Relevant bibliographies by topics / Medium Secure Psychiatric Care

Academic literature on the topic 'Medium Secure Psychiatric Care'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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Journal articles on the topic "Medium Secure Psychiatric Care"

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Kasmi, Yasir. "Profiling medium secure psychiatric intensive care unit patients." Journal of Psychiatric Intensive Care 6, no. 02 (December 10, 2009): 65–71. http://dx.doi.org/10.1017/s1742646409990185.

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Nelson, D. "Service innovations: the Orchard Clinic: Scotland's first medium secure unit." Psychiatric Bulletin 27, no. 03 (March 2003): 105–7. http://dx.doi.org/10.1192/s0955603600001641.

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The development of forensic psychiatry provision in Scotland lags behind that in other parts of the United Kingdom. Until recently, there were no medium secure units in the country and mentally disordered offenders (MDOs) requiring such care had to be managed in intensive psychiatric care unit (IPCU) settings. In November 2000, The Orchard Clinic, a medium secure unit sited at the Royal Edinburgh Hospital, was opened. This paper discusses the background to this development, the government policies setting out plans for the care, services and support of MDOs in Scotland, progress and work of the new unit to date and plans for developments in other parts of Scotland.
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Nelson, D. "Service innovations: the Orchard Clinic: Scotland's first medium secure unit." Psychiatric Bulletin 27, no. 3 (March 2003): 105–7. http://dx.doi.org/10.1192/pb.27.3.105.

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The development of forensic psychiatry provision in Scotland lags behind that in other parts of the United Kingdom. Until recently, there were no medium secure units in the country and mentally disordered offenders (MDOs) requiring such care had to be managed in intensive psychiatric care unit (IPCU) settings. In November 2000, The Orchard Clinic, a medium secure unit sited at the Royal Edinburgh Hospital, was opened. This paper discusses the background to this development, the government policies setting out plans for the care, services and support of MDOs in Scotland, progress and work of the new unit to date and plans for developments in other parts of Scotland.
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Beer, M. Dominic. "Psychiatric intensive care and low secure units: where are we now?" Psychiatric Bulletin 32, no. 12 (December 2008): 441–43. http://dx.doi.org/10.1192/pb.bp.108.019489.

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SummaryThe last decade has seen clinicians and policy makers develop psychiatric intensive care units and low secure units from the so-called ‘special care wards’ of the 1980s and 1990s. Psychiatric intensive care units are for short-term care, while low secure units are for care for up to about 2 years. Department of Health standards have been set for these units. A national survey has shown that there are two main patient groups in the low secure units: patients on forensic sections coming down from medium secure units and those on civil sections who are transferred from general psychiatric facilities. Recent clinical opinion has emphasised the important role both psychiatric intensive care units and low secure units play in providing a bridge between forensic and general mental health services.
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Lelliott, Paul, Bernard Audini, and Richard Duffett. "Survey of patients from an inner-London health authority in medium secure psychiatric care." British Journal of Psychiatry 178, no. 1 (January 2001): 62–66. http://dx.doi.org/10.1192/bjp.178.1.62.

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BackgroundUnderprovision by the National Health Service (NHS) has led to an increase in medium secure psychiatric beds managed by the independent sector. Black people are overrepresented in medium secure care.AimsTo describe those people from an inner-London health authority occupying all forms of medium secure provision. To compare those in NHS provision with those in the independent sector, and Black patients with White patients.MethodA census of those in medium secure care in August 1997.ResultsThe 90 patients in independent-sector units were similar to the 93 patients in NHS units except that they were more likely to have been referred from general psychiatric services (48% v. 19%) and less likely to have been referred from the criminal justice system or a high-security hospital (37% v. 63%). There were few differences between Black and White patients.ConclusionsThe NHS meets only part of the need for medium secure care of the population of this London health authority. This comparison of the characteristics of Black and White patients does not help to explain why Black people are overrepresented in medium secure settings.
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Broadhurst, Scott, and Kathryn Swindell. "Screening for ADHD in male medium secure psychiatric services." BJPsych Open 7, S1 (June 2021): S11. http://dx.doi.org/10.1192/bjo.2021.89.

