A study of patients identified as unmanageable prior to admission to an independent medium-secure hospital

A previous study of patient admissions to an independent medium-secure psychiatric hospital by Moss, Green and Naismith (1996) suggested an increased flexibility in the admission of patients identified as having 'exceptional management problems.' In particular this was found to relate to a cohort of 59 patients admitted after having been identified as 'unmanageable' in their parent district. This appeared to provide the impetus, for a number of reasons, for their subsequent referral to the private sector. This study examines the characteristics of these patients, and discusses how the independent sector may be providing a service either unavailable within the National Health Service or for which the National Health Service is unsuitable, in terms of patients either requiring medium- to long-term hospital care in conditions of security, or those who cannot live independently and therefore require 'asylum' (which is no longer available within the National Health Service). In this sense the independent sector could be seen as meeting a national need by acting as a 'safety valve' for National Health Service psychiatric facilities.