Abstract
The development of forensic psychiatry provision in Scotland lags behind that in other parts of the United Kingdom. Until recently, there were no medium secure units in the country and mentally disordered offenders (MDOs) requiring such care had to be managed in intensive psychiatric care unit (IPCU) settings. In November 2000, The Orchard Clinic, a medium secure unit sited at the Royal Edinburgh Hospital, was opened. This paper discusses the background to this development, the government policies setting out plans for the care, services and support of MDOs in Scotland, progress and work of the new unit to date and plans for developments in other parts of Scotland.
Highlights
The development of forensic psychiatry provision in Scotland lags behind that in other parts of the United Kingdom
Two reports (Department of Health and Social Security, 1974; Home Office/Department of Health and Social Secuity, 1975) recommended the development of medium secure units in each health authority region and the latter suggested that 1000 beds would be required in England
It stated that health boards and local authorities should enter service-level agreements with the criminal justice agencies to provide effective local arrangements for the assessment and treatment of people who appear to be mentally disordered
Summary
The sub-speciality of forensic psychiatry has expanded greatly over the past 15 to 20 years. In 1970, there were only two forensic psychiatrists in England, there were no medium secure units and, outside of ordinary psychiatric hospitals, MDOs were either treated in special hospitals or in prison. Two reports (Department of Health and Social Security, 1974; Home Office/Department of Health and Social Secuity, 1975) recommended the development of medium secure units in each health authority region and the latter suggested that 1000 beds would be required in England. A further report (Department of Health/Home Office, 1992) highlighted the need for MDOs to be cared for in a hospital setting rather than within the criminal justice system. This report found that there were 602 beds in medium secure units in England, considerably less than the 1500 beds it recommended
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