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Chapter 7 - Models of Care in Forensic Psychiatry

Published online by Cambridge University Press:  06 June 2024

By
Harry Kennedy
Edited by
Mary Davoren  and
Harry G. Kennedy
Mary Davoren
Affiliation:
Broadmoor Hospital and West London NHS Trust
Harry G. Kennedy
Affiliation:
Trinity College Dublin
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Summary

A model of care defines how health services are delivered. It typically has four elements: goals; pathways and processes; treatment programmes; and evaluation in which a logic model relates resources delivered to sustained health gains and defined outcome measures. The elements of therapeutic security – environmental, relational, procedural and managerial – influence specifically forensic models of care. Services that manage serious risks must ensure judgement support frameworks, resilience and sustainable levels of service. Population needs and prison morbidity surveys should shape services at a national level. Prison in-reach services based on screening, diversion and continuity of care are an integral part of a forensic model of care, along with highly supportive and structured community services for the conditionally discharged patient. Forensic psychiatry services may to some extent be a bellwether for both positive and problematic aspects of the larger model of care for mental health for a population and may be the first places to see signs of service strain elsewhere. Tertiary highly specialised services should aim for excellence. Excellence is the process of leading continuous improvement of outcomes for patients through the virtuous cycle of research, development, teaching and training. Investing in excellence as a key priority and value is essential.

Keywords

Model of careEvaluationStratified therapeutic securityOutcome measuresExcellence
Type
Chapter
Information
Seminars in Forensic Psychiatry , pp. 176 - 207
Publisher: Cambridge University Press
Print publication year: 2024

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References

Fallon, PBR, Edwards, B, Daniels, G. Report of the Committee of Inquiry into the Personality Disorder Unit, Ashworth Special Hospital. London, The Stationery Office, 1999.Google Scholar
Kennedy, HG, Simpson, A, Haque, Q. Perspective on excellence in forensic mental health services: what we can learn from oncology and other medical services. Frontiers in Psychiatry 2019; 10: 733.CrossRefGoogle ScholarPubMed
Kennedy, HG. Models of care in forensic psychiatry. BJPsych Advances 2021: 1–14.CrossRefGoogle Scholar
Agency for Clinical Innovation. Understanding the Process to Develop a Model of Care: An ACI Framework. Version 1.0, May. Chatsworth New South Wales Australia, NSW Agency for Clinical Innovation, 2013.Google Scholar
Collins, H, Evans, R. Rethinking Expertise. Chicago, IL, University of Chicago Press, 2008.Google Scholar
O’Grady, J. The complementary roles of regional and local secure provision for psychiatric patients. Health Trends 1990; 22 (1): 14–16.Google ScholarPubMed
O’Reilly, R, Allison, S, Bastiampiallai, T. Observed outcomes: an approach to calculate the optimum number of psychiatric beds. Administration and Policy in Mental Health and Mental Health Services 2019; 46 (4): 507–17.CrossRefGoogle ScholarPubMed
Kennedy, H. Therapeutic uses of security: mapping forensic mental health services by stratifying risk. Advances in Psychiatric Treatment 2002; 8 (6): 433–43.CrossRefGoogle Scholar
Von Bertalanffy, L. The meaning of general system theory. General System Theory: Foundations, Development, Applications 1973: 30–53.Google Scholar
Noble, D. Claude Bernard, the first systems biologist, and the future of physiology. Experimental Physiology 2008; 93 (1): 16–26.CrossRefGoogle Scholar
Yoon, J, Domino, ME, Norton, EC, Cuddeback, GS, Morrissey, JP. The impact of changes in psychiatric bed supply on jail use by persons with severe mental illness. The Journal of Mental Health Policy and Economics 2013; 16 (2): 81–92.Google ScholarPubMed
Grove, P, Macleod, J, Godfrey, D. Forecasting the prison population. OR Insight 1998; 11 (1): 3–9.CrossRefGoogle Scholar
McLaren, N. A critical review of the biopsychosocial model. Australian & New Zealand Journal of Psychiatry 1998; 32 (1): 86–92.CrossRefGoogle ScholarPubMed
Harrison, GW, Millard, PH. Balancing acute and long-term care: the mathematics of throughput in departments of geriatric medicine. Methods of Information in Medicine 1991; 30 (3): 221–8.CrossRefGoogle ScholarPubMed
McClean, SI, Millard, PH. Go with the Flow: A Systems Approach to Healthcare Planning. London, Royal Society of Medicine Press, 1996.Google Scholar
Millard, PH, McClean, SI. Modelling Hospital Resource Use: A Different Approach to the Planning and Control of Health Care Systems. London, Royal Society of Medicine Press, 1994.Google Scholar
Falk, M. Secure facilities in local psychiatric hospitals. In Gostin, L (ed.) Secure Provision. London, Tavistock, 1985.Google Scholar
Kinsman, L, Rotter, T, James, E, Snow, P, Willis, J. What is a clinical pathway? Development of a definition to inform the debate. BMC Medicine 2010; 8 (1): 31.CrossRefGoogle ScholarPubMed
