Skip to main content Accessibility help
×
Hostname: page-component-76fb5796d-25wd4 Total loading time: 0 Render date: 2024-04-26T23:21:48.326Z Has data issue: false hasContentIssue false

Chapter 11 - Forensic Psychiatry and Adult Inpatient Secure Settings

from Section 3 - Violence in Different Settings

Published online by Cambridge University Press:  09 May 2023

Masum Khwaja
Affiliation:
Imperial College of Science, Technology and Medicine, London
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Get access

Summary

Forensic psychiatry is a medical discipline, developed from the foundations of the asylum era, which focuses on the assessment and treatment of offenders with mental disorders. The complexity of the patient cohort is arguable reflected in the complexity of their clinical pathways, which necessitates some understanding of the legal system that for most patients, works in parallel to that of health and social care. In this chapter, we briefly review the historical context through which modern forensic psychiatry has emerged within England and Wales. This includes some high-profile individual cases that led to the development of concepts such as fitness to plead and the psychiatric defence of not guilty by reason of insanity. We then provide an outline of how inpatient secure services are structured, the relevant criminal sections of the Mental Health Act at each stage of the trial process and some of the challenges associated with managing this complex cohort of individuals.

Type
Chapter
Information
The Prevention and Management of Violence
Guidance for Mental Healthcare Professionals
, pp. 166 - 186
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Forshaw, D. The Origins and Early Development of Forensic Mental Health. Handbook of Forensic Mental Health. London: Routledge; 2008.Google Scholar
Crotty, H. D. The history of insanity as a defence to crime in English criminal law. California Law Review 1924;12(2):105–23.Google Scholar
Hamilton, J. R. Insanity legislation. Journal of Medical Ethics 1986;12(1):1317.Google Scholar
Peters, T. King George III, bipolar disorder, porphyria and lessons for historians. Clinical Medicine (London) 2011;11(3):261–4.Google Scholar
Gutheil, T. G. The history of forensic psychiatry. Journal of the American Academy of Psychiatry and the Law Online 2005;33(2):259.Google Scholar
Moran, R. The origin of insanity as a special verdict: The trial for treason of James Hadfield (1800). Law & Society Review. 1985;19(3):487519.Google Scholar
Pritchard, Rv. 7 Car & P 303, 7 Car and P 304, 173 ER 135, [1836] EWHC KB 1, 7 Car & P 303 1836. www.bailii.org/ew/cases/EWHC/KB/1836/1.html. Accessed 01.05.2022].Google Scholar
Brown, P. Unfitness to plead in England and Wales: Historical development and contemporary dilemmas. Medicine, Science and the Law 2019;59(3):187–96.Google Scholar
Law Commission. Unfitness to Plead: Law Commission; 2016. www.lawcom.gov.uk/project/unfitness-to-plead/. Accessed 01.05.2022.Google Scholar
Marcantonio, v R. (Rev 1) [2016] EWCA Crim 14. www.bailii.org/ew/cases/EWCA/Crim/2016/14.html. Accessed 01.05.2022.Google Scholar
West, D. J. and Walk, A. Daniel McNaughton His Trial and the Aftermath. London: Gaskell; 1977.Google Scholar
Ellison, D. R. and Hass, H. E. A recent judicial interpretation of the M’Naghten Rules. The British Journal of Delinquency 1953;4(2):128–33.Google Scholar
Moran, R. Knowing Right from Wrong. The Insanity Defense of Daniel McNaughtan. New York: The Free Press; 1981.Google Scholar
Daniel, M’Naghten’s Case UKHL J16, 8 ER 718 1843. www.bailii.org/uk/cases/UKHL/1843/J16.html. Accessed 01.05.2022.Google Scholar
Law Commission. Insanity and Automatism: Law Commission; 2013. www.lawcom.gov.uk/project/insanity-and-automatism/. Accessed 01.05.2022.Google Scholar
HM Government. Mental Health Act 1959. London: HMSO; 1959. www.legislation.gov.uk/ukpga/Eliz2/7-8/72. Accessed 01.05.2022.Google Scholar
