Study of engagement in treatment by medium secure psychiatric patients
Research type
Research Study
Full title
Study of the experience relating to engagement in treatment of inpatients in a medium secure psychiatric service whose length of admission is over three years.
IRAS ID
76508
Contact name
Annie Bartlett
Contact email
Sponsor organisation
St Georges, University of London
Research summary
Medium secure units are intended to care for patients detained under the Mental Health Act (MHA) who pose a serious danger to the public. Such patients may have previously been admitted to high secure hospitals or transferred from prison, or they individuals may have no previous convictions and been transferred from mainstream psychiatric services due to seriously aggressive behaviour.
Treatments offered in medium secure care include those for major mental illnesses as well as psychological treatments such as offense related therapies. The duration of inpatient stay is likely to be determined by the patients’ response to treatment. The legality and appropriateness of their detention is regularly reviewed by the Mental Health Review tribunal.
Since the inception of medium secure services, length of stay was anticipated to be around two years. A number of recent reviews have found length of stay to greatly exceed this. Mean length of stay has been found to vary considerably between services.
Medium secure care is highly restrictive and prolonged admission cannot be justified on ethical grounds. In addition, care is expensive and length of stay is increasingly scrutinized for economic reasons. Engagement in treatment is felt to be a significant determinant of length of stay.
The study applies a qualitative approach using a semi-structured interview to elucidate the views, attitudes and experience, relating to engagement in treatment of medium secure patients whose length of stay exceeds three years. A Grounded Theory approach using qualitative methods of analysis will be employed to create theories which explain the factors which influence engagement and disengagement in treatment in the study population. The study population is a large forensic psychiatric service in London. Interviews with 15-20 participants will be sought.
It is hoped that the findings will assist services seeking to become more accessible and user friendly.
REC name
London - Riverside Research Ethics Committee
REC reference
13/LO/0930
Date of REC Opinion
12 Aug 2013
REC opinion
Further Information Favourable Opinion