Managing High Security Psychiatric CareThe 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. |
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Contents
List of figures | 10 |
1 Interlocking worlds in high security | 14 |
2 Maslows hierarchy of needs | 23 |
Brief History of the Special Hospitals | 27 |
The Inheritance | 39 |
1 Rampton Hospital staff in 1940s | 41 |
Tackling the Culture | 51 |
1 Catch 22 from the Broadmoor patients | 64 |
referrals admissions | 128 |
Resolving a Policy Crisis | 136 |
1 Patient relationship in a special hospital some | 148 |
A Chaplain Reflects | 157 |
Freedom from Restraint | 165 |
A Doctors View | 181 |
Improving Care | 193 |
Research and Development | 204 |
A Chairman Remembers | 67 |
Security and Therapy | 75 |
1 Security drawing by John Lynch | 81 |
The Physical Environment | 85 |
1 Dormitory Weymouth Ward Broadmoor Hospital | 90 |
2 Amber Ward Ashworth Hospital | 96 |
Industrial Relations | 99 |
Describing the Patients | 111 |
1 Ten Tribunal Tips from the Broadmoor patients | 113 |
Learning Disability in the Special Hospitals | 123 |