Search results for ‘Subject term:"secure units"’ Sort:
Results 1 - 10 of 12
Secure inpatient services: a needs assessment
- Authors:
- HALL Ian, et al
- Journal article citation:
- Journal of Intellectual Disabilities and Offending Behaviour, 5(1), 2014, pp.38-53.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to complete a thorough needs assessment that would enable the development of a robust pathway of care for adults with a learning disability requiring secure care, and to assist commissioners to make informed planning decisions. Design/methodology/approach: The paper identified people with a learning disability originating from London who were in secure care, and collected data about them. The paper used reference groups to inform the analysis. Findings: The paper identified 249 people in secure services and was able to include 136 patients in the analysis. In all, 64 were in NHS provision and 72 in independent sector provision; 109 (80.1 per cent) were male and 27 (19.9 per cent) female; on average, patients were cared for 61.5 miles away from their homes; NHS patients were far closer to home; 69.1 per cent had a mild learning disability; 82.3 per cent had a history of violence; approximately one in six patients could not progress due to a lack of an appropriate ward, facility, resource and/or intervention. Practical implications: Secure care for this population is a major public health issue. Many are placed a long way from home. Local services should be developed, and there should be sufficiently robust “step down” places for patients to be discharged to. Originality/value: Systematic identification of the needs of a marginalised group to enable better more appropriate care pathways to be developed in the future. (Publisher abstract)
We can still feel good: evaluation of the I can feel good programme second edition in a low secure unit
- Authors:
- ASHWORTH Sarah, et al
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 15(2-3), 2021, pp.33-45.
- Publisher:
- Emerald
Purpose: This paper aims to present the process of reviewing, adapting and evaluating, the second edition of the I Can Feel Good programme (Ashworth et al., 2018) and adapted DBT programme facilitated at a low-security psychiatric hospital for men with intellectual disability. Through the presentation of programme development, evaluation and revision, a more thorough and transparent understanding of the process involved can be disseminated. Design/methodology/approach: The programme lasted approximately 14 months and covered all four modules. N = 5, all-male, ages ranged between 23 and 57 years old. All detained under the MHA (1983) with a primary diagnosis of Mild ID with comorbid psychiatric diagnoses including mental illness, autism spectrum disorders and personality disorder. To evaluate routine effectiveness a pre-post comparison within groups design was used. A standardised GAS approach provided a template to score the degree to which identified goals were achieved over the intervention for participants. Findings: Wilcoxon signed-rank tests were used due to data not meeting parametric assumptions regarding normal distribution. Except for the mindfulness module, all modules saw pre to post programme psychometric results in the desired direction, evidencing skills acquisition. Coping in crisis and managing feelings modules outcomes neared statistical significance, with the module of people skills demonstrating statistical significance (p < 0.05). Originality/value: Upon examination of the results, it appears as though the second edition pilot programme, displayed initially promising results. The clinical and statistical aspects of the programme are explored, in the hope that clinicians may consider the programme’s application and utility within various clinical contexts, in addition to gaining insight into the process of programme development and refinement. (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)
Service user experiences of a motivational group
- Authors:
- FINN Lucinda Charlotte, GREY Danielle, BRAHAM Louise G.
- Journal article citation:
- Journal of Forensic Practice, 15(4), 2013, pp.269 -280.
- Publisher:
- Emerald
Purpose: The Forward Motion Motivational Group (FMMG) is a psychological group intervention facilitated in the Mental Health Directorate of a high-secure Hospital. Research has highlighted a limited amount of service user involvement within secure settings. The aims of the study were to explore participant's experiences of FMMG, to establish whether these reflected the aims of the programme, to provide participants with the opportunity to recommend changes to the current service provision and to explore whether the programme supported engagement in further psychological interventions. Design/methodology/approach: Ten programme completers were interviewed using a semi-structured interview. The interview transcripts were analysed using thematic analysis (Braun and Clarke, 2006) alongside Beutow (2010) Saliency Analysis Guidelines. Findings: Thematic analysis of the data resulted in five key themes: expectations, group experience, programme facilitators, learning and programme aims and programme development. Practical implications: Qualitative measures provide an insight into whether participant's experiences reflect the programme aims which is a valuable indicator of treatment effectiveness. Participants advocated the value of completing an introductory group to broaden their insight into the structure and delivery of psychological group interventions. Originality/value: Given the limited amount of research involving service users within secure settings, it is specifically the service user's experiences and suggestions for programme development that are considered within this paper. This highlights the value of service user involvement for those interested in conducting research within secure settings. (Publisher abstract)
Government response to the Office of the Children's Commissioner's report: 'I think I must have been born bad': emotional well-being and mental health of children and young people in the youth justice system
- Authors:
- GREAT BRITAIN. Ministry of Justice, GREAT BRITAIN. Department of Health
- Publisher:
- Great Britain. Ministry of Justice
- Publication year:
- 2011
- Pagination:
- 17p.
- Place of publication:
- London
The Children’s Commissioner (OCC) published this report into the emotional well-being and mental health of children and young people in the youth justice system. The report contained 19 principal recommendations for the Ministry of Justice, the Youth Justice Board and the Department of Health. This is the joint Governmental response to each of these. The OCC found there is a lack of consistency and wide variation in the type, level and quality of measures put in place to support the emotional well-being and good mental health of children in the youth justice system and specifically, in the children and young people's secure estate. The 19 recommendations call for the following: children should be placed in units of no more than 150; staff-child ratios should be small enough to ensure meaningful relationships with key workers; all children should have a health screening assessment on entering custody; re-settlement plans should ensure children are well supported when they leave custody; and all children's prisons should be inspected by an inspectorial body with expertise in inspecting closed institutions.