Aspland, E, Gartner, D, Harper, P. Clinical pathway modelling: a literature review. Health Systems 2021; 10 (1): 1–23.CrossRefGoogle Scholar
James, D. Court diversion at 10 years: can it work, does it work and has it a future? The Journal of Forensic Psychiatry 1999; 10 (3): 507–24.CrossRefGoogle Scholar
Shaw, J, Creed, F, Price, J, Huxley, P, Tomenson, B. Prevalence and detection of serious psychiatric disorder in defendants attending court. The Lancet 1999; 353 (9158): 1053–6.CrossRefGoogle ScholarPubMed
Purchase, ND, McCallum, AK, Kennedy, HG. Evaluation of a psychiatric court liaison scheme in north London. BMJ 1996; 313 (7056): 531–2.CrossRefGoogle ScholarPubMed
Pierzchniak, P, Purchase, N, Kennedy, H. Liaison between prison, court and psychiatric services. Health Trends 1997; 29 (1): 26–9.Google Scholar
Holloway, J, Shaw, J. Providing a forensic psychiatry service to a magistrates’ court: a follow-up study. The Journal of Forensic Psychiatry 1993; 4 (3): 575–81.CrossRefGoogle Scholar
Greenberg, D, Nielsen, B. Moving towards a statewide approach to court diversion services in NSW. New South Wales Public Health Bulletin 2003; 14 (12): 227–9.CrossRefGoogle Scholar
O’Neill, C, Smith, D, Caddow, M et al. STRESS-testing clinical activity and outcomes for a combined prison in-reach and court liaison service: a 3-year observational study of 6177 consecutive male remands. International Journal of Mental Health Systems 2016; 10: 67.CrossRefGoogle Scholar
Jones, RM, Patel, K, Simpson, AIF. Assessment of need for inpatient treatment for mental disorder among female prisoners: a cross-sectional study of provincially detained women in Ontario. BMC Psychiatry 2019; 19 (1): 98.CrossRefGoogle ScholarPubMed
Steel, J, Thornicroft, G, Birmingham, L et al. Prison mental health inreach services. British Journal of Psychiatry 2007; 190 (5): 373–4.CrossRefGoogle ScholarPubMed
Simpson, AIF, Jones, RM. Two challenges affecting access to care for inmates with serious mental illness: detecting illness and acceptable services. The Canadian Journal of Psychiatry 2018; 63 (10): 648–50.CrossRefGoogle ScholarPubMed
Giblin, Y, Kelly, A, Kelly, E, Kennedy, HG, Mohan, D. Reducing the use of seclusion for mental disorder in a prison: implementing a high support unit in a prison using participant action research. International Journal of Mental Health Systems 2012; 6 (1): 2.CrossRefGoogle Scholar
Forrester, A, Till, A, Simpson, A, Shaw, J. Mental illness and the provision of mental health services in prisons. British Medical Bulletin 2018; 127 (1): 101–9.CrossRefGoogle ScholarPubMed
Doyle, M, Power, LA, Coid, J et al. Predicting post-discharge community violence in England and Wales using the HCR-20V3. International Journal of Forensic Mental Health 2014; 13 (2): 140–7.CrossRefGoogle Scholar
Pratt, D, Piper, M, Appleby, L, Webb, R, Shaw, J. Suicide in recently released prisoners: a population-based cohort study. The Lancet 2006; 368 (9530): 119–23.Google ScholarPubMed
Smith, D, Harnett, S, Flanagan, A et al. Beyond the walls: an evaluation of a Pre-Release Planning (PReP) programme for sentenced mentally disordered offenders. Frontiers in Psychiatry 2018; 9: 549.CrossRefGoogle ScholarPubMed
Cohen, A, Eastman, N. Assessing Forensic Mental Health Need: Policy, Theory and Research. London, RCPsych Publications, 2000.Google Scholar
Shaw, J, Davies, J, Morey, H. An assessment of the security, dependency and treatment needs of all patients in secure services in a UK health region. The Journal of Forensic Psychiatry 2001; 12 (3): 610–37.CrossRefGoogle Scholar
Kennedy, HG. Therapeutic uses of security: mapping forensic mental health services by stratifying risk. Advances in Psychiatric Treatment 2002; 8 (6): 433–43.CrossRefGoogle Scholar
Kaye, C, Franey, A. Managing High Security Psychiatric Care. London, Jessica Kingsley Publishers, 1998.Google Scholar
Crichton, JHM. Defining high, medium, and low security in forensic mental healthcare: the development of the Matrix of Security in Scotland. The Journal of Forensic Psychiatry & Psychology 2009; 20 (3): 333–53.CrossRefGoogle Scholar
Broderick, C, Azizian, A, Kornbluh, R, Warburton, K. Prevalence of physical violence in a forensic psychiatric hospital system during 2011–2013: patient assaults, staff assaults, and repeatedly violent patients. CNS Spectrums 2015; 20 (3): 319–30.CrossRefGoogle Scholar
Sekol, I, Farrington, DP, Ireland, JL. Bullying in secure settings. Journal of Aggression, Conflict and Peace Research 2016; 8 (2).CrossRefGoogle Scholar
Department of Health. Environmental Design Guide: Adult Medium Secure Services. 15 April 2011.Google Scholar
Reed, JL. Report of the Working Group on High Security and Related Psychiatric Provision. London, Department of Health, 1994.Google Scholar
Tilt, RPB, Martin, C, Maguire, N, Preston, M. Report of the Review of Security at the High Security Hospitals. London, Department of Health, 2000.Google Scholar
Hinton, R, Kaye, C, Franey, A. The physical environment. Managing High Security Psychiatric Care 1998: 85–98.Google Scholar
Reed, J. Review of Health and Social Services for Mentally Disordered Offenders and Others Requiring Similar Services. London, HM Stationery Office, 1992.Google Scholar
