The need for longer term psychiatric care in medium or low security

Abstract

AbstractThe provision of long‐term inpatient care for some mentally disordered patients is one objective of mental health policy. Because medium‐secure units were established in England with the objective of patients staying between 18 and 24 months, longer term care in secure conditions in England and Wales has mainly been provided by the high‐security (special) hospitals. There has been very limited provision specifically designed for patients needing longer term psychiatric care in security below the levels of the high‐security hospitals. This has led to patients being detained in inappropriate levels of security or in acute wards when rehabilitative care is more appropriate. A survey of all patients in all high‐ or medium‐secure units in England and Wales in December 1994 by questionnaire to their consultants showed that of some 1500 patients in the high‐security special hospitals, 490 would be more appropriately placed in longer term medium security and 150 in longer term low security. Of some 1250 patients in the current shorter stay medium‐secure units, 183 were considered to need longer term medium security and 278 longer term low security. To these must be added those in the general psychiatric service who need local/low secure care, perhaps 1300 in England. Overall there appears to be a need for some 750 beds in England and Wales offering long‐term medium security and 2000 beds offering longer term low security. Copyright © 1997 Whurr Publishers Ltd.