Welcome to this special edition of The Journal of Forensic Psychiatry & Psychology. We are delighted that researchers and practitioners from the fields of forensic and clinical psychology, psychiatry, and criminology have agreed to share their research and observations with the readers of this special issue. The following pages contain eight outstanding articles that shed light on contemporary research and understanding relating to current practice with women in secure care. We are honoured to present these papers from authorities in this field as they provide fresh insights from which such an important area of work can continue to develop.
The first paper, by Walker and colleagues, describes a study conducted in three female prisons in England, which piloted a brief psychological intervention aimed at reducing thoughts and actions linked to self-harm and suicide risk in women in prison with a history of self-harm. Therapeutic obstacles associated with implementing the study are discussed. The authors conclude that the pilot is innovative and promising for vulnerable imprisoned women but that further research is required into brief, specialised psychological programmes in correctional environments. The second paper, by Bainbridge, evaluates the development of the therapeutic environment of a Psychologically Informed Planned Environments (PIPE) unit for women in custody in HMP Low Newton near Durham in the north-east of England. Drawing on accounts from focus groups with imprisoned women, she suggests why, for many women, the environment plays a significant part in their recovery and progression in prison. Next, following the prison theme, Allen and colleagues use a case study to examine the integrated service model utilised in HMP/YOI Holloway, a large women’s prison in London, which has recently been closed. This novel paper illustrates the development and application of case formulations and recommendations derived from several perspectives. The authors describe the benefits of such an integrated approach and highlight its potential for nurturing change and recovery when working in the challenging environment of women’s prisons.
The fourth paper in this special issue focuses on secure care pathways for women and describes an evaluation by Edge and colleagues of Women’s Enhanced Medium Secure Services (WEMSS) as a model of care compared to standard medium secure forensic psychiatric services. The authors describe a study comparing the clinical and risk outcomes of women in both mainstream medium secure and WEMSS services and examined their pathways of care. The findings are clear: WEMSS services showed no additional clinical benefit and the authors suggest that the women in their care could be cared for equally well within standard medium secure services. Bartlett and Somers, in the fifth paper of this special issue, develop the theme of service delivery and explore professional perspectives in providing care to women in secure services. They present the findings from semi-structured interviews that highlight the gendered nature of the therapeutic challenge and the complexity of the women in the professional’s care. From the accounts of clinicians and managers, it is suggested by the authors that service delivery is substantially informed by the ideas of relational security, attachment theory, and the recovery model. The sixth paper, by Logan and Taylor takes this theme further still, with a review of the special challenges of working with women in secure care compared to men and the nature of the skills required in practitioners and managers.
The seventh paper, by Ramsden and colleagues, reflects on the learning gained from the first commissioned Intensive Intervention Risk Management (IIRM) service that supports women ‘Through the Gate’ and back into the community in West Yorkshire. Their findings indicate how they overcame some of the challenges in the early days of set up and suggest that coherent, holistic management is most effective when services are integrated, responsive, offer a partnership approach, and are responsive to the social context for women offenders. Subsequently, Powell and colleagues in the final paper present a systematic review of prison policy and government documents in England and Wales with regards to mother and child separation in prison and analysed the extent to which these documents drew on attachment theory. The authors conclude that developing and researching specific attachment-informed interventions might be one way forward as would further attachment-based research in this area as currently there is a limited body of evidence and research base. This special issue concludes with an afterword from Bartlett about the closure of London’s oldest women’s prison, HMP/YOI Holloway, in 2016, and what this closure says about how much of a priority women are and should be in forensic mental health and correctional services.
We are pleased to commend this special issue of papers on women in secure care to you. We trust that it will make an impact in three important ways. First, women in secure care are small in their numbers but disproportionately significant in impact – on the services that detain them, on the practitioners who work with them, and on the wider families and communities of the women themselves. We owe it to our colleagues, our services, and our service users, to understand what it is we do together and why and to ensure that, though a niche area, the needs of women in secure care are understood as well as they can be and that clinical practice is informed accordingly. Second, the needs of women in secure care are not the same as the needs of men in the same kinds of services – women are not other varieties of men. Therefore, what works for men should not be assumed to have relevance to women in secure care unless it is clearly demonstrated to be the case. Instead, working with women is a specialised area of practice, and skills and interventions should be developed with the needs and aspirations of women in mind. We have prepared this special issue with this recommendation very clearly in mind and we trust that this expectation will be clear from all the papers to follow. Finally, unless we understand the needs of women in secure care and respond to them with appropriate interventions compassionately delivered, we put at risk the safety of those who depend on these women in and outside of care, most especially their children. Therefore, it is with much hope and expectation that we recommend this special issue to you.
Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
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Caroline Logan
Greater Manchester Mental Health NHS Foundation Trust
Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
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Jenny Shaw
Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, Manchester, UK
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