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AimsRoughly 25% of the prison population are known to meet the criteria for attention-deficit/hyperactivity disorder (ADHD), a five-fold increase on the general population. Medium secure psychiatric services receive a high percentage of referrals from the prison service. ADHD has primary symptoms of inattention, hyperactivity and impulsivity. Untreated ADHD could clearly have a detrimental impact on the effectiveness of therapeutic interventions, as well as increasing incidents of violence, aggression and other transgressive behaviours.There are two aims: To screen the medium secure services population at the Spinney Hospital, Atherton, UK for ADHD, using a validated screening tool. This would generate candidates for further structured clinical assessment for ADHD; To implement ADHD screening as a feature of the Admission Care Plan within medium secure services at the Spinney.MethodThe study population is the medium secure service at The Spinney Hospital, Atherton. At the time of study this was 52 male service users.The team members have evaluated several screening tools. The tool eventually chosen was the B-BAARS, which is a simple 6-question tool that is validated for use in adults. The tool takes around 1 minute to complete. All 52 service users were screened between 20/01/2021 and 30/01/2021.Result1 of the 52 service users had a current diagnosis of ADHD and was being treated with medication. 3 of the 52 service users had childhood diagnoses of ADHD that had lapsed in adulthood and who were untreated. Of the remaining 51 service users without a current diagnosis of ADHD, 9 were positive on screening as worthy of further assessment (17.65%). Assessments of the 9 service users positive in screening will be completed by medical and psychology disciplines.ConclusionThere appears to be clear merit for routine screening for ADHD within medium secure psychiatric services, given the service user population and the results described above. As a result of this survey, within The Spinney Hospital the B-BAARS will be incorporated into the Admission Care Plan of all new admissions to medium secure services as a Quality Improvement Intervention. Over time this will be re-audited and there will be assessment of any impact on incidents and positive engagement with activities.
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Moss, Katrina R. "A Comparative Study of Admissions to Two Public Sector Regional Secure Units and One Independent Medium-Secure Psychiatric Hospital." Medicine, Science and the Law 40, no. 3 (July 2000): 216–22. http://dx.doi.org/10.1177/002580240004000305.

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To date there has been no research carried out in respect of the contribution being made by the independent sector to medium-secure psychiatric care. There are also no published studies comparing the provision of the independent sector with that of the public sector. As such this is a neglected field of study. This paper examines the characteristics of patients admitted to one independent medium-secure psychiatric hospital and two regional secure units in terms of their demographic characteristics, source, detention under the Mental Health Act, 1983, psychiatric diagnosis, criminal history and discharge. The results of the study are tested for their significance using the chi-square distribution. There is discussion of how the independent sector may be providing a service either unavailable within the National Health Service or for which the National Health Service is unsuitable in terms of patients either requiring medium- to long-term hospital care in conditions of security or those who cannot live independently and therefore require ‘asylum’, which is no longer an option within the National Health Service. In this sense, the independent sector could be seen as meeting a national need by acting as a ‘safety valve’ for National Health Service facilities.
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Davies, Steffan, Martin Clarke, Clive Hollin, and Conor Duggan. "Long-term outcomes after discharge from medium secure care: a cause for concern." British Journal of Psychiatry 191, no. 1 (July 2007): 70–74. http://dx.doi.org/10.1192/bjp.bp.106.029215.

