Security needs of South West Thames Special Hospital patients: 1992 and 1993. No way out?

Abstract

Two audit surveys were carried out, one in 1992 and the other in 1993, to examine the security needs of South West Thames Region (SWTR) Special Hospital patients. Special Hospital responsible medical officers (RMOs) were surveyed regarding need for security, appropriate placement and reasons for transfer delay for South West Thames patients. Results from both audits were strikingly similar and were also consistent with previous studies based on RMO surveys. They suggest that there are large numbers of Special Hospital patients who do not require maximum security. Assessed need for medium- and long-stay (greater than 2 years) medium secure care in the region highlighted current deficiencies in medium secure provision within South West Thames, which falls short of both Department of Health and Home Office specifications. The most frequently cited reason for postponement of transfer was Home Office delays. The consistent findings of this and previous studies emphasize the ongoing problem of overcontainment in Special Hospitals, which is contrary to government policy and accepted psychiatric practice. The serious implications of this for the rehabilitation and civil liberties of Special Hospital patients cannot be ignored. It is suggested that assessing the needs of Special Hospital patients by using RMO surveys may be the most cost-effective method for regional health authorities to employ, given the expense and time-scales involved in more complex, research-based assessments of need.

Key Words:

• needs assessment
• Special Hospital
• maximum security