lack of security in psychiatric hospitals

[Upwind]

Just because people are unwell does not mean they are not dangerous. I wonder if the risk assessments are being made from the patients' perspective rather than that of the community or society - where with prisoners the latter are considered more.

from the BBC: "There were at least 116 escapes from medium and low secure psychiatric hospitals last year, a BBC investigation has found.Some of the units held patients who had committed serious and violent crimes.Last year, Darren Harkin, a convicted killer, escaped from Hayes Hospital, a secure private hospital near Bristol, and raped a 14-year-old girl. The former chief inspector of prisons, Sir David Ramsbotham, described the figures as horrifying...

...Two other cases which have raised security concerns at the Hayes, included an incident in which patient Tamer Mahmood was taken to St Werburghs City Farm - a place popular with families and schoolchildren.The farm said it was not informed he was on the sex offenders register and despite being accompanied by staff Mahmood absconded for 17 hours.The Hayes Hospital admitted they may have been wrong not to inform the farm of the patient's criminal history on this occasion. Even so they said they might in future withhold such information depending on individual circumstances.Earlier in March another patient from the Hayes, who was allowed a pint at a local pub every week under supervision, became aggressive.

Following these three incidents Carol Povey, head of adult services at the National Autistic Society, was asked whether security should be stepped up, but said this was not necessarily the best course of action. "The Hayes is not a prison. It is a hospital which specialises in working with people with autistic spectrum disorders. Our primary aim is therapeutic, to help people grow in their independence," he said. "People who live here are here because they've been assessed. "There has been an incident which was absolutely tragic, but we're working with complex people. We try to get the balance between therapy and security and it's extremely difficult to do that."

[squigglywig]

Security is dreadful in most low security units (I speak as someone who absconded successfully many times whilst allegedly sectioned/on constant 1:1 supervision from units designed for under 18s). However they are called low security for a reason. It is hardly escaping if the doors aren't locked to begin with.

Most people placed in a low or medium security setting are not a danger to others.

This kind of reporting is sure to really help alleviate the stigma and prejudice out there about MH issues. Congrats BBC.

[squigglywig]

Last sentence should have had a

[Upwind]

I think that the report does highlight that some of these patients should not be in low or medium security units. The best possible guide as to whether a mentally ill patient will be dangerous is whether they have been so in the past. The two patients named above clearly had been and so should not have been treated as low risk.

[squigglywig]

Yes - you're right Upwind, sorry, just a sore point.

On second, calmer, reading I'm confused why Mr Harkin wasn't in a special hospital.

The report does still lean heavily towards the forensic end of the spectrum and doesn't give any space to the idea that most of those escapes will have been people who have never and will never harm anyone but themselves.

[Upwind]

Agree Squigglywig. I don't think that "Carol Povey, head of adult services at the National Autistic Society" did her organisation any favours either. She seemed to be dismissing an obvious danger. After what has happened the hospital should be assuring the community that it won't happen again because either security will be stepped up or they will not accept patients with a violent criminal history. If they hope that the community will be welcoming and supportive of their residents, the least they can do is take any risks seriously!

[squigglywig]

I don't think she did either. Treatment vs. security is a difficult balance to be sure - but it reads a bit like the 14 yr old was just an occupational hazard with the "but we're working with complex people." comment!

[undercovercat]

Lack of anything id say. My brother gets sectioned at least once a year.
The doctors go to a HUGE effort to get him into a secure place and he is sectioned for 28 days and they let him out within 24-36 hours.
This may have something to do with the fact hes around 20 stone and built like a brick shit house and essentially mad. (Paranoid schizophrenia)
Complete waste of time.

[squigglywig]

Where I used to be they had "crash teams" (delightfully named) of male nurses built like brick shithouses who could come and sit on people to stop them absconding or being discharged early.

Seems ridiculous that the docs manage to find a secure bed but then he's discharged because they can't, I'm guessing, manage?

[undercovercat]

Thats exactly what happens, they dose him up, and let him go.
He NEEDS a month to recover, of 3 meals a day, someone to talk to(psychiatrist, other patients) and a rest from the madness that is the rest of his year.
Oh he towers over the crash teams

[squigglywig]

Wish he'd been on my ward - I'd have hid behind him! Bloody crash teams! I'm all sane now I promise

Is he on Enhanced CPA? Can they not make a plan that says he needs a longer period of admission? What causes the episodes to occur so frequently?

[undercovercat]

Not sure about the terms, the doctors say he will be in for 28 days, the reassure him, and us, and then, the ward lets him out, encourages him home, areanges a taxi for him to be returned home.
Sure you are sane now, arent we all

[Upwind]

There is a more thoughful analysis of this in the Times today.