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BackgroundThere are few long-term follow-up studies of patients discharged from medium secure units in the UK, even though these units were introduced over 20 years ago.AimsTo describe mortality, rates of reconviction at different time periods; violent behaviour (not leading to conviction), readmission and employment, after discharge from a medium secure unit.MethodOf 595 first admissions over a 20-year period, 550 discharged cases were followed-up. Multiple data sources were used.ResultsFifty-seven (10%) patients had died, of whom 18 (32%) died by suicide, and the risk of death was six times greater than in the general population. Almost half (49%) of those discharged were reconvicted and almost two-fifths (38%) of patients were readmitted to secure care.ConclusionsCommunity psychiatric services need to be aware that those discharged from medium secure care are a highly vulnerable group requiring careful follow-up if excess mortality high levels of psychiatric morbidity and further offending are to be prevented.
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Long, Clive G., Olga Dolley, Ruth Barron, and Clive R. Hollin. "Women transferred from prison to medium-secure psychiatric care: the therapeutic challenge." Journal of Forensic Psychiatry & Psychology 23, no. 2 (March 30, 2012): 261–73. http://dx.doi.org/10.1080/14789949.2012.674151.

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McClean, Rowan James. "Assessing the security needs of patients in medium secure psychiatric care in Northern Ireland." Psychiatrist 34, no. 10 (October 2010): 432–36. http://dx.doi.org/10.1192/pb.bp.109.027672.

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Aims and methodTo determine the security needs of patients in medium secure services in Northern Ireland and to identify those requiring long-term secure care. Patients were rated on the Security Needs Assessment Profile.ResultsFifteen patients (45%) could be managed in conditions of low security. Twelve patients (36%) require over 5 years' further treatment in secure care. Particular security needs include relational nursing skills, restricted access to alcohol and drugs, and robust physical security.Clinical implicationsThis study should be replicated across the UK to determine whether forensic services are responding to patients' needs. Pathways out of medium security need to be better developed, with regional expansion of low secure services.
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Dissertations / Theses on the topic "Medium Secure Psychiatric Care"

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Melzer, David. "Clinicians' perceptions of factors influencing admission to medium secure psychiatric care in England and Wales." Thesis, University of Cambridge, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.614235.

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Wilkes, Victoria Louise. "Predicting length of stay in a male medium secure psychiatric hospital." Thesis, University of Birmingham, 2012. http://etheses.bham.ac.uk//id/eprint/3772/.

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This thesis examines factors associated with length of hospital stay for mentally disordered offenders, detained within the medium secure psychiatric estate. Following an introduction, Chapter two presents a systematic literature review examining the current literature on factors that predict length of stay for patients detained in medium secure hospitals. Mixed results were found. There was limited convergence across clinical and forensic variables investigated, but greater consensus on what is not associated with length of stay. The limited research available and inconsistencies found indicates the need for further research. Chapter three comprises an empirical research study, investigating which variables within a population of male mentally disordered offenders predict length of stay within a regional, medium secure psychiatric hospital. Preliminary analyses revealed statistically significant relationships between length of stay and nine variables. Effect sizes were small to medium. Logistic regression revealed a statistically significant relationship between length of stay of two years or more and having a diagnosis of schizophrenic disorder. Chapter four presents a critical review of the Historical, Clinical, Risk–20 Violence Risk Assessment (HCR-20) (Version 2), a widely adopted risk assessment framework utilised within forensic psychiatry and the standardised measure used within the empirical study. The review explores the literature on the reliability and validity of the HCR-20, and considers its strengths and limitations. A discussion of the work presented concludes the thesis.
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Watson, William. "Haven of change : the history of a secure psychiatric hospital." Thesis, University of Cambridge, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.259691.

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Parkinson, John. "Black Caribbean men in high secure psychiatric care : a descriptive-interpretative analysis." Thesis, Anglia Ruskin University, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.248823.

