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The prevalence of constant supportive observations in high, medium and low secure services

  • Katie Lambert (a1), Simon Chu (a1) (a2), Chris Duffy (a1), Victoria Hartley (a1), Alison Baker (a3) and Jane L. Ireland (a1) (a2) (a3)...

Abstract

Aims and method

We explored the prevalence and use of constant supportive observations (CSO) in high, medium and low secure in-patient services in a single National Health Service (NHS) mental health trust. From clinical records, we extracted data on the length of time of CSO, the reason for the initiation of CSO and associated adverse incidents for all individuals who were placed on CSO between July 2013 and June 2014.

Results

A small number of individuals accounted for a disproportionately large proportion of CSO hours in each setting. Adverse incident rates were higher on CSO than when not on CSO. There was considerable variation between different settings in terms of CSO use and the reasons for commencing CSO.

Clinical implications

The study describes the prevalence and nature of CSO in secure forensic mental health services and the associated organisational costs. The marked variation in CSO use between settings suggests that mental health services continue to face challenges in balancing risk management with minimising restrictive interventions.

Declaration of interest

A.B. and J.L.I. are both directly employed by the NHS trust in which the study was conducted.

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Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence to Simon Chu (SChu@uclan.ac.uk)

References

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The prevalence of constant supportive observations in high, medium and low secure services

  • Katie Lambert (a1), Simon Chu (a1) (a2), Chris Duffy (a1), Victoria Hartley (a1), Alison Baker (a3) and Jane L. Ireland (a1) (a2) (a3)...

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The prevalence of constant supportive observations in high, medium and low secure services

  • Katie Lambert (a1), Simon Chu (a1) (a2), Chris Duffy (a1), Victoria Hartley (a1), Alison Baker (a3) and Jane L. Ireland (a1) (a2) (a3)...
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