Newman, O. Defensible Space: People and Design in the Violent City. London, Architectural Press, 1973.Google Scholar
Georgiou, MNP, Jethwa, J, Townsend, K. Physical Security in Secure Care. London, Royal College of Psychiatrists Centre for Quality Improvement, 2020.Google Scholar
Seppanen, A, Tormanen, I, Shaw, C, Kennedy, H. Modern forensic psychiatric hospital design: clinical, legal and structural aspects. International Journal of Mental Health Systems 2018; 12: 58.CrossRefGoogle ScholarPubMed
Tighe, J, Gudjonsson, GH. See, Think, Act Scale: preliminary development and validation of a measure of relational security in medium- and low-secure units. The Journal of Forensic Psychiatry & Psychology 2012; 23 (2): 184–99.CrossRefGoogle Scholar
James, DV, Fineberg, NA, Shah, AK, Priest, RG. An increase in violence on an acute psychiatric ward: a study of associated factors. British Journal of Psychiatry 1990; 156: 846–52.CrossRefGoogle Scholar
Siu, BW-M, Au-Yeung, CC-Y, Chan, AW-L et al. Measuring the profiles of the security needs of forensic psychiatric inpatients: validation of the See, Think, Act Scale. Asia-Pacific Psychiatry 2019; 11 (2): e12341.CrossRefGoogle ScholarPubMed
Allen, E. See Think Act: Relational Security in Secure Mental Health Services. London, Department of Health, 2010.Google Scholar
Doyle, M, Jones, P. Hodges’ Health Career Model and its role and potential application in forensic mental health nursing. Journal of Psychiatric and Mental Health Nursing 2013; 20 (7): 631–40.CrossRefGoogle ScholarPubMed
Wampold, BE. How important are the common factors in psychotherapy? An update. World Psychiatry: Official Journal of the World Psychiatric Association (WPA) 2015; 14 (3): 270–7.CrossRefGoogle ScholarPubMed
Bowers, L, Alexander, J, Bilgin, H et al. Safewards: the empirical basis of the model and a critical appraisal. Journal of Psychiatric and Mental Health Nursing 2014; 21 (4): 354–64.CrossRefGoogle ScholarPubMed
Allen, E. Your Guide to Relational Security: See Think Act. London, Royal College of Psychiatrists Quality Network for Forensic Mental Health, 2016.Google Scholar
Chester, V, Alexander, RT, Morgan, W. Measuring relational security in forensic mental health services. BJPsych Bulletin 2017; 41 (6): 358–63.CrossRefGoogle ScholarPubMed
Priebe, S, Kelley, L, Omer, S et al. The effectiveness of a patient-centred assessment with a solution-focused approach (DIALOG+) for patients with psychosis: a pragmatic cluster-randomised controlled trial in community care. Psychotherapy and Psychosomatics 2015; 84 (5): 304–13.CrossRefGoogle ScholarPubMed
Omer, S, Golden, E, Priebe, S. Exploring the mechanisms of a patient-centred assessment with a solution focused approach (DIALOG+) in the community treatment of patients with psychosis: a process evaluation within a cluster-randomised controlled trial. PLoS One 2016; 11 (2): e0148415.CrossRefGoogle ScholarPubMed
Anthony, WA. Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosocial Rehabilitation Journal 1993; 16 (4): 11.CrossRefGoogle Scholar
Warner, R. Does the scientific evidence support the recovery model? The Psychiatrist 2010; 34 (1): 3–5.CrossRefGoogle Scholar
Donnelly, V, Lynch, A, Devlin, C et al. Therapeutic alliance in forensic mental health: coercion, consent and recovery. Irish Journal of Psychological Medicine 2011; 28 (1): 21–8.CrossRefGoogle ScholarPubMed
McCullough, S, Stanley, C, Smith, H et al. Outcome measures of risk and recovery in Broadmoor High Secure Forensic Hospital: stratification of care pathways and moves to medium secure hospitals. BJPsych Open 2020; 6 (4): e74.CrossRefGoogle ScholarPubMed
Livingston, JD, Nijdam-Jones, A, Lapsley, S, Calderwood, C, Brink, J. Supporting recovery by improving patient engagement in a forensic mental health hospital: Results from a demonstration project. Journal of the American Psychiatric Nurses Association 2013; 19 (3): 132–45.CrossRefGoogle Scholar
Pouncey, CL, Lukens, JM. Madness versus badness: the ethical tension between the recovery movement and forensic psychiatry. Theoretical Medicine and Bioethics 2010; 31 (1): 93–105.CrossRefGoogle ScholarPubMed
Simpson, AI, Penney, SR. The recovery paradigm in forensic mental health services. Criminal Behaviour and Mental Health 2011; 21 (5): 299–306.CrossRefGoogle ScholarPubMed
Roychowdhury, A. Bridging the gap between risk and recovery: a human needs approach. The Psychiatrist 2011; 35 (2): 68–73.CrossRefGoogle Scholar
Davoren, M, Hennessy, S, Conway, C et al. Recovery and concordance in a secure forensic psychiatry hospital: the self rated DUNDRUM-3 programme completion and DUNDRUM-4 recovery scales. BMC Psychiatry 2015; 15: 61.CrossRefGoogle Scholar
Katsakou, C, Bowers, L, Amos, T et al. Coercion and treatment satisfaction among involuntary patients. Psychiatric Services 2010; 61 (3): 286–92.CrossRefGoogle ScholarPubMed
Hansson, L, Björkman, T, Priebe, S. Are important patient‐rated outcomes in community mental health care explained by only one factor? Acta Psychiatrica Scandinavica 2007; 116 (2): 113–18.CrossRefGoogle ScholarPubMed
Stensgaard, L, Andersen, MK, Nordentoft, M, Hjorthøj, C. Implementation of the safewards model to reduce the use of coercive measures in adult psychiatric inpatient units: An interrupted time-series analysis. Journal of Psychiatric Research 2018; 105: 147–52.CrossRefGoogle ScholarPubMed