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Over-representation of black men in psychiatric detention is a matter of concern. At Rampton Hospital in the nineteen nineties thirty percent of male mentally ill admissions were Black Caribbean, increasingly born in the United Kingdom. Effects of this have been recorded and discussed by inquiries into secure psychiatric care. Research into the perceptions of treatment of Black Caribbean users of mental health services has been recommended. Adopting a sociological perspective has been urged especially methods that seek to understand participants in their own terms. The present study adopts an inductive phenomenological approach to reflect the beliefs of this population; and their views concerning effects of race, illness, treatment and punishment. All consenting members of the population were interviewed and this data audiotaped and transcribed. Reflexive analysis utilised Ethnograph, a program for qualitative analysis. A classification of types of qualitative analytic theory in relation to the use of qualitative analysis programs helped define theoretical claims for the analysis. Analytic techniques based on Grounded Theory were used to develop an organising system from the reduced data. Validation of transcripts and coding included both participants and independent experts. Stage One involved four interviews; followed by revision of the interview schedule. Stage Two involved nine further interviews. This data was combined with participant feedback from validation. The organising system of clearly defined coded categories and their relationships was used in executing an analytic strategy of matrix and network displays, which enhances analytic transparency. This first produced displays and narratives for each participant; data reduction, which then supported cross-case analysis of important emerging themes and an analysis of causal streams. These streams were combined in a causal model from which propositions were derived. This research is innovative with this population and in the methods of analysis adopted. Relationships of race, beliefs, identity, treatment and punishment to mode of detention, adaptation and compartmentalisation have emerged and been examined.
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LeMay, Carrie C., Jill D. Stinson, Lydia L. Eisenbrandt, Courtney Smith, and Megan Quinn. "Polypharmacy Among Psychiatric Inpatients With Serious Mental Illness in Secure Forensic Care." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/7951.

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Polypharmacy is broadly defined as the administration of more than one medication in a single patient, with the most commonly used definition indicating the concurrent use of five or more medications. Polypharmacy occurs in most clinical settings, particularly inpatient settings and treatment settings for persons with chronic illness and the elderly. Reasons for receiving more than one medication include ineffective treatment with monotherapy, targeting specific but varied symptoms, treating two distinct but co-morbid illnesses, addressing unremitting symptoms, and treating extrapyramidal side effects. Research indicates that each medication added to the patient’s regimen increases the likelihood of an adverse outcome, as well as the risk of adverse drug reactions, drug-to-drug interactions, cumulative toxicity, medication errors, patient non-compliance, patient morbidity, and patient mortality. The current study seeks to investigate the rates of polypharmacy and related characteristics predictive of polypharmacy within a forensic psychiatric setting. A total of 182 patients residing in a secure forensic psychiatric hospital were selected. The sample is predominantly male (80.8%, n=147) and majority Caucasian (55.5%, n=101), African American (40.1%, n=73), and Hispanic (2.2%, n=4), with a mean age of 43.5 (SD=13.2). Participants range from persons with at least one mental health disorder (100%, n=182) to persons with at least one chronic illness (74.5%, n=132). Of those currently taking medications, 99.2% have been prescribed more than one type of medication, with 93.1% of those individuals being prescribed four or more. Polypharmacy was observed in 91% of participants. Of those diagnosed with a mood or psychotic disorder, an average of 3.6 different types of psychotropic medications were prescribed. Co-morbidity of mental illness was predictive of polypharmacy trends, F(1,181)=5.28, p<.05. Additionally, individuals with at least one chronic illness also were subjected to polypharmacy practices, with rates increasing for those with more than one chronic illness. As a measure of onset and severity of symptoms, age at first hospitalization and age of onset of aggressive behaviors were measured, and, interestingly, both measures were predictive of polypharmacy within these patients, F(1, 181)=13.45, p<.01. Results indicate that perceived severity of symptomology, aggression, and complex health problems all contribute to polypharmacy practices among prescribing physicians. The high rates of polypharmacy observed are concerning because of the potential for increased aversive health outcomes. Understanding the predictive factors, rates, and trends of polypharmacy has valuable implications for the future treatment and rehabilitation of individuals residing in a forensic psychiatric setting.
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LeMay, Carrie, Jill D. Stinson, and Megan Quinn. "THE RELATIONSHIP BETWEEN ADVERSE CHILDHOOD EXPERIENCES, MENTAL HEALTH OUTCOMES, AND POLYPHARMACY AMONG PSYCHIATRIC INPATIENTS IN SECURE FORENSIC CARE." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/asrf/2018/schedule/168.

