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Managing returns to prison from medium-secure services: qualitative study.

Sarah-Jayne Leonard1, Caroline Sanders2, Jennifer J Shaw3

  • 1Offender Health Research Network, Centre for Mental Health and Safety, University of Manchester, UK.

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|June 8, 2021
PubMed
Summary
This summary is machine-generated.

Discharge decisions for prisoners in medium-secure mental health services are influenced by external factors and resource limitations. Reconsidering treatment criteria and increasing provision are crucial for effective rehabilitation.

Keywords:
Forensic mental health servicesoffender pathwayprison mental healthsecure services

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Area of Science:

  • Forensic Psychiatry
  • Mental Health Services Research
  • Criminal Justice System

Background:

  • Limited understanding of discharge decision-making for individuals transitioning from prison to medium-secure mental health services.
  • Specific challenges exist for patients returned to prison after treatment.

Purpose of the Study:

  • To investigate organizational influences on care pathways for individuals admitted to medium-secure services from correctional facilities.
  • To identify factors impacting treatment and discharge decisions within these specialized services.

Main Methods:

  • Purposive and snowball sampling recruited 24 clinicians.
  • Data collected through focus groups (13 clinicians) and semi-structured interviews (11 clinicians).
  • Thematic analysis identified key themes in clinician experiences.

Main Results:

  • External factors, including commissioning criteria and legal status (Mental Health Act 1983, court status), significantly direct clinicians' pathway decisions.
  • These external factors shape clinicians' perceptions of medium-secure services' role and appropriate patient profiles.
  • Discretionary decisions regarding continued treatment are influenced by these systemic and legal considerations.

Conclusions:

  • A significant deficit exists in resources to address the mental health needs of prisoners in medium-secure services.
  • Revising criteria for prolonged treatment in medium-secure settings is necessary to meet clinical needs.
  • Substantial increases in medium-secure hospital capacity are likely required for effective rehabilitation of this population.