Department of Health and Social Care. Guidance on the High Security Psychiatric Services (Arrangements for Safety and Security) Directions 2019. London, Community and Social Care/Mental Health, Disability and Dementia/Mental Health Policy, 2019.Google Scholar
Department for Health and Social Security. High Security Psychiatric Services (Arrangements for Safety and Security) Directions 2019. London, gov.uk, 2019.Google Scholar
Aimola, L, Jasim, S, Tripathi, N et al. Impact of peer-led quality improvement networks on quality of inpatient mental health care: study protocol for a cluster randomized controlled trial. BMC Psychiatry 2016; 16 (1): 331.CrossRefGoogle ScholarPubMed
Kennedy, HG, Simpson, A, Haque, Q. Perspective on excellence in forensic mental health services: what we can learn from oncology and other medical services. Frontiers in Psychiatry 2019; 10.CrossRefGoogle Scholar
Freestone, M, Bull, D, Brown, R et al. Triage, decision-making and follow-up of patients referred to a UK forensic service: validation of the DUNDRUM toolkit. BMC Psychiatry 2015; 15: 239.CrossRefGoogle ScholarPubMed
Williams, HK, Senanayke, M, Ross, CC, Bates, R, Davoren, M. Security needs among patients referred for high secure care in Broadmoor Hospital England. BJPsych Open 2020; 6 (4): e55.CrossRefGoogle ScholarPubMed
Crocker, AG, Nicholls, TL, Charette, Y, Seto, MC. Dynamic and static factors associated with discharge dispositions: the National Trajectory Project of Individuals Found Not Criminally Responsible on Account of Mental Disorder (NCRMD) in Canada. Behavioral Sciences & the Law 2014; 32 (5): 577–95.CrossRefGoogle ScholarPubMed
Gordon, H, Oyebode, O, Minne, C. Death by homicide in special hospitals. Journal of Forensic Psychiatry 1997; 8 (3): 602–19.CrossRefGoogle Scholar
Völlm, BA, Bickle, A, Gibbon, S. Incidents of hostage-taking in an English high-secure hospital. The Journal of Forensic Psychiatry & Psychology 2013; 24 (1): 16–30.CrossRefGoogle Scholar
Wilkie, T, Penney, SR, Fernane, S, Simpson, AI. Characteristics and motivations of absconders from forensic mental health services: a case-control study. BMC Psychiatry 2014; 14 (1): 91.CrossRefGoogle ScholarPubMed
Simpson, AIF, Penney, SR, Fernane, S, Wilkie, T. The impact of structured decision making on absconding by forensic psychiatric patients: results from an A-B design study. BMC Psychiatry 2015; 15 (1): 103.CrossRefGoogle ScholarPubMed
Learmont, J. Review of Prison Service Security in England and Wales and the Escape from Parkhurst Prison on Tuesday 3rd January 1995. London, HM Stationery Office, 1995.Google Scholar
Woodcock, SJ. Report of the Enquiry into the Escape of Six Prisoners from the Special Security Unit at Whitemoor Prison, Cambridgeshire, on Friday 9th September 1994. London, HM Stationery Office, 1994.Google Scholar
Simpson, AI, Chatterjee, S, Darby, P et al. Management of COVID-19 Response in a Secure Forensic Mental Health Setting: Réponse à la gestion de la COVID-19 dans un établissement sécurisé de santé mentale et de psychiatrie légale. The Canadian Journal of Psychiatry 2020; 65 (10): 695–700.CrossRefGoogle Scholar
Kennedy, HG, Mohan, D, Davoren, M. Forensic psychiatry and Covid-19: accelerating transformation in forensic psychiatry. Irish Journal of Psychological Medicine 2020: 1–26.CrossRefGoogle Scholar
Horsky, J, Schiff, GD, Johnston, D et al. Interface design principles for usable decision support: a targeted review of best practices for clinical prescribing interventions. Journal of Biomedical Informatics 2012; 45 (6): 1202–16.CrossRefGoogle ScholarPubMed
Patel, VL, Cohen, TA, Murarka, T et al. Recovery at the edge of error: debunking the myth of the infallible expert. Journal of Biomedical Informatics 2011; 44 (3): 413–24.CrossRefGoogle ScholarPubMed
Patel, VL, Cytryn, KN, Shortliffe, EH, Safran, C. The collaborative health care team: the role of individual and group expertise. Teaching and Learning in Medicine 2000; 12: 117–32.CrossRefGoogle Scholar
Patel, VL, Groen, GJ, Arocha, JF. Medical expertise as a function of task difficulty. Memory & Cognition 1990; 18: 394–406.CrossRefGoogle ScholarPubMed
Darzi, A. A High Quality Workforce: NHS Next Stage Review. London, Department of Health, 2008.Google Scholar
Nicol, E. Improving clinical leadership and management in the NHS. Journal of Healthcare Leadership 2012; 4: 59–69.CrossRefGoogle Scholar
Priest, RG, Fineberg, N, Merson, S, Kurian, T. Length of stay of acute psychiatric inpatients: an exponential model. Acta Psychiatrica Scandinavica 1995; 92 (4): 315–17.CrossRefGoogle ScholarPubMed
Sharma, A, Dunn, W, O’Toole, C, Kennedy, HG. The virtual institution: cross-sectional length of stay in general adult and forensic psychiatry beds. International Journal of Mental Health Systems 2015; 9 (1): 25.CrossRefGoogle ScholarPubMed
Shah, A, Waldron, G, Boast, N, Coid, JW, Ullrich, S. Factors associated with length of admission at a medium secure forensic psychiatric unit. The Journal of Forensic Psychiatry & Psychology 2011; 22 (4): 496–512.CrossRefGoogle Scholar