HM Government. Report of the Committee of Inquiry into the Personality Disorder Unit, Ashworth Special Hospital. London: HMSO; 1999. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/265696/4194.pdf. Accessed 01.05.2022.Google Scholar
HM Government. Reforming the Mental Health Act: Summary, Department of Health and Social Care. London: HMSO; 2021. www.gov.uk/government/consultations/reforming-the-mental-health-act/reforming-the-mental-health-act. Accessed 01.05.2022.Google Scholar
Pollitt, J. D. Management of the mentally abnormal offender. Proceedings of the Royal Society of Medicine 1977;70:877–80.Google Scholar
HM Government. Special Hospitals. Ministry of Health. London: HMSO; 1961.Google Scholar
Ewins, D. The Butler Report. British Journal of Law and Society 1976;3(1):101–9.Google Scholar
Coid, J. W. The Christopher Clunis enquiry. Psychiatric Bulletin 1994;18(8):449–52.Google Scholar
Bowden, P. Graham Young (1947–90); the St Albans poisoner: his life and times. Criminal Behaviour and Mental Health 1996;6(S1):1724.Google Scholar
NHS England, Services specification: High secure mental health services (Adult). London: NHS England 2021. www.england.nhs.uk/publication/service-specification-high-secure-mental-health-services-adult/. Accessed 04.01.2023.Google Scholar
NHS England. Service specification: Medium secure mental health services (Adult). London: NHS England; 2018. www.england.nhs.uk/publication/service-specification-medium-secure-mental-health-services-adult/. Accessed 01.05.2022.Google Scholar
NHS England. Service specification: Low secure mental health services (Adult). London: NHS England; 2018. www.england.nhs.uk/publication/service-specification-low-secure-mental-health-services-adult/. Accessed 01.05.2022.Google Scholar
Kennedy, HG. Therapeutic uses of security: Mapping forensic mental health services by stratifying risk. Advances in Psychiatric Treatment 2002;8(6):433–43.Google Scholar
HM Government. Best practice guidance: Specification for adult medium-secure services. Department of Health. London: HMSO; 2007. http://data.parliament.uk/DepositedPapers/Files/DEP2007-0001/DEP2007-0001.pdf. Accessed 02.05.2022.Google Scholar
Quality Network for Forensic Mental Health Services. Physical Security in Secure Care London: RCPsych. www.rcpsych.ac.uk/docs/default-source/improving-care/ccqi/quality-networks/secure-forensic/qnfmhs-physical-security-in-secure-care.pdf?sfvrsn=9a67ef6d_2. Accessed 01.05.2022.Google Scholar
Quality Network for Forensic Mental Health Services. See Think Act. London: RCPsych. www.rcpsych.ac.uk/improving-care/ccqi/quality-networks-accreditation/forensic-mental-health-services/see-think-act. Accessed 01.05.2022.Google Scholar
Royal College of Psychiatrists. Quality Network for Forensic Mental Health Services London: RCPsych. www.rcpsych.ac.uk/improving-care/ccqi/quality-networks-accreditation/forensic-mental-health-services. Accessed 02.05.2022.Google Scholar
Quality Network for Forensic Mental Health Services. Relational Security Explorer. London: RCPsych. www.rcpsych.ac.uk/docs/default-source/improving-care/ccqi/quality-networks/secure-forensic/forensic-see-think-act-qnfmhs/sta_hndbk_2nded_web.pdf?sfvrsn=90e1fc26_4. Accessed 01.05.2022.Google Scholar
Douglas, K. S., Hart, S. D., Webster, C. D. et al. Historical-Clinical-Risk Management-20, Version 3 (HCR-20V3): Development and Overview. International Journal of Forensic Mental Health 2014;13(2):93108.Google Scholar
Council of Europe. European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT). Strasbourg: Council of Europe. www.coe.int/en/web/cpt. Accessed 02.05.2022.Google Scholar
Kennedy, H. G., O’Neill, C., Flynn, G., Gill, P. and Davoren, M. The DUNDRUM Toolkit V1.0.30. Dublin: Trinity’s Access to Research Archive; 2016. www.tara.tcd.ie/handle/2262/76545. Accessed 01.05.2022.Google Scholar
Institute of Mental Health. Secure hospital care: Information for carers 2018. https://institutemh.org.uk/images/research/7778_Secure_Hospital_Care_Brochure_A5_Online.pdf. Accessed 04.01.2023.Google Scholar
