Ageing in forensic psychiatric secure settings: the views of members of staff

Claudio Di Lorito,Tom Dening,Birgit Völlm

doi:10.1080/14789949.2018.1542449

Claudio Di Lorito, Tom Dening + Show 1 more

Open Access

https://doi.org/10.1080/14789949.2018.1542449

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Abstract

ABSTRACTBackground: Although the prevalence of older patients in forensic psychiatric services is increasing, research around service provision for this population is very limited. We aimed to gather the views of members of staff on how well secure services are meeting the challenges of an ageing population.Methods: Three focus groups were carried out with 13 members of staff working with older patients in secure services. A topic guide, based on the research team’s previous research, guided the sessions. The focus groups were audio-recorded, transcribed and analysed through thematic analysis.Results: Two themes were identified: (1) Identifying patients’ needs, which focused on how promptly any emerging issues in the older patients are identified and reported; (2) addressing patients’ needs, which focused on how the unique needs of the older patients are addressed, once established.Conclusions: There are unique age-related issues that may have an impact on the older patients’ opportunities for recovery, including a lack of specialist training for members of staff, prolonged stay in secure care and a limited number of age-relevant activities. Far from optimal, provision requires improvement through the active involvement of the primary stakeholders.

Highlights

Secure forensic psychiatric services in England and Wales offer specialist treatment to individuals, who, given the severity of their mental illness, may pose a safety risk to themselves and others.In the United Kingdom and in several other Western countries, individuals over 50 years old in secure services represent around 20% of the patient population (Di Lorito, Dening, & Völlm, 2018a; Di Lorito et al, 2017)
Two themes were identified: (i) Identifying patients’ needs, which focused on how promptly any emerging issues in the older patients are identified and reported; (ii) addressing patients’ needs, which focused on how the unique needs of the older patients are addressed, once established
Older patients experience longer stays than the overall forensic psychiatric population (Lightbody, Gow & Gibb, 2010), prisoners sentenced for the same offence and patients in general psychiatric settings (Vӧllm, Bartlett & McDonald, 2016)

Summary

Introduction

In the United Kingdom and in several other Western countries, individuals over 50 years old in secure services represent around 20% of the patient population (Di Lorito, Dening, & Völlm, 2018a; Di Lorito et al, 2017) This percentage is destined to grow, given the ageing of the population (Senior et al, 2013), less lenient approaches to elder crime and the more frequent prosecution of historical offences, compared to the past (RECOOP, 2015; Yorston, 2015; Moll, 2013; Frazer, 2003). Older patients experience longer stays than the overall (i.e. all ages) forensic psychiatric population (Lightbody, Gow & Gibb, 2010), prisoners sentenced for the same offence and patients in general psychiatric settings (Vӧllm, Bartlett & McDonald, 2016) These factors combined cause an accumulation of long-term and newly admitted older patients in secure care. We aimed to gather the views of members of staff on how well secure services are meeting the challenges of an ageing population

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