Harty, M-A, Shaw, J, Thomas, S et al. The security, clinical and social needs of patients in high security psychiatric hospitals in England. The Journal of Forensic Psychiatry & Psychology 2004; 15 (2): 208–21.CrossRefGoogle Scholar
Völlm, BA, Edworthy, R, Huband, N et al. Characteristics and pathways of long-stay patients in high and medium secure settings in England: a secondary publication from a large mixed-methods study. Frontiers in Psychiatry 2018; 9.CrossRefGoogle Scholar
Pierzchniak, P, Farnham, F, Taranto, N et al. Assessing the needs of patients in secure settings: a multi-disciplinary approach. The Journal of Forensic Psychiatry 1999; 10 (2): 343–54.CrossRefGoogle Scholar
Sharma, A, Dunn, W, O’Toole, C, Kennedy, HG. The virtual institution: cross-sectional length of stay in general adult and forensic psychiatry beds. International Journal of Mental Health Systems 2015; 9: 25.CrossRefGoogle ScholarPubMed
O’Neill, C, Heffernan, P, Goggins, R et al. Long-stay forensic psychiatric inpatients in the Republic of Ireland: aggregated needs assessment. Irish Journal of Psychological Medicine 2003; 20 (4): 119–25.Google ScholarPubMed
Flynn, G, O’Neill, C, McInerney, C, Kennedy, HG. The DUNDRUM-1 structured professional judgment for triage to appropriate levels of therapeutic security: retrospective-cohort validation study. BMC Psychiatry 2011; 11: 43.CrossRefGoogle ScholarPubMed
Davoren, M, Byrne, O, O’Connell, P et al. Factors affecting length of stay in forensic hospital setting: need for therapeutic security and course of admission. BMC Psychiatry 2015; 15: 301.CrossRefGoogle ScholarPubMed
Habets, P, Jeandarme, I, Kennedy, HG. Applicability of the DUNDRUM-1 in a forensic Belgium setting. Journal of Forensic Practice 2019; 21 (1): 85–94.CrossRefGoogle Scholar
Jeandarme, I, Habets, P, Kennedy, H. Structured versus unstructured judgment: DUNDRUM-1 compared to court decisions. International Journal of Law and Psychiatry 2019; 64: 205–10.CrossRefGoogle ScholarPubMed
Habets, P, Jeandarme, I, Kennedy, HG. Determining security level in forensic psychiatry: a tug of war between the DUNDRUM toolkit and the HoNOS-Secure. Psychology, Crime & Law 2020: 1–19.CrossRefGoogle Scholar
Eastman, N, Bellamy, S. Admission Criteria for Secure Services Schedule (ACSeSS). London, St Georges Hospital Medical School, 1998.Google Scholar
Pinals, DA FW, Warburton, K, Wik, A, Hollen, V, Fisher, WH. Forensic Patients in State Psychiatric Hospitals: 1999–2016. Alexandria, VA, National Association of State Mental Health Program Directors, Directors NAoSMHP, 2017. Report No. 9.Google Scholar
Salize, HJ, Dressing, H. Admission of mentally disordered offenders to specialized forensic care in fifteen European Union member states. Social Psychiatry and Psychiatric Epidemiology 2007; 42 (4): 336–42.CrossRefGoogle ScholarPubMed
NHS Digital. Mental Health Act Statistics, Annual Figures: 2016–17, Experimental Statistics. London, NHS Digital, 2017.Google Scholar
Gupta, S, Akyuz, EU, Baldwin, T, Curtis, D. Community treatment orders in England: review of usage from national data. BJPsych Bulletin 2018; 42 (3): 119–22.CrossRefGoogle ScholarPubMed
Chow, WS, Priebe, S. How has the extent of institutional mental healthcare changed in Western Europe? Analysis of data since 1990. BMJ Open 2016; 6 (4): e010188.CrossRefGoogle ScholarPubMed
Tomlin, J, Lega, I, Braun, P et al. Forensic mental health in Europe: some key figures. Social Psychiatry and Psychiatric Epidemiology 2020: 1–9.CrossRefGoogle Scholar
DeTaranto, N, Bester, P, Pierczhniak, P, Mccallum, A, Kennedy, H. Medium secure provision in NHS and private units. The Journal of Forensic Psychiatry 1998; 9 (2): 369–78.Google Scholar
Coid, J, Kahtan, N, Cook, A, Gault, S, Jarman, B. Predicting admission rates to secure forensic psychiatry services. Psychological Medicine 2001; 31 (3): 531.CrossRefGoogle ScholarPubMed
Kennedy, HG, Iveson, RC, Hill, O. Violence, homicide and suicide: strong correlation and wide variation across districts. British Journal of Psychiatry 1999; 175: 462–6.CrossRefGoogle ScholarPubMed
O’Neill, C, Kelly, A, Sinclair, H, Kennedy, H. Deprivation: different implications for forensic psychiatric need in urban and rural areas. Social Psychiatry and Psychiatric Epidemiology 2005; 40 (7): 551–6.CrossRefGoogle ScholarPubMed
Davoren, M, Byrne, O, O’Connell, P et al. Factors affecting length of stay in forensic hospital setting: need for therapeutic security and course of admission. BMC Psychiatry 2015; 15 (1): 301.CrossRefGoogle ScholarPubMed
Eckert, M, Schel, SH, Kennedy, HG, Bulten, BH. Patient characteristics related to length of stay in Dutch forensic psychiatric care. The Journal of Forensic Psychiatry & Psychology 2017; 28 (6): 863–80.CrossRefGoogle Scholar
Lawrence, D, Davies, TL, Bagshaw, R et al. External validity and anchoring heuristics: application of DUNDRUM-1 to secure service gatekeeping in South Wales. BJPsych Bulletin 2018; 42 (1): 10–18.CrossRefGoogle ScholarPubMed
Williams, HK, Senanayke, M, Ross, CC, Bates, R, Davoren, M. Security needs among patients referred for high secure care in Broadmoor Hospital, England. BJPsych Open 2020; 6 (4).CrossRefGoogle ScholarPubMed
