			Home About us Contact

Security Hospital (security + hospital)

Distribution by Scientific Domains

Psychology	100%

Kinds of Security Hospital

high security hospital

Selected Abstracts

Theory of mind functioning in mentally disordered offenders detained in high security psychiatric care: its relationship to clinical outcome, need and risk

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 5 2007
David Murphy
Background,Theory of mind (ToM) refers to the cognitive mechanisms that allow us to infer our own mental states and those of others. Whilst ToM deficits are frequently observed among individuals with schizophrenia, little is known about their relationship to functional outcome. Aims,Among patients with schizophrenia in a high security hospital, to test whether ToM performance, in relation to other cognitive and clinical variables, is related to measures of subsequent clinical outcome. Methods,ToM was assessed using the modified advanced test (MAT) and the revised eyes task (RET). Outcome, including ongoing need and risk, was assessed using the HoNOS secure, CANFOR and HCR-20 respectively three years post ToM assessment. Results,Performance on the RET was the only variable to be significantly correlated with the symptom ratings of the HoNOS secure and the HCR-20 total scores. Performance on the RET also accounted for approximately half of the variance in the CANFOR ratings and a third in the risk management item ratings of the HCR-20. Age, number of years diagnosed with schizophrenia and other aspects of cognition were also significantly correlated with the HoNOS security scale. Conclusions,The results suggest that social perceptual ToM may be a useful prognostic indicator, but also that ToM impairments may represent an unmet need. Replication of the work with larger and more diverse samples of people with schizophrenia is necessary, as well as trials of therapeutic effort directed at improvement of ToM impairments. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Children, admitted to high security (special) hospital

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2003
Adolescent Forensic Psychiatry, Claire Dimond Consultant in Child
Introduction The Special Hospitals in England provide psychiatric treatment in high security. The aim of this study was to examine the demographics and background characteristics of children admitted to high security hospitals in England, using the special hospital case register. Method Forty-six children (the subject group) were admitted to a high security hospital under the MHA (1983) classification of disorder of mental illness and/or psychopathic disorder between 1983 and 1999, 33 (72%) of whom were male. A comparison group of adults was matched on sex, legal classification of detention and MHA 1983 classification of disorder. Results The children were admitted for a similar range of offences to those of the comparison group. However, the children had received convictions for criminal damage and violence at a significantly earlier age, they were more likely to have experienced a change in carer during their childhood, been placed in a children's home and were less likely to be living with a family member on their 16th birthday. Children admitted to special hospital experience a lot of disruption in their childhood and are extremely high users of multi-agency services as they grow up. Discussion Issues are raised regarding how to provide a developmentally sensitive service for children who require high security care. Copyright © 2003 Whurr Publishers Ltd. [source]

Changes in patterns of excessive alcohol consumption in 25 years of high security hospital admissions from England and Wales

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2003
Celia McMahon
Background It is now generally acknowledged that alcohol abuse increases the risk of violence among people with major mental disorder. Studies in the 1980s and earlier, however, tended to report an inverse relationship between their alcohol use and violence. Aims A study was undertaken to test a hypothesis that among people with major mental disorder considered to pose a serious risk to others the likelihood of excessive alcohol consumption in a period leading up to a violent or dangerous act has increased over time. Methods Analysis was made of annual high security hospital admission cohort case register data of 1 January 1975 to 31 December 1999; alcohol use data were taken from interview and records, and problem drinking defined as consumption of alcohol in excess of 21 units per week during the 12 months prior to the index offence or act. Results There was a linear increase in the proportion of patients in five-year admission cohorts who had engaged in excessive alcohol consumption during the year prior to their index offence or act. The increase was steeper among women than men, but cut across all diagnosis and offending groups. It was strongly associated with increasing tendency to abuse illicit drugs. Conclusions The greater proportion of patients affected by excessive alcohol consumption occurred in spite of a reduction over the same period in admission of people in the diagnostic groups most likely to be implicated in substance misuse (personality disorder). This increased trend may simply reflect similar trends in the general population, but may also be associated with a lack of services or current consensus on appropriate treatment for patients whose mental illness is complicated by excessive alcohol use. Regardless, the trend suggests a growing need for ,dual diagnosis' services within and outside high security hospital. Copyright © 2003 Whurr Publishers Ltd. [source]

