From special hospital to regional secure unit: a qualitative study of the problems experienced by patients

For those patients in the United Kingdom who are compulsorily detained in a special hospital the most common route of release is via other psychiatric hospitals, especially regional secure units. That a large percentage of these patients are subsequently readmitted (43% in this study) indicates that they experience problems within the regional secure unit. A grounded theory approach was used to investigate this experience from the patients' perspective by interviewing a sample of 14 patients who had been readmitted to one special hospital. Data analysis can prove difficult in grounded theory and the approach that was used--a variant of the constant comparative method--is described. A number of inductively developed categories were generated from the interview data and one category is reported here. From these categories a theory of 'failure' is postulated that, it is contended, both describes and explains the process of readmission. Finally, the implications for practice in terms of the preparation of patients for transfer are addressed.