Centre for Mental Health. Briefing Note: Secure Care Services 2013. www.centreformentalhealth.org.uk/sites/default/files/2018-09/securecare.pdf. Accessed 04.01.2023.Google Scholar
HM Government. High security psychiatric services directions 2019: Arrangements for safety and security. London: HMSO; 2019.Google Scholar
NHS England. The offender personality disorder pathway strategy 2015. London. www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2016/02/opd-strategy-nov-15.pdf. Accessed 17.04.2022.Google Scholar
Till, A., Selwood, J. and Silva, E. The assertive approach to clozapine: Nasogastric administration. BJPsych Bulletin 2019;43(1):21–6.Google Scholar
Blott, H., Bhattacherjee, S. and Harris, E. An evaluation of the use of electroconvulsive therapy in a United Kingdom high secure psychiatric hospital. European Psychiatry 2017;41(S1):S373-S.Google Scholar
Saleem, R., Kaitiff, D., Treasaden, I. and Vermeulen, J. Clinical experience of the use of triptorelin as an antilibidinal medication in a high-security hospital. Journal of Forensic Psychiatry & Psychology 2011;22(2):243–51.Google Scholar
Hare Duke, L., Furtado, V., Guo, B. and Völlm, B. A. Long-stay in forensic-psychiatric care in the UK. Social Psychiatry and Psychiatric Epidemiology 2018;53(3):313–21.Google Scholar
National Association of Psychiatric Intensive Care & Low Secure Units 2022. https://napicu.org.uk/. Accessed 17.04.2022.Google Scholar
Sarkar, J. and di Lustro, M. Evolution of secure services for women in England. Advances in Psychiatric Treatment 2011;17(5):323–31.Google Scholar
Sahota, S., Davies, S., Duggan, C. et al. Women admitted to medium secure care: Their admission characteristics and outcome as compared with men. International Journal of Forensic Mental Health 2010;9(2):110–17.Google Scholar
Bartlett, A. and Hassell, Y. Do women need special secure services? Advances in Psychiatric Treatment 2001;7(4):302–9.Google Scholar
Milne, S., Barron, P., Fraser, K. and Whitfield, E. Sex differences in patients admitted to a regional secure unit. Medicine, Science and the Law 1995;35(1):5760.Google Scholar
Coid, J., Kahtan, N., Gault, S. and Jarman, B. Women admitted to secure forensic psychiatry services: Comparison of women and men. Journal of Forensic Psychiatry 2000;11(2):275–95.Google Scholar
National Health Service. National Deaf Services: South West London and St George’s Mental Health NHS Trust. www.swlstg.nhs.uk/our-services/specialist-services/national-deaf-services. Accessed 01.05.2022.Google Scholar
HM Government. Transforming care: A national response to Winterbourne View Hospital. Department of Health. London: HMSO; 2012.Google Scholar
HM Government. Mentally disordered offenders – the restricted patient system. Ministry of Justice. London: HMSO; 2020.Google Scholar
Vai, B., Mazza, M. G., Delli Colli, C. et al. Mental disorders and risk of COVID-19-related mortality, hospitalisation, and intensive care unit admission: A systematic review and meta-analysis. Lancet Psychiatry 2021;8(9):797812.Google Scholar
Puzzo, I., Aldridge-Waddon, L., Stokes, N., Rainbird, J. and Kumari, V. The impact of the COVID-19 pandemic on forensic mental health services and clinical outcomes: A longitudinal study. Frontiers in Psychiatry 2022;12:112.Google Scholar
Taquet, M., Luciano, S., Geddes, J. R. and Harrison, P. J. Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62,354 COVID-19 cases in the USA. The Lancet Psychiatry 2021;8(2):130–40.Google Scholar
Ross, C., Brown, P., Brown, C. et al. COVID-19 Vaccination in those with mental health difficulties: A guide to assist decision-making in England, Scotland, and Wales. Medicine, Science and the Law 258024221086054. 11 Mar. 2022, https://doi.org/10.1177/00258024221086054.Google Scholar
Rix, K., Eastman, N. and Adshead, G. [on behalf of the Special Committee for Professional Practice and Ethics]. Responsibilities of psychiatrists who provide expert opinion to courts and tribunals. London: RCPsych; 2015.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×