Health () set out the first national minimum standards for low security hospital services, which have been superseded by the Royal College of Psychiatrists' Quality Network for Forensic Mental Health Services (Tucker et al, ; Holder and Souza, ).…”

Mental Health Reform at a Systems Level: Widening the Lens on Recovery-Oriented Care

“…This was one of several reports of general programs of training and practice designed to enhance the degree to which inpatient care is client-centred, empowering, and based on approaches that emphasize various ways of identifying individualized tools where recovery can be better supported. Such approaches include scripting of clinical interactions and designing physical spaces, 31 the Good Lives Model, 32 which is a strengths-based approach, grounded in personal goals and an emphasis on community integration, and papers generally recommending recovery-oriented programming and the means to hold clinicians accountable for such practices. 16,22,[33][34][35][36][37] While not suggesting that they are outside the bounds of scientific inquiry, these latter approaches were not examined with respect to impact other than in some instances examining the level of knowledge uptake in trainings.…”

An initial evaluation of the Global Review Form as an approach to measuring individual change

“…3 foot garden wall, open door policy, 1 staff : 4 patients. All areas provide multi-professional care with the service provision within the low secure ward having been previously described (Davies, Maggs and Lewis, 2010). Whilst those in the low secure ward typically stay for up to 18 months, those within the locked rehabilitation area have the longest inpatient stays, often longer than 2 years.…”