The voice of detainees in a high security setting on services for people with personality disorder

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2002
Sue Ryan
Background British government Home and Health Departments have been consulting widely about service development for people with ,dangerous severe personality disorder' (DSPD). There has, however, been no consultation with service users, nor is there any user view literature in this area. Methods All people detained in one high security hospital under the legal classification of psychopathic disorder were eligible but those on the admission or intensive care wards were not approached. Views of service were elicited using a purpose designed semi-structured interview. The principal researcher was independent of all clinical teams. Confidentiality about patients' views was assured. Aims To establish views on services from one subgroup of people nominated by the government department as having ,DSPD'. Results Sixty-one of 89 agreed to interview. With security a given, about half expressed a preference for a high security hospital setting, 20% prison and 25% elsewhere, generally medium secure hospitals. Participants most valued caring, understanding and ,experience' among staff. An ideal service was considered to be one within small, domestic living units, providing group and individual therapies. Some found living with people with mental illness difficult, but some specified not wanting segregated units. Views were affected by gender and comorbidity. Conclusions As the sample were all in hospital, the emphasis on treatment may reflect a placement bias. All but five participants, however, had had experience of both health and criminal justice services, so were well placed to talk with authority about preferences. Copyright © 2002 Whurr Publishers Ltd. [source]

Name change among offender patients: an English high security hospital sample

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2002
Birgit Völlm Clinical Research Fellow
Background There is scant literature on change of name among psychiatric patients but a more substantial amount on the use of aliases among offenders. No one to our knowledge has explored name changes among offender patients. Aim This study was undertaken to establish the prevalence of name change among high security hospital patients and to compare those who changed name with those who did not. Hypothesis It was hypothesized that name change would be associated with male gender, repeated offending and a diagnosis of personality disorder. Method The clinical records of all patients resident in one high security hospital on 31 January 2000 were searched. As all such patients are compulsorily detained, all name changes must be recorded. Any change prior to that date was also noted, together with basic demographic and diagnostic information; supplementary data were obtained from the special hospitals' case register. Results Seventy-one patients (17%) of the resident population changed names (exclusive of a woman changing her surname on marriage). Name changing was associated with disrupted upbringing. Patients with personality disorder were more likely to change names than those with psychosis, regardless of sex, age or ethnic group. Those with psychosis were more likely to select unusual or symbolic names. Conclusions On the evidence of previous literature, people from this serious offender patient population were more likely to change names than other psychiatric patients but less likely than non-mentally-disordered offenders. Changes by people with psychosis seemed related to their illness, whereas changes by those with personality disorder might reflect childhood disruptions in rearing patterns. Copyright © 2002 Whurr Publishers Ltd. [source]

Psychosis and offending in British Columbia: characteristics of a secure hospital population

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 3 2001
Nicola Hodelet Specialist Registrar
Introduction There is an increased likelihood of violence in the mentally ill although the risk is small. Aims The study aimed to ascertain the features in a secure hospital population that linked offending and mental illness. Method A survey of patients in the high security hospital serving the province of British Columbia in Canada was carried out. Information on 175 mentally disordered offenders was extracted and included demographic data and specific characteristics of their offences, diagnoses and psychotic symptoms. Results The most prevalent offences were crimes of violence, but 39% of patients were not primarily violent offenders. Almost two-thirds (61%) had two or more diagnoses. A large majority of the patients were psychotic, schizophrenia being the most common diagnosis. There was a highly significant association between psychosis and violence, but the strength of the association was not increased by the presence of imperative hallucinations or delusions. The sample comprised various ethnic groups, one of which, Native Americans, was over-represented. However, no association was found between violent offending and ethnicity, or age or years of illness. Discussion The study replicates previous findings of the link between violent offending and psychosis, but not a specific link between violent offending and psychotic drive. A surprising finding was a lack of association between violent offences and substance misuse. Copyright © 2001 Whurr Publishers Ltd. [source]

