The transition from high secure, to medium secure, services for people with personality disorder: Patients and clinicians experiences

Abstract

This study explored patients' and receiving clinicians' experience of the transition process from high secure, to medium secure, services. Sixteen patients and 20 receiving clinicians participated in semi-structured interviews, which were subjected to qualitative thematic analyses. Six themes emerged from patient interviews: (1) lack of/inappropriate pre-transfer information, (2) culture shock, (3) threat of return to the high secure service, (4) ‘feels like starting treatment again’, (5) boredom factor and (6) gains in medium security. Five complementary themes emerged from clinician interviews: (1) patients' fears and frustrations, (2) challenging and inappropriate behaviours, (3) motivational and engagement problems, (4) limited communication between services and (5) requirement for greater patient preparation. On the basis of these findings, it is concluded that the transition process should be improved by enhancing preparation for patients and by encouraging greater liaison/integration between the two facets of secure care.

Keywords:

• medium secure units
• high secure hospitals
• personality disorder
• transitions
• patient experiences
• clinician experiences