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Persons exposed to adverse childhood experiences (ACEs) are at increased risk of developing long-term negative health consequences. ACEs have a cumulative negative impact on mental health outcomes in particular. Evidence suggests that those in forensic psychiatric settings are disproportionally exposed to ACEs, lending to potentially greater complexity in the relationship between ACEs, psychiatric comorbidity, and behavioral problems. Additionally, within this population a common intervention for mental health symptomology includes pharmacology, particularly as health issues compound. As a medication regimen becomes more complex, the risk for negative consequences – including drug interactions, side effects, and even death – increases. Limited empirical research describing associations between ACEs, mental health outcomes, and polypharmacy is available. Furthermore, no published studies to date have examined these relationships in forensic inpatient mental health populations, despite the evidence that these populations are disproportionately exposed to maltreatment and household dysfunction in childhood, frequently have higher rates of physical and mental health problems, and are usually treated with multiple forms of medications in response to health and behavioral needs. To address gaps in existing research, the relationship between ACEs, mental health outcomes, and prescription practices will be examined within a forensic inpatient sample. The current study seeks to investigate the impact of ACEs on mental health outcomes and the relationship to polypharmacy practices within a forensic psychiatric setting. A total of 182 patients residing in a secure forensic psychiatric hospital were selected. The sample is predominantly male (80.8%, n=147) and majority Caucasian (55.5%, n=101) or African American (40.1%, n=73), with a mean age of 43.5 (SD=13.2). Participants range from persons with at least one mental health disorder (100%, n=182) to persons with at least one chronic illness (74.5%, n=132). It is expected that greater experiences of childhood maltreatment and household dysfunction will result in greater negative mental health outcomes and associated behaviors. This relationship is expected to contribute to polypharmacy practices among prescribing physicians. Because high rates of polypharmacy yield a potential for increased aversive health outcomes, understanding the association between ACEs and other predictive factors and polypharmacy practice has valuable implications for the treatment and rehabilitation of persons in forensic mental health settings.
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Thomas, Stuart David Michael. "Inverse care? : comparing needs and satisfaction with services between prisoners in health care centres and patients in forensic medium secure units." Thesis, King's College London (University of London), 2005. https://kclpure.kcl.ac.uk/portal/en/theses/inverse-care---comparing-needs-and-satisfaction-with-services-between-prisoners-in-health-care-centres-and-patients-in-forensic-medium-secure-units(efc10d6c-fc93-4745-8820-51ea62c7a7f6).html.

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Turcan, Maja. "One amongst several : working as a member of a multidisciplinary team in a medium secure psychiatric setting : how do we understand, organise and communicate our experiences?" Thesis, University of Essex, 2011. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.548577.

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Books on the topic "Medium Secure Psychiatric Care"

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Great Britain. Social Services Inspectorate. An inspection of social work in the medium secure units. [London?]: Dept. of Health, 1996.

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Moss, Katrina Rachel. Medium secure psychiatric provision in the private sector. Manchester: Universityof Manchester, 1997.

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Parry-Crooke, Georgie. Good girls: Surviving the secure system : a consultation with women in high and medium secure psychiatric settings. London: University of North London, 2000.

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Institutions observed: Towards a new concept of secure provision in mental health. London: King Edward's Hospital Fund for London, 1986.

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Great Britain. Department of Health. Mental health policy implementation guide: National minimum standards for general adult services in Psychiatric Intensive Care Units (PICU) and low secure environments. London: Department of Health, 2002.

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Moss, Katrina R. Medium Secure Psychiatric Provision in the Private Sector. Ashgate Publishing, 1998.

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Moss, Katrina R. Medium Secure Psychiatric Provision in the Private Sector. Taylor & Francis Group, 2020.

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Moss, Katrina R. Medium Secure Psychiatric Provision in the Private Sector. Taylor & Francis Group, 2018.

