scholarly journals Patients in Broadmoor Hospital from the South Western region: an audit of transfer procedures

1991 ◽  
Vol 15 (2) ◽  
pp. 81-84 ◽  
Author(s):  
Jeanette Smith ◽  
Martin Donovan ◽  
Harvey Gordon
Keyword(s):  
Psychiatric Hospitals ◽  
Home Office ◽  
Mentally Disordered ◽  
The Public ◽  
Maximum Security ◽  
Hospital Patients ◽  
Male Patients ◽  
Transfer Procedures ◽  
Special Hospital ◽  
Special Hospitals

Broadmoor Hospital is one of the three special hospitals covering England and Wales. It provides approximately 500 beds for mentally disordered patients who on account of their dangerous, violent or criminal propensities constitute a grave and immediate danger to the public, requiring treatment in conditions of special security (Section 4, National Health Service Act, 1977). It is generally recognised, however, that there are patients in special hospitals no longer requiring treatment in conditions of maximum security. These patients could probably be more appropriately cared for elsewhere if the facilities existed in general psychiatric hospitals or the community. However, special hospital consultants frequently encounter significant obstacles when attempting to transfer patients to local hospitals. Dell (1980) highlighted this problem, suggesting that 16% of special hospital patients were waiting to leave, following the agreement of the DHSS and the Home Office to their transfer. This delay appeared to be due to hospitals not wanting to accept patients who might prove to be difficult or dangerous. At the time of this current study (March 1990) these difficulties in transferring patients were particularly relevant as two of the special hospitals, Broadmoor and Ashworth (Park Lane and Moss Side) were full for male patients and therefore closed to male admissions, despite a continuing demand for beds.

Survey of incapacity associated with mental handicap at Rampton and Moss Side Special Hospitals: a comparison with the 1970 National Survey

1975 ◽  
Vol 5 (3) ◽  
pp. 300-306
Author(s):  
Elizabeth Parker
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
National Survey ◽  
Mentally Handicapped ◽  
Mental Handicap ◽  
Hospital Patients ◽  
Special Hospital ◽  
Special Hospitals

SynopsisThe results of a survey carried out at Rampton and Moss Side Special Hospitals into physical and behavioural incapacity associated with mental handicap are described and compared with the findings of the 1970 National Survey. The Special Hospital patients were found to be less mentally handicapped than similar patients in subnormality hospitals in the National Health Service. The prevalence of physical incapacity associated with mental handicap was also lower in the Special Hospitals but the Special Hospital patients were assessed as more behaviourally disordered. In both surveys the incapacities present were concentrated in the severely mentally handicapped patients. In the Special Hospitals survey the women, when compared with the men, were found to be more behaviourally disordered and to suffer from a greater degree of multiple severe incapacity. All the differences found between the two surveys are consistent with the statutory criteria for admission to a Special Hospital.

Transfer Delays in a Special Hospital Population

1995 ◽  
Vol 35 (3) ◽  
pp. 237-244 ◽  
Author(s):  
M Dolan ◽  
G C Shetty
Keyword(s):  
Mental Health ◽  
Transfer Trial ◽  
Home Office ◽  
Maximum Security ◽  
Psychiatric Units ◽  
Hospital Population ◽  
Special Hospital ◽  
Current Standards

Forty-four cases referred for transfer/trial leave from a Special Hospital in the latter part of 1989 were followed up and their progress on 1 January 1992 was examined. Thirty-four were accepted but only 19 moved out to psychiatric units offering treatment under conditions of lesser security. Three of the original 44 patients were discharged by Mental Health Tribunals and one has died. Twenty-three have never left maximum security. Factors largely beyond the control of Special Hospital consultants accounted for most of the delay in the transfer procedure. Fifty-eight per cent of the total time taken for transfer was attributable to delays by regional/district services in the assessment, response and admission of cases. Noticeable delays in receiving Home Office recommendations were also encountered in restricted cases. Suggestions for improving current standards are made.

Maximum and Medium Security: The Interface

1995 ◽  
Vol 35 (3) ◽  
pp. 249-254 ◽  
Author(s):  
Jeanette Smith ◽  
Arden Tomison ◽  
Adrian James ◽  
Martin Donovan
Keyword(s):  
Quality Of Care ◽  
Working Relationships ◽  
Maximum Security ◽  
Proactive Approach ◽  
Medium Security ◽  
Transfer Procedures ◽  
Special Hospitals

This paper examines transfer delays for patients moving between medium and maximum security hospitals. Delays appear to be getting shorter and Special Hospitals in particular respond very quickly to requests for admission. Recommendations are made for further improvements in transfer procedures. The authors argue that with closer working relationships between clinicians in Special Hospitals and Regional Secure Units, and the new proactive approach to transfers, the system will become increasingly flexible and responsive. Consequent improvements in the quality of care in Special Hospitals are anticipated, making the arguments for closing them, in turn, less convincing.