Davoren, M, Abidin, Z, Naughton, L et al. Prospective study of factors influencing conditional discharge from a forensic hospital: the DUNDRUM-3 programme completion and DUNDRUM-4 recovery structured professional judgement instruments and risk. BMC Psychiatry 2013; 13: 185.CrossRefGoogle ScholarPubMed
Davoren, M, O’Dwyer, S, Abidin, Z et al. Prospective in-patient cohort study of moves between levels of therapeutic security: the DUNDRUM-1 triage security, DUNDRUM-3 programme completion and DUNDRUM-4 recovery scales and the HCR-20. BMC Psychiatry 2012; 12: 80.CrossRefGoogle ScholarPubMed
Adams, J, Thomas, SD, Mackinnon, T, Eggleton, D. The risks, needs and stages of recovery of a complete forensic patient cohort in an Australian state. BMC Psychiatry 2018; 18 (1): 35.CrossRefGoogle Scholar
Wharewera-Mika, J, Cooper, E, Wiki, N et al. The appropriateness of DUNDRUM-3 and DUNDRUM-4 for Māori in forensic mental health services in New Zealand: participatory action research. BMC Psychiatry 2020; 20 (1): 1–9.CrossRefGoogle ScholarPubMed
Müller-Isberner, R, Webster, CD, Gretenkord, L. Measuring progress in hospital order treatment: relationship between levels of security and C and R scores of the HCR-20. International Journal of Forensic Mental Health 2007; 6 (2): 113–21.CrossRefGoogle Scholar
Pillay, SM, Oliver, B, Butler, L, Kennedy, HG. Risk stratification and the care pathway. Irish Journal of Psychological Medicine 2008; 25 (4): 123–7.CrossRefGoogle ScholarPubMed
Abidin, Z, Davoren, M, Naughton, L et al. Susceptibility (risk and protective) factors for in-patient violence and self-harm: prospective study of structured professional judgement instruments START and SAPROF, DUNDRUM-3 and DUNDRUM-4 in forensic mental health services. BMC Psychiatry 2013; 13: 197.CrossRefGoogle ScholarPubMed
Dolan, M, Blattner, R. The utility of the Historical Clinical Risk-20 Scale as a predictor of outcomes in decisions to transfer patients from high to lower levels of security: a UK perspective. BMC Psychiatry 2010; 10 (1): 76.CrossRefGoogle ScholarPubMed
Dolan, M, Khawaja, A. The HCR–20 and post‐discharge outcome in male patients discharged from medium security in the UK. Aggressive Behavior: Official Journal of the International Society for Research on Aggression 2004; 30 (6): 469–83.CrossRefGoogle Scholar
SanSegundo, MS, Ferrer-Cascales, R, Bellido, JH et al. Prediction of violence, suicide behaviors and suicide ideation in a sample of institutionalized offenders with schizophrenia and other psychosis. Frontiers in Psychology 2018; 9: 1385.CrossRefGoogle Scholar
Ogloff, JR, Daffern, M. The dynamic appraisal of situational aggression: an instrument to assess risk for imminent aggression in psychiatric inpatients. Behavioral Sciences & the Law 2006; 24 (6): 799–813.CrossRefGoogle ScholarPubMed
Hvidhjelm, J, Sestoft, D, Skovgaard, LT et al. Aggression in psychiatric wards: effect of the use of a structured risk assessment. Issues in Mental Health Nursing 2016; 37 (12): 960–7.CrossRefGoogle ScholarPubMed
Maguire, T, Daffern, M, Bowe, SJ, McKenna, B. Evaluating the impact of an electronic application of the Dynamic Appraisal of Situational Aggression with an embedded Aggression Prevention Protocol on aggression and restrictive interventions on a forensic mental health unit. International Journal of Mental Health Nursing 2019; 28 (5): 1186–97.CrossRefGoogle ScholarPubMed
Kennedy, HG, Davoren, M, O’Flynn, P, O’Sullivan OP, . How to measure progress in forensic care. In Birgit Vollm, PB (ed.) Long-Term Forensic Psychiatric Care: Clinical, Ethical and Legal Challenges. Cham, Switzerland Springer International Publishing, 2019, pp. 103–21.Google Scholar
Kennedy, HG, Mullaney, R, McKenna, P et al. A tool to evaluate proportionality and necessity in the use of restrictive practices in forensic mental health settings: the DRILL tool (Dundrum restriction, intrusion and liberty ladders). BMC Psychiatry 2020; 20 (1): 515.CrossRefGoogle ScholarPubMed
Reed, J. The need for longer term psychiatric care in medium or low security. Criminal Behaviour and Mental Health 1997; 7 (3): 201–12.CrossRefGoogle Scholar
Huband, N, Furtado, V, Schel, S et al. Characteristics and needs of long-stay forensic psychiatric inpatients: a rapid review of the literature. International Journal of Forensic Mental Health 2018; 17 (1): 45–60.CrossRefGoogle Scholar
Völlm, B, Edworthy, R, Holley, J et al. A mixed-methods study exploring the characteristics and needs of long stay patients in high and medium secure settings in England: implications for service organisation. Health Services and Delivery Research 2017; 5 (11): 1–234.CrossRefGoogle Scholar
O’Neill, C, Heffernan, P, Goggins, R et al. Long-stay forensic psychiatric inpatients in the Republic of Ireland: aggregated needs assessment. Irish Journal of Psychological Medicine 2003; 20 (4): 119–25.Google ScholarPubMed
Mezey, G, Hassell, Y, Bartlett, A. Safety of women in mixed-sex and single-sex medium secure units: staff and patient perceptions. British Journal of Psychiatry 2005; 187: 579–82.CrossRefGoogle ScholarPubMed
Harty, M, Somers, N, Bartlett, A. Women’s secure hospital services: national bed numbers and distribution. The Journal of Forensic Psychiatry & Psychology 2012; 23 (5–6): 590–600.CrossRefGoogle ScholarPubMed
