Study of clinical complexity of Forensic Patients in Secure Settings
Research type
Research Study
Full title
In a comparison of personality-disordered patients in high secure and medium secure hospital settings; are high secure patients more ‘Complex Cases’ who require specialist treatment?
IRAS ID
106183
Contact name
Simon Duff
Contact email
Research summary
Whilst clinicians often refer to their patients as ‘complex cases’, this label is not formally defined. Some say they are the opposite of ‘pure cases’ in that they have multiple mental health diagnoses or problems, rather than just one distinct difficulty.
This study will examine the ‘complexity’ of Personality-Disordered (PD) patients in a high security forensic hospital, and compare them to PD patients detained in medium security environments. It will be interesting to discover just how ‘complex’ the patients are in each setting, as this will improve our understanding of our client group, meaning that we will be able to tailor the treatments on offer and design suitable care pathways to help patients on their recovery journeys.
When considering PD patients in a high security hospital, it is possible that they are more ‘complex’ than those in other hospitals. They could have more mental health and behavioural difficulties than other patients, and therefore be so difficult to treat that they have been moved to a high security setting for specialist clinical care. However it is also possible that they are not more clinically ‘complex’ than patients in a medium security unit, but are instead more ‘difficult cases’ (eg. patients who are frequently violent towards staff/peers) that have been moved to a high security setting for specialist physical management. This study will examine these different possibilities.
The success of this research will rely on our ability to measure clinical ‘complexity’. We will administer the Personality Assessment Inventory (PAI) questionnaire to PD patients. The PAI will identify personality traits relating to personality disorder, psychosis, symptoms of trauma, drug/alcohol problems, behavioural problems such as aggression, anxiety, and depression (among other problems). This data will be examined alongside file information (eg. recorded clinical diagnoses), in order to map our own definition of ‘clinical complexity’.
REC name
East Midlands - Derby Research Ethics Committee
REC reference
14/EM/1012
Date of REC Opinion
8 Jul 2014
REC opinion
Favourable Opinion