Transfer of Special Hospital Patients to the NHS

1980 ◽  
Vol 136 (3) ◽  
pp. 222-234 ◽  
Author(s):  
Susanne Dell
Keyword(s):  
National Health Service ◽  
Department Of Health ◽  
Hospital Patients ◽  
Severely Handicapped ◽  
Transferred Patients ◽  
Open Wards ◽  
Special Hospital ◽  
Special Hospitals ◽  
Made In

SummaryIn 1976, 163 patients were approved by the Department of Health and Social Security for transfer from the Special Hospitals to the open wards of the National Health Service. By autumn 1978, a quarter were still waiting for admission. Patients meeting most difficulty were the severely handicapped non-offenders, who were usually refused unseen on the ground that local subnormality hospitals were full. The role of the DHSS and of the Regional and Area Authorities was in general restricted to bewailing problems they could not help to solve.Some two years after their transfer, enquiries were made in the NHS about the 105 transferred patients. Removal back to the Special Hospital had been requested for seven, and another three had been removed by the police and prosecuted.

scholarly journals Preventive detention exhumed – and enhanced

1999 ◽  
Vol 23 (12) ◽  
pp. 703-704 ◽  
Author(s):  
Derek Chiswick
Keyword(s):  
Sexual Offenders ◽  
The Other ◽  
Psychiatric Condition ◽  
House Of Commons ◽  
Home Office ◽  
The Public ◽  
Department Of Health ◽  
Special Hospitals ◽  
Severe Personality Disorder ◽  
Consultation Paper

In 1997 there were 57 000 notifiable crimes of serious or sexual violence recorded by police in England and Wales (Home Office, 1998) – more than 1000 per week or approximately one every 10 minutes. On 15 February 1999 the Home Secretary, Jack Straw, announced new measures “better to protect the public from dangerous people in our society” (House of Commons, 1999). He said the measures were to target “those who are capable of committing acts of a serious sexual or violent nature”. Of the 57 000 potential targets, Mr Straw believes 1800 men are already detained in prisons and special hospitals; he intends to identify a further 500 or so men currently at liberty and lock them away indefinitely, in advance of their offending. His intention in respect of the other 54 700 violent or sexual offenders, responsible for 99% of serious violence, is not stated. Mr Straw believes that the 500 men in the community (and the 1800 in custody) share a common psychiatric condition and that this is what makes them dangerous. His policy for identifying the men, and what he intends to do with them and similar people, is contained in the recently published consultation paper on dangerous people with severe personality disorder (Home Office & Department of Health, 1999).

What Happens to Patients Released from the Special Hospitals?

1981 ◽  
Vol 138 (4) ◽  
pp. 340-345 ◽  
Author(s):  
Paul Bowden
Keyword(s):  
Accurate Prediction ◽  
Criminal Histories ◽  
Hospital Patients ◽  
Special Hospital ◽  
Special Hospitals

SummaryNHS consultants who are asked to accept Special Hospital patients can judge the prognosis, since the extent of both psychiatric and criminal histories provides the most accurate prediction of future behaviour. Patients discharged to the community have different outcomes from those transferred to NHS hospitals, but overall about one in five of those released are returned to a Special Hospital; up to one in two will subsequently be convicted, but the offences are mainly trivial and directed at property. Perhaps one in ten will be involved in serious or homicidal acts of violence.

Route of discharge for special (high-security) hospital patients with personality disorder

1999 ◽  
Vol 175 (3) ◽  
pp. 224-227 ◽  
Author(s):  
Sophie Davison ◽  
Elizabeth Jamieson ◽  
Pamela J. Taylor
Keyword(s):  
Personality Disorder ◽  
Hospital Discharge ◽  
Psychiatric Hospitals ◽  
Considerable Proportion ◽  
High Security ◽  
Hospital Patients ◽  
Special Hospital

BackgroundA considerable proportion of patients with personality disorder are discharged directly to the community from special (high-security) hospitals.AimsTo examine whether patients with personality disorder discharged directly to the community are more likely to be re-convicted than those transferred to psychiatric hospitals of lesser security.MethodRe-conviction data for a f ive-to nine-year follow-up were collected for a four-year (1988–1991) special hospital discharge cohort of patients with personality disorder.ResultsIndividuals discharged directly to the community were not significantly more likely to be re-convicted than those transferred to less secure psychiatric hospitals. However, patients discharged to the community without formal conditions of supervision were more likely to be re-convicted than those discharged to the community with conditions or those transferred to other psychiatric hospitals.ConclusionsFormal supervision after discharge may be more important than actual destination in influencing the likelihood of re-conviction.