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Moss, Katrina R. Medium Secure Psychiatric Provision in the Private Sector. Taylor & Francis Group, 2018.

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Moss, Katrina R. Medium Secure Psychiatric Provision in the Private Sector. Taylor & Francis Group, 2018.

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Book chapters on the topic "Medium Secure Psychiatric Care"

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Foster, Sheena, and Peter Bates. "Forensic Carers and Secure Inpatient Services." In Long-Term Forensic Psychiatric Care, 219–31. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-12594-3_15.

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McGuire, Frank, Julie Carlisle, and Fiona Clark. "Trauma-Informed Care in Secure Psychiatric Hospitals." In Trauma-Informed Forensic Practice, 348–62. London: Routledge, 2022. http://dx.doi.org/10.4324/9781003120766-26.

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Holley, Jessica, and Tim Weaver. "The Experience of Long-Stay in Secure Psychiatric Hospitals in the UK: The Patient Perspective." In Long-Term Forensic Psychiatric Care, 199–217. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-030-12594-3_14.

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Kotze, Beth. "The Policy Context and Governance." In Longer-Term Psychiatric Inpatient Care for Adolescents, 161–67. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-1950-3_18.

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AbstractThe Walker Unit opened in 2009 as the first of its kind in Australia to provide an intensive longer stay secure psychiatric inpatient rehabilitation programme for adolescents with severe mental illness who had not benefited from at least one but generally repeated admissions or prolonged care in other tertiary inpatient unit settings. Unusually, this happened at a time when the focus of reform in mental health at a State and National level is on community models, early intervention and community residential care rather than extended inpatient care in the specialist clinical sector. As a first of its kind, the Unit is an important innovation in inpatient mental health care and has garnered a reputation in the clinical sector for creating value in mental health care.
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Ho, Stephen, and Steve Hoare. "The Physical Environment." In Longer-Term Psychiatric Inpatient Care for Adolescents, 9–19. Singapore: Springer Nature Singapore, 2022. http://dx.doi.org/10.1007/978-981-19-1950-3_2.

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AbstractMany readers will have worked in facilities that were once state-of-the-art in design, but have become unfit for the purpose. Capacity to modify the physical environment of a psychiatric unit in response to changing clinical need or practice is essential. The Walker Unit differs from adolescent units at other locations because of its larger internal footprint and greater secure outdoor space. Substantive modifications to the Walker Unit over time have included requisitioning of space to create a learning centre, modification of some bedrooms to create a parent retreat, the establishment of a sensory room, and repurposing of the seclusion area to become a de-escalation suite. The chapter will describe the physical environment of the Walker Unit referenced to Australasian Health Facility Guidelines, and current best practice.
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Brown, Steven D., and Paula Reavey. "Institutional Forgetting/Forgetting Institutions: Space and Memory in Secure Forensic Psychiatric Care." In Institutions Inc., 7–29. London: Palgrave Macmillan UK, 2016. http://dx.doi.org/10.1057/9781137481498_2.

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Moss, Katrina R. "Private Mental Health Care." In Medium Secure Psychiatric Provision in the Private Sector, 41–60. Routledge, 2018. http://dx.doi.org/10.4324/9780429449208-4.

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Moss, Katrina R. "Mental Health Care and the Law." In Medium Secure Psychiatric Provision in the Private Sector, 61–76. Routledge, 2018. http://dx.doi.org/10.4324/9780429449208-5.

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Moss, Katrina R. "Access to Independent Psychiatric Care: A Study of Admissions to Stockton Hall Psychiatric Hospital 1989–92." In Medium Secure Psychiatric Provision in the Private Sector, 96–132. Routledge, 2018. http://dx.doi.org/10.4324/9780429449208-7.

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Moss, Katrina R. "Access to Public Sector Psychiatric Care: A Study of Admissions to Two Regional Secure Units 1989–92." In Medium Secure Psychiatric Provision in the Private Sector, 77–95. Routledge, 2018. http://dx.doi.org/10.4324/9780429449208-6.

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