A psychoanalytic view of two forensic mental health services

The work of forensic mental health practitioners is particularly challenging because of the pervasive and long-term difficulties of mentally disordered offenders and the combined therapeutic and custodial duties of forensic services. Despite this, little has been written about the psychological impact of this type of work on staff and the organization of forensic services. The focus in this article is on two services where the author worked: a regional secure unit (RSU) and community forensic mental health service. The complexity of the task in both services is discussed. Suggestions are made about the feelings, conscious and unconscious, which the task and working environment arouse in practitioners. Observations relating to the working culture of the two services are offered, broadly understood as organizational defences against anxiety in the staff groups. Concepts from the psychoanalytic study of organizations are used to analyse these observations. There is a discussion as to how to limit the need for the development of organizational defences in forensic mental health.