scholarly journals Mildly mentally handicapped offenders: an alternative to custody

1993 ◽  
Vol 17 (4) ◽  
pp. 199-201 ◽  
Author(s):  
Christine Johnson ◽  
Jeanette Smith ◽  
Geoff Stainer ◽  
Martin Donovan
Keyword(s):  
Mentally Ill ◽  
Justice System ◽  
Psychiatric Treatment ◽  
Penal System ◽  
Mentally Disordered Offenders ◽  
Mentally Handicapped ◽  
Home Office ◽  
Mentally Disordered ◽  
Medium Security ◽  
Special Hospitals

Concern is increasingly being expressed about the lack of provision for mentally disordered offenders, who by default end up within the penal system. Gunn et al (1991) in a study of sentenced prisoners identified a significant number who were mentally disordered to be in need of psychiatric treatment. Among these, 0.4% were considered to be mentally handicapped. Recent reports have emphasised the importance of diverting these individuals from the criminal justice system (Woolf & Tumin, 1991; Home Office, 1990; British Medical Association, 1990). However, the majority of such offenders do not fulfil the criteria for admission to hospital under the Mental Health Act 1983. Most are not overtly mentally ill and do not require treatment in conditions of medium security such as exist in regional secure units. However, it is not clear what provision there should be for such individuals. Smith (1988) described an open forensic unit for mildly mentally handicapped offenders (the Leander Unit). She concluded that there was a need for a specialised service to cater for these patients, who were neither appropriately nor adequately provided for by the general psychiatric services, the mentally handicapped services, regional secure units or special hospitals. Unfortunately, in practice there are very few facilities for this group of patients.

Riforma psichiatrica e psicoterapia sistemica. Continuitŕ, sviluppi, problemi aperti

PSICOBIETTIVO ◽  
2009 ◽  
pp. 47-64
Author(s):  
Luigi Onnis
Keyword(s):  
Public Services ◽  
Health Workers ◽  
Psychiatric Hospitals ◽  
Mental Health Workers ◽  
Basic Principles ◽  
Psychiatric Reform ◽  
The Public ◽  
Italian Law ◽  
New Interpretation ◽  
Systemic Psychotherapy

- The Author, in this paper, first of all reconstructs the essential historical phases of the theoretical and practical renewal process which preceded and accompanied the 180 law approval, that established the psychiatric hospitals closing. He then describes the Italian psychiatric reform characteristics, underlining how it produces the emerging of needs of new interpretation and intervention methods about psychic sufference: in this perspective psychotherapy has a crucial role and the italian law in psychotherapeutic training regulation is a further support. Particularly systemic psychotherapy proposes common basic principles with regard to the psychiatric reform and can represent an useful instrument for developping innovative concepts and practices. Finally the Authors put critically in evidence the problems still unresolved, not only concerning the need of a full application of the reform law, with the creation of territorial services and structures where they are still lacking or insufficient, but, over all, promoting the diffusion into the public services of a psychotherapeutic culture and practice.Key Words: Italian Psychiatric Reform, Law 180, Systemic Psychotherapy, Psychotherapeutic Culture, Public Services, Mental Health Workers Formation.Parole chiave: riforma psichiatrica italiana, legge 180, psicoterapia sistemica, cultura psicoterapeutica, servizi pubblici, formazione degli operatori.

Sadistic Fantasy, Sadistic Behaviour and Offending

1983 ◽  
Vol 143 (1) ◽  
pp. 20-29 ◽  
Author(s):  
M. J. MacCulloch ◽  
P. R. Snowden ◽  
P. J. W. Wood ◽  
H. E. Mills
Keyword(s):  
Personality Traits ◽  
Descriptive Study ◽  
Hospital Patients ◽  
Special Hospital ◽  
Psychopathic Disorder

SummaryThis paper explores the genesis of sadistic behaviour in men and its relationship to crime. Sixteen male special hospital patients, each with a diagnosis of psychopathic disorder, formed the basis of this descriptive study. In only three cases were the crimes explicable in terms of external circumstances and personality traits. The offences of the remaining 13 cases became comprehensible only when the offender's internal circumstances were explored: investigation revealed repetitive sadistic masturbatory fantasies which had spilled over into overt behaviour because the patients had felt impelled to seek and create increasingly dangerousin vivo‘try-outs' of their fantasies. The paper discusses the crucial link between sadistic fantasy and behaviour.

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