Patients with mental illness held with unnecessary security

Many patients with a serious mental illness
are being kept in levels of security that are unnecessarily high
according to new research, writes Alex
Dobson.

Almost eight out of 10 secure patients are in
units that are not suited to their needs. Only one in five patients
in a maximum security hospital, whose cases were reviewed by
psychiatrists, were found to need that level of security.

The influence of the home office is given as
one of the reasons why some patients are being kept in units with
security levels much higher than is required.

In the research, reported in the Journal of
Forensic Psychiatry, psychiatrists looked at patients with mental
illness from the north west region of England in secure mental
health units. Psychiatrists at the region’s special, high
security hospital, and three medium secure and seven high
dependency units, were asked to review those patients by completing
a detailed questionnaire to help researchers assess their
needs.

“The results showed that 261 patients, or 79
per cent, were placed at a level of security inappropriate to their
needs,” the research reveals.

It adds: “We found that several factors were
associated with patients being currently placed at an
inappropriately high level of security. One of these was the
influence of the home office.”

It says that the influence of the home office
was a factor that increased the likelihood of a patient being
placed at a level of security too high for his of her needs. In 90
out of 149 cases where patients were in conditions where security
was too high, home office influence was listed as `high’.

It says that some of the patients did not need
to be in any kind of secure unit: “Twenty two are described as
having no security needs and low dependency needs, posing the
questions of why they are currently inpatients in secure care.”

The report also shows that while 149 patients
were in units where security was too high for their needs, 54 were
in placements where security was considered to be too low.

The report, ‘An assessment of the
security, dependency, and treatment needs of all patients in secure
services in a UK health region’, calls for a review of the
system. It says there is a need for longer-stay, high-dependency
services with low and medium levels of security.

“Currently we sort patients by security need
and length of stay. Our findings suggest that a radical redesign of
services based around dependency needs at intermediate levels of
security could more appropriately take into account patients’
needs,” it says.