Search results for ‘Subject term:"secure units"’ Sort:
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The development and future of deaf forensic mental health services
- Authors:
- GIBBON Simon, DOYLE Colin
- Journal article citation:
- British Journal of Forensic Practice, 13(3), August 2011, pp.191-196.
- Publisher:
- Emerald
This paper reviews the need for, and development of, specialist deaf secure mental health services. The authors begin by giving a brief overview of deafness and the relationship between deafness, mental health problems and offending. They go on to summarise the literature and the Department of Health (DoH) guidance and provide a description of the current UK services. In 2001, Young et al. highlighted the needs of deaf mentally disordered offenders and the requirement for specialist forensic mental health services for this group. Since then several DoH guidance documents have been published and there have been substantial service developments.
An informal review of the literature on community meetings and the potential for their application in a secure adolescent service
- Author:
- SHER Marilyn A.
- Journal article citation:
- Therapeutic Communities: the International Journal of Therapeutic Communities, 31(3), Autumn 2010, pp.282-297.
- Publisher:
- Emerald
In the UK, the term therapeutic community is generally used to describe small cohesive communities where service users have a significant involvement in decision-making and running of their unit. Community meetings are a feature of therapeutic communities, and in secure services may involve regular meetings of all service users and relevant staff to discuss issues that affect the community as a whole. This article describes and explores some of the key themes emerging from reviews and studies about community meetings. It looks at definitions, process, structure and leadership of community meetings, therapeutic approaches and techniques, group processes, evaluation of effectiveness, and applicability to adolescent forensic services. The author concludes that having the aims of community meetings specifically focused and reflective of therapeutic and group process and addressing specific client group needs could enhance their successful application, and that although further research needs to be undertaken on the usefulness of community meetings in secure adolescent services they do have potential value in such environments.
Rapid review of evidence of the impact on health outcomes of NHS commissioned health services for people in secure and detained settings to inform future health interventions and prioritisation in England
- Author:
- LEAMAN Jane
- Publisher:
- Public Health England
- Publication year:
- 2016
- Pagination:
- 103
- Place of publication:
- London
A review of evidence of the impact on health outcomes of NHS commissioned health services for people in secure and detained settings. The report draws on the findings from a rapid review of the literature and qualitative data gathered through more than 40 one-to-one interviews with key informants. The review highlighted significant improvements in the quality of care supported by strong partnerships; healthcare staff development; increased transparency of services and outcomes; prisoner engagement and liaison and diversion services. The review also identified seven areas for prioritisation by the Department of Health: whole prison approach focusing on both rehabilitation and resettlement, and giving access to healthcare to a population who would normally be underserved, through policies in prisons that promote health, an environment in prisons which is actively supportive of health, and prevention, health education and other health promotion initiatives; links with wider care pathways and community structures/services; developing robust data and intelligence; increasing the focus on self-management and peer-led services and proactive/early intervention services; establishing equitable resourcing and responsive services to meet different needs – recognising one-size-doesn’t-fit-all; and strengthening the focus on improving health as a positive mediator of change in criminal behaviour. (Edited publisher abstract)
Does punishment in secure residential youth care work? An overview of the evidence
- Authors:
- de VALK S., et al
- Journal article citation:
- Journal of Children's Services, 10(1), 2015, pp.3-16.
