Trends in special (high-security) hospitals

Jamieson, Elizabeth; Butwell, Martin; Taylor, Pamela J.; Leese, Morven

doi:10.1192/bjp.176.3.253

Cited by 37 publications

(22 citation statements)

References 7 publications

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“…However, due to inconsistencies in defining medium secure units, the authors are sceptical about the validity in comparing`real numbers' of women; some of the increase may be due to the exodus of women from special hospitals. However, what is clearer is that women currently occupy 19% of the beds in medium secure units, which suggests a 1:5 female/male ratio consistent with that of the special hospitals (Jamieson et al, 2000). The lack of clear governmental reporting of the`real numbers' and distribution of women in medium secure units has an impact on the management of these patients and the delegation of limited resources.…”

Section: Discussionmentioning

confidence: 99%

The changing climate for women patients in medium secure psychiatric units

Hassell¹,

Bartlett

2001

Psychiatr. bull.

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We conducted a telephone survey of medium secure units in England and Wales to determine the distribution of women patients. RESULTSThe survey identified 1836 medium secure beds, housing 342 women patients. Women in the NHS were housed primarily in mixedgender units (170 women, 94%). Most NHS beds in single-gender units were for men (56 beds), whereas most private sector beds in single-gender units were for women (79 beds). CLINICAL IMPLICATIONSIncreased awareness of the often inappropriateness of services for women in mixed-gender units has led to units deciding not to admit women patients and, inadvertently, more single-gender beds for men in NHS units than for women. The NHS units have to rely on private sector units to provide beds in singlegender units for women, perhaps at the expense of effective continuity of care.

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Section: Discussionmentioning

confidence: 99%

The changing climate for women patients in medium secure psychiatric units

Hassell¹,

Bartlett

2001

Psychiatr. bull.

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“…screening services or referral routes); assessment; treatment; rehabilitation; continuing care (or transfer or discharge) (see also procedural security) Table 2 As in Table 2 patient workers according to in Table 2 Research has recently shown that fewer patients are admitted on civil sections to London's forensic services, and also that London has a higher proportion of restriction-order patients than do other regions of England (Coid et al, 2001b). At the same time, the numbers admitted to special hospitals are falling year on year (Jamieson et al, 2000). It appears that admission thresholds are drifting upwards in a responsive but unplanned manner, determined by availability of resources rather than any more objective criteria.…”

Section: Box 2 Mapping Modelsmentioning

confidence: 96%

Therapeutic uses of security: mapping forensic mental health services by stratifying risk

Kennedy¹

2002

Adv. psychiatr. treat

153

146

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The syllabus for higher training in forensic psychiatry requires knowledge of the therapeutic uses of security, although there are no references to this in standard texts. Similarly, the process of mapping a mental health service is an essential first step in planning, audit and needs assessment. All mental health services, not just forensic services, are organised to stratify patients according to the risk they present so that they can be cared for in an environment that is safe but imposes the minimum necessary restrictions and intrusions. Forensic mental health services differ from other mental health services mainly by including subsystems which are at higher levels of security than those necessary in local services. Although they have a general orientation towards risk awareness and risk management, they remain integral parts of the mental health services for the populations they serve.

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“…A recent study by Jamieson (Jamieson et al, 2000) has confirmed the continuing demand for high security beds for adults. The authors highlighted that 'routes into special hospital have become more complex over time, with more admissions resulting from failed placements elsewhere'.…”

Section: Service Implicationsmentioning

confidence: 79%

“…The National Health Service Act 1977 for England and Wales requires the Secretary of State to provide high security hospitals for detained mentally disordered patients 'who in his opinion require treatment under conditions of special security on account of their dangerous, violent or criminal propensities'. Changes in their management and referral process have been described previously (Jamieson et al, 2000). As of April 2001, Broadmoor and Rampton merged with other NHS trusts, to form the West London Mental Health NHS Tr ust and Nottinghamshire Healthcare NHS Trust respectively.…”

Section: Introductionmentioning

confidence: 97%