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Use of an extra care area in a medium secure setting for women: Findings and implications for practice

Published online by Cambridge University Press:  13 November 2009

Clive G Long ,
Pheon Silaule  and
Naomi Collier
Clive G Long*
Affiliation:
St Andrew’s Healthcare, St Andrew’s Hospital, Northampton, UK
Pheon Silaule
Affiliation:
St Andrew’s Healthcare, St Andrew’s Hospital, Northampton, UK
Naomi Collier
Affiliation:
St Andrew’s Healthcare, St Andrew’s Hospital, Northampton, UK
*
Correspondence to: Dr C.G. Long, St Andrews Healthcare, Billing Road, Northampton, NN1 5DG. Tel: 01604 616307; E-mail: clong@standrew.co.uk
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Abstract

An evaluation of the Extra Care Area (ECA) in a medium secure psychiatric facility for women is described. A retrospective case note audit over an 18 month period concluded that the ECA was used infrequently for the most disturbed service users who had previously been frequently secluded. Ongoing self harm and aggression in ECA was a feature of some cases raising the possibility that admission may be counter productive for some, particularly when it is combined with a lack of occupational stimulation. Service users valued the opportunity for reflection in a low stimulus environment and there were no repeat admissions. A number of initiatives to improve multidisciplinary care planning, documentation, therapeutic engagement and service user involvement to reduce risk have been actioned. Of particular importance is the need to begin ‘discharge planning’ at the first point of entry to avoid prolonged stays, isolation from peers and dependence on both individual staff attention and a special status living arrangement.

Keywords

Extra care areamedium securewomen’s servicesrisk behaviours
Type
Review
Information
Journal of Psychiatric Intensive Care , Volume 6 , Issue 1 , June 2010 , pp. 39 - 45
Copyright
Copyright © NAPICU 2010

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