Measuring relational security in forensic mental health services

Aims and methodRelational security is an important component of care and risk assessment in mental health services, but the utility of available measures remains under-researched. This study analysed the psychometric properties of two relational security tools, the See Think Act (STA) scale and the Relational Security Explorer (RSE).ResultsThe STA scale had good internal consistency and could highlight differences between occupational groups, whereas the RSE did not perform well as a psychometric measure.Clinical implicationsThe measures provide unique and complimentary perspectives on the quality of relational security within secure services, but have some limitations. Use of the RSE should be restricted to its intended purpose; to guide team discussions about relational security, and services should refrain from collecting and aggregating this data. Until further research validates their use, relational security measurement should be multidimensional and form part of a wider process of service quality assessment.

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Forensic mental health services for children and adolescents: Rationale and development

BJPsych Advances ◽

10.1192/apt.bp.114.013979 ◽

2017 ◽

Vol 23 (1) ◽

pp. 36-43 ◽

Cited By ~ 1

Author(s):

Nick Hindley ◽

César Lengua ◽

Oliver White

Keyword(s):

Mental Health ◽

High Risk ◽

Mental Health Services ◽

Young People ◽

Health Services ◽

Forensic Mental Health ◽

Children And Young People ◽

Service Accessibility ◽

Specialist Services ◽

Form Part

SummaryThis article outlines the rationale for dedicated specialist services for high-risk young people about whom there may be family or professional concerns in relation to mental disorder. It provides an overview of the development and remit of such services and emphasises the need for them to form part of overall service provision for children and young people.Learning Objectives• Greater understanding of the scope and emphasis of forensic child and adolescent mental health services (FCAMHS)• Greater understanding of the different statutory jurisdictions that frequently apply in the cases of high-risk young people• Greater understanding of the importance of initial service accessibility for concerned professionals and for authoritative understanding by FCAMHS of the wide variety of circumstances in which high-risk young people may find themselves

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The prevalence of constant supportive observations in high, medium and low secure services

BJPsych Bulletin ◽

10.1192/bjb.2017.14 ◽

2018 ◽

Vol 42 (2) ◽

pp. 54-58 ◽

Cited By ~ 2

Author(s):

Katie Lambert ◽

Simon Chu ◽

Chris Duffy ◽

Victoria Hartley ◽

Alison Baker ◽

...

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Clinical Implications ◽

Forensic Mental Health ◽

Adverse Incident ◽

Clinical Records ◽

Number Of Individuals ◽

Incident Rates ◽

Health Trust

Aims and methodWe explored the prevalence and use of constant supportive observations (CSO) in high, medium and low secure in-patient services in a single National Health Service (NHS) mental health trust. From clinical records, we extracted data on the length of time of CSO, the reason for the initiation of CSO and associated adverse incidents for all individuals who were placed on CSO between July 2013 and June 2014.ResultsA small number of individuals accounted for a disproportionately large proportion of CSO hours in each setting. Adverse incident rates were higher on CSO than when not on CSO. There was considerable variation between different settings in terms of CSO use and the reasons for commencing CSO.Clinical implicationsThe study describes the prevalence and nature of CSO in secure forensic mental health services and the associated organisational costs. The marked variation in CSO use between settings suggests that mental health services continue to face challenges in balancing risk management with minimising restrictive interventions.Declaration of interestA.B. and J.L.I. are both directly employed by the NHS trust in which the study was conducted.

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Supporting children of forensic in-patients: whose role is it?

Psychiatric Bulletin ◽

10.1192/pb.bp.107.019158 ◽

2009 ◽

Vol 33 (2) ◽

pp. 55-57 ◽

Cited By ~ 3

Author(s):

Oriana Chao ◽

Gori Kuti

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Clinical Implications ◽

Forensic Mental Health

Aims and MethodTo investigate whether children are in contact with their forensic in-patient parents and whether they are offered support regarding their parent's mental health and offending issues. A questionnaire was completed on in-patients in two medium secure units.ResultsOnly 69 of the in-patients surveyed had children aged 18 or under, but only 25 had contact with their children. Support was offered in 14 cases and accepted in 10. Many patients had lost contact with their children.Clinical ImplicationsChildren of forensic in-patients appear to be a neglected group, with limited attempts made to support them. In the absence of specific difficulties of their own, the onus may be on forensic mental health services to initiate contact.

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Providing mental health services to adult offenders in Victoria, Australia: Overcoming barriers

European Psychiatry ◽

10.1016/j.eurpsy.2009.07.003 ◽

2009 ◽

Vol 24 (6) ◽

pp. 395-400 ◽

Cited By ~ 3

Author(s):

P. Mullen ◽

J. Ogloff

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Sex Offenders ◽

Antisocial Behaviour ◽

Models Of Care ◽

Forensic Mental Health ◽

General Mental Health ◽

Problem Behaviours

AbstractPurposeTo illustrate the development of the interface between general and forensic mental health services in Victoria, Australia.MethodDeveloping effective cooperation between the general and forensic mental health services requires overcoming a number of barriers. The attitude of general services that antisocial behaviour was none of their business was tackled through ongoing workshops and education days over several years. The resistance to providing care to those disabled by severe personality disorders or substance abuse was reduced by presenting and promoting models of care developed in forensic community and inpatient services which prioritised these areas. The reluctance of general services to accept offenders was reduced by involving general services in court liaison clinics and in prisoner release plans. Cooperation was enhanced by the provision of risk assessments, the sharing of responsibility for troublesome patients, and a problem behaviours clinic to support general services in coping with stalkers, sex offenders and threateners.ConclusionsActive engagement with general services was promoted at the level of providing education, specialised assessments and a referral source for difficult patients. This generated a positive interface between forensic and general mental health services, which improved the quality of care delivered to mentally abnormal offenders.

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