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Redeveloping secure psychiatric services for women.

Stuart D M Thomas¹, Mairead Dolan, Jenny Shaw

¹Institute of Psychiatry, King's College London, UK. s.thomas@iop.kcl.ac.uk

Medicine, Science, and the Law

|November 24, 2005

Summary

Many women are detained in high-security psychiatric hospitals due to a lack of alternatives. Research shows lower-security settings better meet the needs of some detained women, indicating a need for service reorganization.

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Area of Science:

Forensic Psychiatry
Mental Health Services Research
Clinical Psychology

Background:

Historically, insufficient alternative facilities have led to women's over-detention in high-security psychiatric hospitals (HSPHs) in England.
Previous research has not comprehensively addressed the specific placement and individual needs of these women.

Purpose of the Study:

To survey the individual and placement needs of all females detained in English HSPHs.
To inform service reorganization and improve care for detained women.

Main Methods:

A cross-sectional survey was conducted on October 18, 1999, involving all females in England's three HSPHs.
Data collected focused on individual needs and placement requirements.

Main Results:

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Women requiring lower security services showed significantly lower needs related to violence (OR 0.29) and drug use (OR 0.29) when length of stay was considered.
These women also had lower security, treatment, and dependency needs compared to those remaining in HSPHs.
Differences in accommodation needs were observed among the women.

Conclusions:

A significant reorganization of mental health services is necessary to better accommodate the diverse needs of detained women.
Further research is needed to understand the links between trauma, clinical presentation, antisocial behavior, risk assessment, and care needs.
Prioritizing the special needs of these women in treatment and care planning is crucial.