Mental capacity assessments in secure care: an unnecessary complication?
- Author:
- ROYCHOWDHURY Ashimesh
- Journal article citation:
- Psychiatric Bulletin, 33(12), December 2009, pp.461-464.
- Publisher:
- Royal College of Psychiatrists
This article reviews the key criteria and implications of the Mental Capacity Act 2005 (which set out the legal framework for acting and making decisions on behalf of individuals who lack the mental capacity to make decisions for themselves) and its code of practice for patients in forensic care detained under the Mental Health Act 1983, and looks at the impact of amendments by the Mental Health Act 2007 and its code of practice. Considering changes in legislation, implications for detained individuals, implications for the Human Rights Act, capacity judgements in mental disorder and a case scenario, the author argues that capacity judgements in mental disorder are inherently complex, unreliable and inextricably linked to risk assessment, that an overemphasis on capacity in decision-making about patient management in secure care can obscure the central issue of risk and proportionality under Article 8 of the European Convention on Human Rights, and that services need to ensure an open debate about these issues.
Caught in the system
- Author:
- FRANCIS Joy
- Journal article citation:
- Community Care, 24.12.94, 1994, p.18.
- Publisher:
- Reed Business Information
Increasingly women are being placed in secure psychiatric units and special hospitals when the circumstances behind their admittance are highly questionable - a high percentage have been sexually abused. Looks at the role of the Campaign Group for Women within the Mental Health System in promoting a commitment to revealing the plight of women who, it claims, should not be locked away in the first place, and the support needed for women who work with them.
Deprivation of liberty: a review of published judgments
- Authors:
- ROE Alice, RYAN Mary, POWELL Andrew
- Publisher:
- Nuffield Family Justice Observatory
- Publication year:
- 2022
- Pagination:
- 44
- Place of publication:
- London
This report summarises the key themes and issues identified in 31 judgments, published between 2014 and 2021, relating to applications to deprive children of their liberty under the inherent jurisdiction of the high court or section 25 of the Children Act 1989 and section 119 of the Social Services and Well-being Act (Wales) 2014. A summary of each judgment is available separately from the full report. Increasing concern has been raised about a small but highly vulnerable number of children who are deprived of their liberty by the family courts in England and Wales and the lack of appropriate placements that can meet these children’s needs. This report aims to shine a spotlight on the needs of this group of children and how they could be better supported by the system. Key themes emerging from the review include: shortage of appropriate placements in registered secure children’s homes and secure mental health inpatient beds for children who are in need of this type of provision; concerns about the use of the inherent jurisdiction of the high court to deprive children of their liberty; the placement of children in unregistered or unregulated settings; use of the high court for injunctions against adults to protect children. It was evident that a lot of children spent significant periods of time in suboptimal placements without the therapeutic support they needed to make significant long-term improvements. These placements were often many miles from the child’s home. The judgments provide an indication of the child’s situation when the case is before the court. Some cases return to court and it is possible to get a sense of how the case progresses. However, in most cases, it is unknown what happens after an order is made. In general, there is a lack of research and evidence about children’s outcomes following a secure placement. (Edited publisher abstract)
An exploration of MDT views on key factors to consider when determining a service users required level of security
- Authors:
- KHAN Zulaikha, et al
- Journal article citation:
- Journal of Forensic Practice, 21(1), 2019, pp.38-49.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to identify what key factors multi-disciplinary teams (MDT) deem as most important when making the decision to move service users from one level of security (including low, medium and high secure services) to another. The researchers used the findings from this study to further develop a tool; the assessment for level of security tool (ALS), which aims to structure and streamline this decision-making process. Design/methodology/approach: Data from 18 interviews (MDT staff) were analysed using the Delphi technique (Dalkey and Helmer, 1963). This revealed a range of factors discussed when considering service users moves. Participants were asked to rate these factors in accordance with the Delphi which resulted in the removal of certain less important factors based on their scores. The researchers then compared these factors of relevance with a checklist of 16 items previously proposed by a consultant psychiatrist within the trust. This comparison allowed the researchers to highlight any similarities and differences present. Findings: Findings from staff interviews revealed a range of 20 clinical factors perceived as essential to this process including procedural, relational and physical security aspects. However, variations were evident between the MDT priorities (20 items) and the originally proposed list. This emphasised the need for a tool which facilitates a holistic and streamlined approach. Practical implications: The findings from this research have resulted in the development of the ALS tool comprising of 18 key factors. Originality/value: It is envisaged the development of the ALS tool will not only facilitate and structure the decision-making process but also ensure a person-centred approach. This is because the ALS allows for a holistic approach based on an array of factors deemed important to that particular service user. Furthermore, the ALS tool contributes towards the paucity of published structured professional judgement tools needed to make such decisions. (Edited publisher abstract)
Medium secure forensic psychiatry services: comparison of seven English health regions
- Authors:
- COID Jeremy, et al
- Journal article citation:
- British Journal of Psychiatry, 178, January 2001, pp.55-61.
- Publisher:
- Cambridge University Press
Regional medium secure developments have proceeded unevenly, with wide variations in resources to deliver services. This study compares patients admitted to seven (pre-reorganisation) regional services and styles of serve delivery. It was discovered that un-coordinated development led to under-provision despite high demand. Certain regions prioritised offender patients and did not support local psychiatric services. New standards are required for service specification and resource allocation to redress inequality. Traditional performance measures were of limited usefulness in comparing services.