Managing High Security Psychiatric Care

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The management of the secure psychiatric services is under increasing scrutiny. In Managing High Security Psychiatric Care the contributors examine the management of these services in the light of their experiences and involvement with the Special Hospitals throughout the lifetime of the Special Hospitals Service Authority.
The book illustrates the problems faced by the Special Hospitals and the techniques and action employed to effect major change in these large, enclosed institutions. It illustrates the difficulties and obstacles encountered and focuses on themes which dominated and influenced management and clinical initiatives. Key messages that emerge include close collaboration between managers and clinicians, planning and delivering real change in institutional settings, challenging and restructuring unacceptable attitudes influencing the wider debate about care for mentally disordered offenders.
The book provides a realistic description of the role and purpose of the High Security Psychiatric Service and the key dilemmas it still faces. It also makes suggestions concerning the direction any future service needs to pursue.
The book will be of interest to all those involved in the forensic psychiatric service, other large, closed institutions, and the Criminal Justice system.
  • Published: Jun 01 1998
  • Pages: 200
  • 233 x 173mm
  • ISBN: 9781853025815
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Press Reviews

  • Criminal Behaviour and Mental Health

    `Five psychiatrists write about their varied experiences and particular interests. Pamela Taylor's overview of intimate partnerships and sex among high security patients is outstanding… the book contains fascinating reading for anyone, and readers will approach it from their own backgrounds and perspectives.'
  • Criminal Behaviour and Mental Health

    This book is worth more than just one read. There have been very few comprehensive accounts of the difficulties of providing psychiatric care in hospital settings. Probably none which have so clearly, thoughtfully and provocatively provided insights into the debates and dilemmas facing care within a high security setting. The authors' description of the way forward and the hurdles met on the way is masterful at times because of the simplicity of the description. This is a textbook for all those working within forensic settings.. To the interested public it will be a window into which they can look to find out what really happens behind the walls and fences of high security psychiatric hospitals.
  • Mental Health Care

    `The book assembles an impressive team of contributers, the kind of collection you would hope to find at a good conference, with a real mix of views ond perpectives. There are contributions on management, design, treatment, security, spirituality, multi-disciplinary working, inquiries and the mediawith its enlightening description of the slow progression from prison to hospital culture along the spectrum from custody to care and the political forces which complicate and distract from such progress, the book places the deliberations of today in their historical and political context> It is well worth reading by those within and outside the secure psychiatric service.'
  • Therapeutic Communities

    `a useful insight into the world of the Special Hospitals, which neither glamorises forensic psychiatry nor dwells on the horror stories which are sometimes associated with these institutions. Overall there is a good balance of the opinions of managers and the opinions of clinicians.'
  • British Journal of Psychiatry

    `It is clearly not possible in a brief review to do justice to this densely informative and well argued book. The overall narrative (so it struck me) has some of the features of a Greek tragedy, commitment and passion, hubris, obvious victims (both patients and staff), a chorus of the righteous as well as thoughtful outsiders and an inexorability… as change and hopefulness vie with set-back and kicking in of the cultures of blame. The recent publication of the Fallon report adds another piece to the developing jigsaw. This volume offers important background to the current disputes and debates which have only partly been precipitated by the events leading up to the Fallon report from which staff as well as managers, policy makers and politicians will all benefit as they navigate the likely choppy waters of the next few years.'
  • ZT Monitor, the journal of the Zito Trust

    `This book provides a much-needed objective view of the history and management of the three special hospitals and makes it clear that significant, therapeutic developments have taken place which have challenged, although not entirely defeated, the old custodial culture which the Prison Officers Association have fought so hard, through the working practices of its members, to maintain.'
  • Connection

    `For those with an interest in managemtn of prisons and distributed offender establishments I would recommend this book, it represents the history of a specific management organisation from beginning to end and as such offers a useful example of practice.'
  • The Health Service Journal

    ` captures some of the emotion and anxiety of these large institutions and in a very human way brings these hospitals and their "politics" out of the shadow....the chapters were very well written, informative and a 'good read'.` (Journal of Inner London Probation Service) `Edited by, and with chapters from, two senior NHS managers involved in the special hospitals, this book provides a fascinating… view of the management challenges in the often closed world of Broadmoor, Rampton and Ashworth. The political realities of running such a service are well described and give the reader a flavour of what challenges managers face in handling the relationship between security and therapy. [The book] provides an excellent and useful analysis of the thorny issues of patient relationships, which any forensic mental health service would find valuable. [This book gives] an honest, and at times painful, examination of what goes on.'