Sarah Cooper and Andy Colin Inett
Staff working in forensic inpatient settings are at increased risk of harm perpetrated by patients. Support offered in response to such incidents can have a significant impact on…
Abstract
Purpose
Staff working in forensic inpatient settings are at increased risk of harm perpetrated by patients. Support offered in response to such incidents can have a significant impact on how staff recover. The purpose of this paper is to explore how staff support procedures implemented in one low-secure forensic service impacted on staff recovery.
Design/methodology/approach
In total, 11 members of staff who had direct patient contact volunteered from an opportunity sample. Semi-structured interviews were conducted with each participant, asking about experiences of abuse at work and subsequent staff support procedures. Interviews were analysed using thematic analysis.
Findings
Four overarching themes were identified; experiences of harm, supported recovery, missed opportunities and therapeutic relationships. This led to a better understanding of how staff coped with incidents of abuse at work and how support procedures impacted on their recovery.
Research limitations/implications
The service evaluation was limited by transferability of the findings. The process of sampling may have meant there were biases in those who volunteered to take part. Further projects such as this are required to develop the themes identified.
Practical implications
Findings led to the development of a new integrated model of staff support.
Originality/value
This was one of the first studies in the UK to formally evaluate a staff support procedure in forensic low-secure services and include experiences of both clinical and non-clinical staff who are regularly exposed to potentially harmful events.
Details
Keywords
Andy Inett, Grace Wright, Louise Roberts and Anne Sheeran
Offenders with intellectual disability (ID) have been largely neglected in past forensic literature on assessment of dynamic risk factors. The purpose of this paper is to evaluate…
Abstract
Purpose
Offenders with intellectual disability (ID) have been largely neglected in past forensic literature on assessment of dynamic risk factors. The purpose of this paper is to evaluate the predictive validity of the Short-Term Assessment of Risk and Treatability (START), in a sample of males with IDs in a low-secure hospital (n=28).
Design/methodology/approach
A prospective analysis was conducted, with START scores as the predictor variables, and the number of recorded aversive incidents as the outcome measure.
Findings
Receiver operating characteristic analysis demonstrated that total START risk scores had a significant high predictive accuracy for incidents of physical aggression to others (area under the curve (AUC)=0.710, p<0.001) and property damage/theft (AUC=0.730, p<0.001), over a 30-day period, reducing to medium predictive validity over a 90-day period. Medium predictive validity was also identified for incidents of verbal aggression, suicide, self-harm, and stalking and intimidation. START strength scores were also predictive of overt aggression (AUC=0.716), possible reasons for this are explored.
Research limitations/implications
The small sample size limits the generalisability of the findings, and further research is required.
Practical implications
The paper offers preliminary support for the use of the START with ID offenders in low-secure settings. Given the lack of validation of any previous dynamic risk assessment tools, multi-disciplinary teams in such settings now have the option to use a tool which has potentially good validity with an ID population.
Originality/value
This study represents the first attempt to examine the predictive validity of the START with ID offenders, and a step forward in the understanding of dynamic risk factors for violence in this population. The significant predictive relationship with incidents of physical aggression and property damage offers clinicians a preliminary evidence base supporting its use in low-secure settings.