- Publisher:
- Emerald
Purpose: Violence is a common problem in secure residential units for young people. This paper investigates punishment is an effective way of managing the behaviour of young people in secure residential units. It also aims to provide alternatives to punishment when dealing with violence. Design/methodology/approach: Recent evidence on the effectiveness of punishment in secure residential units is reviewed. In addition, methods which are promising in dealing with violence are described. Findings: The review shows that punishment is often used to regain control by group workers or, alternatively, is a result of professional helplessness in the face of escalating problems. Only when the living group climate is marked by trust and cooperation can punishment be effective. Originality/value: Punishment in secure residential settings can have severe negative consequences. Nevertheless, group workers are tempted to use it as a response to violence in an attempt to gain control. (Edited publisher abstract)
What do we know about children deprived of their liberty? An evidence review
- Author:
- ROE Alice
- Publisher:
- Nuffield Family Justice Observatory
- Publication year:
- 2022
- Pagination:
- 74
- Place of publication:
- London
This report summarises what we know about children and young people deprived of their liberty across welfare, youth justice and mental health settings in England and Wales from national administrative data and recent research studies. Drawing on national administrative data and research from the past ten years, it summarises what we know about the number of children held in different settings, who the children are, where they are placed, their experiences of secure care, and what happens to them afterwards. The report finds that the secure estate in England and Wales is struggling to adequately meet children’s needs. There is a lack of early intervention to support children and their families before risk escalates, and once this occurs, a lack of suitable placements and support in the community that might prevent children needing to enter secure settings. Demand for welfare placements in secure children’s homes, and the increasingly complex needs of children who are referred, exceeds capacity and capability within the system. There is a group of children with very severe mental health needs that do not meet criteria for in-patient mental health treatment. These children are often passed around different agencies with a lack of coordinated care planning between children’s services and mental health services. Although there is a lack of evidence about children’s outcomes, research to date suggests that while some children may benefit in the short term, in the long term a placement in secure care is unable to fundamentally improve children’s outcomes. There is a therefore a need to rethink how we meet the needs of this group of children, based on a better understanding of their journeys, strengths and needs, what a ‘positive outcome’ would look like, and the type of trauma-informed, therapeutic and integrated care that would support children’s resilience and recovery both in secure settings and in the community before, after or instead of a placement in secure care. (Edited publisher abstract)
Understanding the needs and what works for girls in the children and young people’s secure estate: literature review
- Author:
- KHAN Lorraine
- Publisher:
- Centre for Mental Health
- Publication year:
- 2021
- Pagination:
- 107
- Place of publication:
- London
This is a review of academic evidence about the needs of girls in the Children and Young People Secure Estate (CYPSE) in England. CYPSE includes children placed in secure residential care through youth justice legislation and through child protection legislation. Girls are a highly vulnerable group both in custodial and secure care placements. Their pathways into these settings are closely linked with histories of exposure to multiple traumatic events – particularly physical and sexual abuse and ongoing victimisation in interpersonal relationships. Research suggests that girls facing such high levels of childhood adversity, trauma and multiple needs require support that is gender-responsive and trauma-informed. Strong authentic and trusting relationships with workers and strength-based approaches are at the heart of these ways of working. There are concerns that secure settings (and particularly those with a justice, controlling and punitive approach) are inherently harmful and re-traumatising for girls who have experienced multiple traumatic events in their lives. An intersectional trauma-based approach is also advocated recognising that girls often have intersecting identities and experiences of discrimination (e.g. based on ethnicity, class, sexual and gender identity) which may amplify trauma and oppression. Some question the extent to which these approaches can successfully be adapted to secure institutions which can default to organisational and controlling procedures rather than person centred approaches. Therapeutic residential approaches appear to outperform justice-based approaches in highly quality reviews of the available evidence. Emerging evidence suggests that for maltreated children, stabilising the developmental disruption that children face following this legacy of maltreatment, is a priority before broader work on offending becomes feasible. High quality community wraparound approaches such as Treatment Oregon Fostering and Multi Systemic Therapy show consistently good evidence for girls as an alternative to placement in secure settings and could be adapted further to reflect gender responsive and trauma informed approaches (Edited publisher abstract)
Unlocking potential: a study of the isolation of children in custody in England
- Author:
- CHILDREN'S COMMISSIONER FOR ENGLAND
- Publisher:
- Office of the Children's Commissioner
- Publication year:
- 2015
- Pagination:
- 6
- Place of publication:
- London
Summarises the findings of a study to assess the nature, prevalence, causes and impact of isolation and solitary confinement of children in the youth justice secure estate in England, to inform understanding and allow the development of recommendations to better protect and promote the wellbeing of children in custody and to ensure that the use of isolation does not have a negative impact on reoffending and reintegration. The report finds that around a third of children experience isolation and segregation. More prevalent in larger young offending institutions, it is often used as a method for maintaining order and safety in environments where violence between young offenders and towards staff is common place. With some young people spending as many as 22 hours a day in isolation, the risks to the mental health of this highly vulnerable group are significant. The paper calls for a radical reform of the youth custody system to provide the environment and the approach needed to improve the outcomes and life chances of children in custody and to reduce reoffending. (Edited publisher abstract)
Developing the leave/abscond risk assessment (LARA) from the absconding literature: an aide to risk management in secure services
- Authors:
- HEARN Dave, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(6), 2012, pp.280-290.
