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Civil and forensic patients in secure psychiatric settings: A comparison

  • Nuwan Galappathie (a1), Sobia Tamim Khan (a1) and Amina Hussain (a1)
Abstract
Aims and method

To evaluate differences between male patients in secure psychiatric settings in the UK based on whether they are detained under civil or forensic sections of the Mental Health Act 1983. A cohort of patients discharged from a secure psychiatric hospital were evaluated for length of stay and frequency of risk-related incidents.

Results

Overall, 84 patients were included in the study: 52 in the forensic group and 32 in the civil group. Civil patients had more frequent incidents of aggression, sex offending, fire-setting and vulnerability, whereas forensic patients had more frequent episodes of self-harm.

Clinical implications

Secure hospitals should ensure treatment programmes are tailored to each patient's needs. Civil patients require greater emphasis on treatment of their mental illness, whereas forensic patients have additional offence-related treatment needs. Regular liaison between forensic and general adult services is essential to help ensure patients can return to appropriate settings at the earliest opportunity in their recovery.

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Copyright
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence to Nuwan Galappathie (ngalappathie@standrew.co.uk)
Footnotes
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Declaration of interest

None.

Footnotes
References
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1 Goldberg, D. The state of British psychiatry. Prog Neurol Psychiatry 2006; 10: 1216.
2 Turner, T, Salter, M. Forensic psychiatry and general psychiatry: re-examining the relationship. Psychiatric Bull 2008; 32: 26.
3 Information Centre. Inpatients Formally Detained in Hospitals under the Mental Health Act 1983, and Patients Subject to Supervised Community Treatment: Annual Report, England, 2013/14. Health and Social Care Information Centre, UK Government Statistical Service, 2014.
4 Coid, J, Kahtan, N, Gault, S, Cook, A, Jarman, B. Medium secure forensic psychiatry services: comparison of seven English health regions. Br J Psychiatry 2001; 178: 5561.
5 Reed, S. People with learning disabilities in a low secure in-patient unit: comparison of offenders and non-offenders. Br J Psychiatry 2004; 185: 499504.
6 Dickens, G, Sugarman, P, Walker, L. HoNOS-secure: a reliable outcome measure for users of secure and forensic mental health services. J Forens Psychiatry Psychol 2007; 18: 507–14.
7 Schizophrenia Commission. The Abandoned Illness: A Report by the Schizophrenia Commission. Rethink Mental Illness, 2012.
8 Tuddenham, L, Hunter, R. Prosecution of violent patients. Psychiatric Bull 2005; 29: 275.
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BJPsych Bulletin
  • ISSN: 2056-4694
  • EISSN: 2056-4708
  • URL: /core/journals/bjpsych-bulletin
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Civil and forensic patients in secure psychiatric settings: A comparison

  • Nuwan Galappathie (a1), Sobia Tamim Khan (a1) and Amina Hussain (a1)
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