Casenote assessment of psychopathy in a high security hospital

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 1 2001
Dr David Reiss
Introduction There is now a large amount of data demonstrating the internal reliability and construct validity of the Hare Psychopathy Checklist (PCL/PCL-R) when used in the assessment of psychopathy in male forensic populations. It has well-established psychometric properties when scored following a review of collateral information and a subsequent interview. However, its internal reliability and factor structure, when casenote information alone has been used, have not been examined outside North America. Method A sample of 89 patients from a British high security hospital, with the legal classification of psychopathic disorder, was scored retrospectively on the PCL-R from their medical files only. The psychometric properties of the PCL-R were analysed. Results The PCL-R ratings showed a high level of internal reliability. The factor structure was very similar to that found in Hare's North American sample of forensic psychiatric patients. Discussion The findings support the application of the PCL-R, when scored using existing file data alone, to a British high security hospital population. Copyright © 2001 Whurr Publishers Ltd. [source]

Trauma in the family: groupwork on family awareness for men in high security hospital

CRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2000
Estelle Moore BSc MSc PhD C.Psychol
Introduction It is typically considered important in clinical practice to generate an understanding of the relationships and consequences of interaction patterns within the families of patients with serious interpersonal difficulties and histories of violent offending. Method Eight men on a dedicated treatment unit for patients with personality disturbance within a maximum security hospital participated in structured groupwork which focused on family awareness. Results Two measures of outcome were employed: their recollections of family life were assessed before and after the intervention, and their general progress in rehabilitation was followed up 12 months later. Summary scores of the participants' recall of feelings associated with familial figures indicate that the group reported changes in their feelings over the eight-month period. For the duration of the group, and during the subsequent year, the group members remained on the same ward; two had been transferred to medium security at follow-up. Discussion The inherent bias and the small numbers in the group prevent generalization. However, it seems that patients who participated in group work are likely to remain on the ward studied or be moved to lower security. The recollection and sharing experiences of family life may have reduced the patients' sense of isolation. Copyright © 2000 Whurr Publishers Ltd. [source]

Children, admitted to high security (special) hospital

Presentations of psychosis with violence: variations in different jurisdictions.

BEHAVIORAL SCIENCES & THE LAW, Issue 5 2008
A comparison of patients with psychosis in the high security hospitals of Scotland, England
Background International literature is consistent on there being a significant relationship between psychosis and violence, less so on its extent and nature, but two main presentational types are increasingly recognized. In one, people are unremarkable before onset of illness and psychotic symptoms commonly drive violence; in the other, psychosis is preceded by childhood conduct problems, associated with personality disorder, and psychotic symptoms seem less relevant. Aims To explore the extent to which variations in aspects of social and service context in different jurisdictions affect presentational type among people admitted to high security hospitals. Hypotheses There will be differences between jurisdictions in proportions of patients with pure psychosis or with psychosis and antecedent personality disorder, but symptom drive to violence will be more common in the pure psychosis group regardless of social, legal and service context. Method Independently conducted record studies were used to compare high security hospital patients with psychosis in Scotland and England, all resident between 25 August 1992 and 13 August 1993. Results The cohorts were similar in offence histories, predominance of schizophrenia, age at first hospitalization for psychosis and first high security hospitalization. More Scottish patients had co-morbid substance misuse diagnoses and/or personality disorder than patients in England. Psychotic symptom drive to the index offence was, however, four times more likely in the pure psychosis groups, regardless of sex, ethnic group or country. Scottish patients spent less time in high security after the index act. Conclusions Our hypotheses were sustained. Knowledge about lifestyle before onset of psychosis is important for interpreting literature on how psychotic symptoms relate to violence. This may also influence longer term outcome, although the shorter length of secure hospital stay in Scotland was perhaps affected more by greater availability of open ,step-down' beds. Copyright © 2008 John Wiley & Sons, Ltd. [source]