Search results

1 – 3 of 3
Per page
102050
Citations:
Loading...
Access Restricted. View access options
Article
Publication date: 3 March 2020

Sana Rabab, Jack Tomlin, Nick Huband and Birgit Völlm

Patients detained in high-security psychiatric hospitals are particularly vulnerable to excessive restrictions and exploitation. In the UK, the care quality commission (CQC…

231

Abstract

Purpose

Patients detained in high-security psychiatric hospitals are particularly vulnerable to excessive restrictions and exploitation. In the UK, the care quality commission (CQC) monitors and regulates forensic healthcare provision. The purpose of this study is to identify key concerns highlighted in CQC inspection reports of the three high-secure hospitals in England between 2010 and 2018.

Design/methodology/approach

In this qualitative study, 49 CQC inspection reports from three high-secure hospitals were subjected to thematic analysis.

Findings

Five central themes emerged: staffing and management; restrictive practice; physical environment and ward atmosphere; patients’ needs and involvement in their care; and legal and statutory matters. There was some variation in the overall quality of care between the hospitals. Positive staff–patient interactions and good practice in assessing and delivering care were consistently observed. However, enduring staff shortages within each hospital were experienced negatively and sometimes co-occurred with concerns over restrictive practices, poor care-plan procedure and inadequate legal documentation. Over time, Rampton and Broadmoor Hospitals appeared to worsen with regard to staffing levels, staff morale and management involvement. While services progressed over time in providing patients with access to advocacy and information concerning their rights, in some recent inspections it remained unclear whether patients were adequately involved in the care-plan process.

Practical implications

These findings provide preliminary indicators for areas requiring further attention from policymakers, clinicians and advocates.

Originality/value

This study appears to be the first systematic analysis of key concerns expressed in CQC reports of English high-security hospitals.

Details

The Journal of Forensic Practice, vol. 22 no. 2
Type: Research Article
ISSN: 2050-8794

Keywords

Access Restricted. View access options
Article
Publication date: 21 September 2012

Mary Jinks, Mary McMurran and Nick Huband

This paper seeks to highlight the findings from a research project on improving treatment engagement for clients with personality difficulties.

1411

Abstract

Purpose

This paper seeks to highlight the findings from a research project on improving treatment engagement for clients with personality difficulties.

Design/methodology/approach

The authors provide an overview of the studies conducted to date. These are a systematic review of the literature examining non‐completion of psychosocial treatment by people with personality disorder, a systematic review of assessments to measure treatment engagement, and a Delphi survey of both staff and patients' views on factors that impact on engagement in psychosocial treatment for this client group.

Findings

Poor engagement with psychosocial treatment is an issue for clients with personality disorder and rates of non‐completion are high. Discontinuation of treatment is associated with adverse clinical outcomes. Although a number of assessments exist for measuring engagement, none can be described as comprehensive and few are adequately validated. Engagement factors identified from the survey were broadly in keeping with previous work, but additional factors specific to this client group were identified. A treatment readiness model for people with personality difficulties is described.

Practical implications

Research outputs from the project are a set of specifications for good practice in facilitating engagement, and a web‐based training package aimed at helping staff improve their understanding of their clients' engagement issues.

Originality/value

The findings will be useful to service managers as well as clinicians working directly with people with personality difficulties. Improving client engagement will improve clinical outcomes and service cost‐efficiency.

Details

Mental Health Review Journal, vol. 17 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

Access Restricted. View access options
Article
Publication date: 9 April 2018

Gareth Edward Ross and Jonathan Michael Auty

Democratic Therapeutic Communities (TCs) provide an environment for offenders to work on longstanding emotional and relational problems and address their offending behaviour. The…

1360

Abstract

Purpose

Democratic Therapeutic Communities (TCs) provide an environment for offenders to work on longstanding emotional and relational problems and address their offending behaviour. The purpose of this paper is to explore the experience of making psychological changes on a TC from the perspective of residents.

Design/methodology/approach

Interpretative Phenomenological Analysis was used to explore the experience of five former residents of the TC at HMP Gartree.

Findings

Four main themes emerged, each with two sub-themes: Motivation to Change (sub-themes: Engagement, Determination); Environment (sub-themes: Boundaries, Experience of care); Removal of Masks (sub-themes: Embracing vulnerability, Emerging authenticity) and Relationships (sub-themes: Re-enacting the past, Challenge from peers). Findings are discussed in relation to existing literature.

Research limitations/implications

Understanding service users perspectives on what helps facilitate change can help staff empathise with their experiences and strengthen their relationships. The importance of clear and consistent boundaries that are perceived as fair and the development of meaningful relationships with staff in creating an atmosphere that enables change has implications for other therapeutic or supportive environments. This research represents the experiences of five participants who were motivated to take part and comfortable to speak to a professional about their experiences. As such, generalisations about the wider TC population should be made cautiously and further research would be beneficial.

Originality/value

The research adds to the underrepresented area of service user perspectives in a forensic TC. It contributes a rich account of the experience of psychological change that can help staff working in TCs understand and relate to their residents experiences.

Details

Therapeutic Communities: The International Journal of Therapeutic Communities, vol. 39 no. 1
Type: Research Article
ISSN: 0964-1866

Keywords

1 – 3 of 3
Per page
102050