- Publisher:
- Emerald
Leave out of the ward can be an important part of treatment for patients in secure mental health and learning disability settings. Only a small percentage of patients breach their leave conditions by absconding or failing to return but when incidents occur there can be far reaching negative outcomes for potential victims, the patient and the service. A literature review focussing on absconding was used to develop the leave/abscond risk assessment (LARA) to aid decision making for patients within medium and low secure units. The literature search revealed that: there is a dearth of research on absconding, definitions for absconding are varied (often including escape) making comparisons difficult, and much of the literature focuses on psychiatric acute wards making it difficult to translate into secure environments. Characteristics of absconders vary and are not idiosyncratic enough to help in the development of a risk assessment. Socio-environmental factors seemed more critical and LARA was devised around assessment of these. The authors invite others to evaluate the tool in a clinical or research setting.
Secure care in Scotland, a scoping study: developing the measurement of outcomes and sharing good practice
- Author:
- MOODIE Kristina
- Publisher:
- University of Strathclyde. Centre for Youth and Criminal Justice
- Publication year:
- 2015
- Pagination:
- 22
- Place of publication:
- Glasgow
This is a scoping study designed to help identify evidence gaps regarding the outcomes experienced by children and young people placed in secure care in Scotland. A brief literature review examining recent papers and articles discussing outcomes for young people both in and leaving secure care was carried out. Gaps in the literature were identified and then semi-structured interviews completed with heads or deputy heads of service within each of the five secure units in Scotland, to further clarify where the gaps and challenges are in relation to this subject. The study found that while individual units have been working to identify their own outcomes models, there is currently an evidence gap with regards to both short term outcomes and longitudinal follow up of young people leaving secure care. The immediate issues identified by respondents from the secure units in Scotland were the lack of continuity of care for young people, mental health and the support young people in secure units require, and the reduction in collaboration and sharing of good practice. The report suggests that there needs to be greater clarity around what through-care and aftercare means and how long, as a service or even as a relationship with an individual, it should be involved with those young people transitioning out of secure care or reintegrating into the community. As the importance of measuring outcomes has been clearly identified by the Scottish Government, and as all five secure units in Scotland now have an outcomes framework embedded within their practice, the report concludes that now would seem to be the ideal time to take an in-depth look at what has been recorded, and to build on these measures to explore the short and long term impact of placement in secure care. (Edited publisher abstract)
Addressing offending risk in low secure mental health services for men: a descriptive review of available evidence
- Authors:
- NAGI Claire, DAVIES Jason
- Journal article citation:
- British Journal of Forensic Practice, 12(1), February 2010, pp.38-47.
- Publisher:
- Emerald
This paper examines the topic of offender rehabilitation, which has been subject to much research over the past decade, where meta-analytic reviews of offender treatment, particularly group treatment based on cognitive behavioural principles, have been reported. Together with the ‘triad of principles’, risk, need and responsivity, they have formed the foundation upon which most offending behaviour interventions have been developed. The authors note, however, that the evidence outcome data from existing programmes is mixed and evidence for interventions for those in forensic mental health settings are still in their infancy. As such, this paper critically considers the current evidence for the treatment of offending behaviour, and its application in forensic mental health settings, in order to inform the development of such treatments in low secure mental health care. Most of the existing research focuses on non-mental health settings, and is largely what will be considered here. The authors conclude that low secure interventions need to capitalise on the evidence of ‘what works’ while revisiting key concepts such as ‘dose’ and ‘responsivity’ in order to design appropriate treatments. Individual outcome evaluation needs to form part of development in this area.