Davoren, M, Hennessy, S, Conway, C et al. Recovery and concordance in a secure forensic psychiatry hospital: the self rated DUNDRUM-3 programme completion and DUNDRUM-4 recovery scales. BMC Psychiatry 2015; 15 (1): 61.CrossRefGoogle Scholar
Adams, J, Thomas, SDM, Mackinnon, T, Eggleton, D. The risks, needs and stages of recovery of a complete forensic patient cohort in an Australian state. BMC Psychiatry 2018; 18 (1): 35.CrossRefGoogle Scholar
Coid, JW, Hickey, N, Yang, M. Comparison of outcomes following after-care from forensic and general adult psychiatric services. British Journal of Psychiatry 2007; 190: 509–14.CrossRefGoogle ScholarPubMed
Leonard, SJ, Webb, RT, Shaw, J. Service transitions, interventions and care pathways following remittal to prison from medium secure psychiatric services in England and Wales: national cohort study. BJPsych Open 2020; 6 (5): e80.CrossRefGoogle ScholarPubMed
Snowden, P, McKenna, J, Jasper, A. Management of conditionally discharged patients and others who present similar risks in the community: integrated or parallel? The Journal of Forensic Psychiatry 1999; 10 (3): 583–96.CrossRefGoogle Scholar
Donnelly, V, Lynch, A, Mohan, D, Kennedy, HG. Working alliance, interpersonal trust and perceived coercion in mental health review hearings. International Journal of Mental Health Systems 2011; 5 (1): 29.CrossRefGoogle ScholarPubMed
Allen, E. Your Guide to Relational Security: See, Think, Act, 3rd ed. London, Royal College of Psychiatrists, 2023.Google Scholar
Patel, VL, Kaufman, DR, Magder, SA. The acquisition of medical expertise in complex dynamic environments. In Ericsson, A (ed.) The Road to Excellence: The Acquisition of Expert Performance in the Arts and Sciences, Sports and Games. Hillside, NJ, Lawrence Erlbaum Publishers, 1996, pp. 127–65.Google Scholar
Patel, VL, Kaufman, DR, Magder, SA. The acquisition of medical expertise in complex dynamic environments. In Ericsson, A (ed.) The Road to Excellence: The Acquisition of Expert Performance in the Arts and Sciences, Sports and Games. Hillside, NJ, Lawrence Erlbaum Publishers, 1996, pp. 127–65.Google Scholar
Galanter, CA, Patel, VL. Medical decision making: a selective review for child psychiatrists and psychologists. Journal of Child Psychology and Psychiatry, and Allied Disciplines 2005; 46 (7): 675–89.Google Scholar
Meehl, PE. Why I do not attend case conferences. Psychodiagnosis: Selected Papers 1973: 225–302.Google Scholar
Haque, Q, Webster, CD. Staging the HCR-20: towards successful implementation of team-based structured professional judgement schemes. Advances in Psychiatric Treatment 2012; 18 (1): 59–66.CrossRefGoogle Scholar
Council of Europe. Dangerous Offenders: Recommendation CM/Rec(2014)3 and Explanatory Report. Strasbourg, Council of Europe, 2014.Google Scholar
Richter, MS, O’Reilly, K, O’Sullivan, D et al. Prospective observational cohort study of ‘treatment as usual’ over four years for patients with schizophrenia in a national forensic hospital. BMC Psychiatry 2018; 18 (1): 289.CrossRefGoogle Scholar
McGuire, J. A review of effective interventions for reducing aggression and violence. Philosophical Transactions of the Royal Society of London Series B, Biological Sciences 2008; 363 (1503): 2577–97.Google ScholarPubMed
Uhrskov Sørensen, L, Bengtson, S, Lund, J, Ibsen, M, Långström, N. Mortality among male forensic and non-forensic psychiatric patients: matched cohort study of rates, predictors and causes-of-death. Nordic Journal of Psychiatry 2020: 1–8.CrossRefGoogle Scholar
Clarke, PDR, Gilchrist, L, Johnstone, L et al. Forensic mental health section. In NHS Education for Scotland (ed.) The Matrix: A Guide to Delivering Evidence-Based Psychological Therapies in Scotland. Edinburgh, The Scottish Government, 2011, pp. 241–9.Google Scholar
Kennedy, H. The DUNDRUM Toolkit V1.0.30. 2016.Google Scholar
Kennedy, H, Castelletti, L, O’Sullivan, O. Impact of Service Organisation on Teaching and Training; a cross border study guide. In Goethals, K (ed.) Forensic Psychiatry and Psychology in Europe. Cham, Springer, 2018, pp. 211–37.Google Scholar
Gunn, J. Management of the mentally abnormal offender: integrated or parallel. Journal of the Royal Society of Medicine 1977; 70 (12): 877–80.CrossRefGoogle ScholarPubMed
Campbell, M. The Matrix: A Guide to Delivering Evidence-Based Psychological Therapies in Scotland. Edinburgh, The Scottish Government, 2011.Google Scholar
O’Reilly, K, Donohoe, G, O’Sullivan, D et al. A randomized controlled trial of cognitive remediation for a national cohort of forensic patients with schizophrenia or schizoaffective disorder. BMC Psychiatry 2019; 19 (1): 27.CrossRefGoogle ScholarPubMed
Moritz, S, Kerstan, A, Veckenstedt, R et al. Further evidence for the efficacy of a metacognitive group training in schizophrenia. Behaviour Research and Therapy 2011; 49 (3): 151–7.CrossRefGoogle ScholarPubMed
Naughton, M, Nulty, A, Abidin, Z et al. Effects of group metacognitive training (MCT) on mental capacity and functioning in patients with psychosis in a secure forensic psychiatric hospital: a prospective-cohort waiting list controlled study. BMC Research Notes 2012; 5 (1): 302.CrossRefGoogle Scholar
