A Regional Interim Secure Unit at the Bethlem Royal Hospital—The First Fourteen Months

A fifteen-bed interim secure unit at the Bethlem Royal Hospital has been functioning since October 1980. During the first 14 months 23 patients were admitted; 16 were males and 7 were females. All had committed dangerous acts but very few had a long history of criminal behaviour. The most common diagnosis was schizophrenia. Personality disorder was not a predominant feature in the majority of cases. Generally the aim is not to provide a full rehabilitation programme but rather to emphasize assessment and treatment of ‘problem behaviour’ until such time as an individual could properly be managed in an ordinary psychiatric unit in one of the local specialized ‘area clinics’. The Bethlem Unit may therefore differ somewhat in its function to that reported by other secure units. There was seldom a simple and direct relationship found between the mental illness and the ‘problem behaviour’. Treatment includes, occupational therapy, social skills training, individual treatment programmes and psychotropic medication. The average stay has been less than 7 months.