Abstract
Substance misuse is prevalent amongst patients detained in secure psychiatric hospitals in England, and is associated with more negative outcomes. However, no data has been published on the availability of substance misuse treatment services in secure units. This questionnaire-based study examined staff impressions of the prevalence and impact of substance misuse problems in secure units, and the availability of treatment services. It found that substance misuse was perceived as a major problem with a substantial impact. However, service provision was poor: some units had no access to treatment services at all and, when services were available, they tended to focus on awareness-raising or relapse prevention rather than treatment of current substance misuse. Few units appeared to be able to refer their patients to the local NHS addictions service.
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