Worrall, A. The service context for clinical guidelines: supporting guideline implementation by assuring and improving the quality of service in which clinicians work. International Review of Psychiatry 2011; 23 (4): 336–41.CrossRefGoogle ScholarPubMed
O’Flynn, P, O’Regan, R, O’Reilly, K, Kennedy, HG. Predictors of quality of life among inpatients in forensic mental health: implications for occupational therapists. BMC Psychiatry 2018; 18 (1): 16.CrossRefGoogle ScholarPubMed
Fortune, Z, Rose, D, Crawford, M et al. An evaluation of new services for personality-disordered offenders: staff and service user perspectives. International Journal of Social Psychiatry 2010; 56 (2): 186–95.CrossRefGoogle ScholarPubMed
Duggan, C. Dangerous and severe personality disorder. British Journal of Psychiatry 2011; 198 (6): 431–3.CrossRefGoogle ScholarPubMed
Tyrer, P, Cooper, S, Crawford, M et al. The successes and failures of the DSPD experiment: the assessment and management of severe personality disorder. Medicine, Science, and the Law 2010; 50: 95–9.CrossRefGoogle ScholarPubMed
Barrett, B, Byford, S. Collecting service use data for economic evaluation in DSPD populations Development of the Secure Facilities Service Use Schedule. The British Journal of Psychiatry Supplement 2007; 49: s75–8.Google ScholarPubMed
Kennedy, HG, O’Reilly, K, Davoren, M, O’Flynn, P, O’Sullivan, OP. How to Measure Progress in Forensic Care. In Völm, B, Braun, P (eds) Long-Term Forensic Psychiatric Care: Clinical, Ethical and Legal Challenges. Cham, Springer, 2019, pp. 103–21.Google Scholar
Carroll, C, Patterson, M, Wood, S et al. A conceptual framework for implementation fidelity. Implementation Science 2007; 2 (1): 40.CrossRefGoogle ScholarPubMed
Bopp, M, Saunders, RP, Lattimore, D. The tug-of-war: fidelity versus adaptation throughout the health promotion program life cycle. The Journal of Primary Prevention 2013; 34 (3): 193–207.CrossRefGoogle ScholarPubMed
Vincent, GM, Guy, LS, Gershenson, BG, McCabe, P. Does risk assessment make a difference? Results of implementing the SAVRY in juvenile probation. Behavioral Sciences & the Law 2012; 30 (4): 384–405.CrossRefGoogle ScholarPubMed
Vincent, GM, Guy, LS, Perrault, RT, Gershenson, B. Risk assessment matters, but only when implemented well: a multisite study in juvenile probation. Law and Human Behavior 2016; 40 (6): 683–96.CrossRefGoogle Scholar
Talbot, E, Bird, Y, Russell, J et al. Implementation of individual placement and support (IPS) into community forensic mental health settings: lessons learned. British Journal of Occupational Therapy 2018; 81 (6): 338–47.CrossRefGoogle Scholar
Scott, K, Lewis, CC. Using measurement-based care to enhance any treatment. Cognitive and Behavioral Practice 2015; 22 (1): 49–59.CrossRefGoogle ScholarPubMed
Harding, KJK, Rush, AJ, Arbuckle, M, Trivedi, MH, Pincus, HA. Measurement-based care in psychiatric practice: a policy framework for implementation. The Journal of Clinical Psychiatry 2011; 72 (8): 1136–43.CrossRefGoogle ScholarPubMed
Glancy, G, Choptiany, M, Jones, R, Chatterjee, S. Measurement-based care in forensic psychiatry. International Journal of Law and Psychiatry 2021; 74: 101650.CrossRefGoogle ScholarPubMed
Bulten, E, Verkes, RJ. Long stay in Europe: a systems-oriented approach. In Völlm, B, Braun, P (eds) Long-Term Forensic Psychiatric Care: Clinical, Ethical and Legal Challenges. Cham, Springer International Publishing, 2019, pp. 27–45.Google Scholar
Taylor, PJ, Maden, A, Jones, D. Long‐term medium‐security hospital units: a service gap of the 1990s? Criminal Behaviour and Mental Health 1996; 6 (3): 213–29.CrossRefGoogle Scholar
Smeekens, MV, Braun, P. Long-term forensic psychiatric care: the Dutch perspective. In Völlm, B, Braun, P (eds) Long-Term Forensic Psychiatric Care: Clinical, Ethical and Legal Challenges. Cham, Springer International Publishing, 2019, pp. 235–50.Google Scholar
Vorstenbosch, ECW, Escuder-Romeva, G. Quality of life in long-term clinical forensic psychiatry. In Völlm, B, Braun, P (eds) Long-Term Forensic Psychiatric Care: Clinical, Ethical and Legal Challenges. Cham, Springer International Publishing, 2019, pp. 139–59.Google Scholar
Simpson, AIF, Gerritsen, C, Maheandiran, M et al. A systematic review of reviews of correctional mental health services using the STAIR framework. Frontiers in Psychiatry 2022; 12.CrossRefGoogle Scholar
McInerney, C, Davoren, M, Flynn, G et al. Implementing a court diversion and liaison scheme in a remand prison by systematic screening of new receptions: a 6 year participatory action research study of 20,084 consecutive male remands. International Journal of Mental Health Systems 2013; 7: 18.CrossRefGoogle Scholar
Greenberg, D, Nielsen, B. Court diversion in NSW for people with mental health problems and disorders. New South Wales Public Health Bulletin 2002; 13 (7): 158–60.CrossRefGoogle ScholarPubMed
Gunn, J. Management of the Mentally Abnormal Offender: Integrated or Parallel. Proceedings of the Royal Society of Medicine 1977; 70 (12): 877–80.Google ScholarPubMed
Khosla, V, Davison, P, Gordon, H, Joseph, V. The interface between general and forensic psychiatry: the present day. Advances in Psychiatric Treatment 2014; 20 (5): 359–65.CrossRefGoogle Scholar

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