Managing returns to prison from medium-secure services: qualitative study
Background Little is known about factors that influence discharge decision-making for people admitted to medium-secure services from prison, particularly for those who are returned to prison following treatment. Aims To explore the organisational influences on care pathways through medium-secure se...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-07-01
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| Series: | BJPsych Open |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472421009285/type/journal_article |
| _version_ | 1827995655372537856 |
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| author | Sarah-Jayne Leonard Caroline Sanders Jennifer J. Shaw |
| author_facet | Sarah-Jayne Leonard Caroline Sanders Jennifer J. Shaw |
| author_sort | Sarah-Jayne Leonard |
| collection | DOAJ |
| description | Background
Little is known about factors that influence discharge decision-making for people admitted to medium-secure services from prison, particularly for those who are returned to prison following treatment.
Aims
To explore the organisational influences on care pathways through medium-secure services for those admitted from prison.
Method
We recruited 24 clinicians via purposive and snowball sampling; 13 shared their experiences via a focus group, and 11 shared their experiences via individual semi-structured interviews. A thematic analysis was conducted, producing three overarching themes: maintenance of throughput and service provision, class of two systems, and desirable and undesirable patients.
Results
Data indicated external factors that direct and, at times, limit clinicians’ pathway decisions, including commissioning criteria and legal status under the Mental Health Act 1983 and within the criminal courts system (i.e. whether on remand or sentenced). These factors also influence how clinicians view the role and function of medium-secure services within the wider forensic mental health system, and therefore the types of patients that are deemed ‘appropriate’ for continued treatment when making discretionary pathway decisions.
Conclusions
There remains a deficit in adequate resources to meet the mental health needs of prisoners who are admitted to medium-secure services. To meet the clinical need of all admissions, criteria for prolonged treatment in medium-secure services needs to be reconsidered, and it is likely that provision for the medium-secure hospital estate will need to increase substantially if effective rehabilitation of those who transfer from prison is to take place.
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| first_indexed | 2024-04-10T04:59:43Z |
| format | Article |
| id | doaj.art-f132fdc9ab9842329006efccce1a54a3 |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T04:59:43Z |
| publishDate | 2021-07-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-f132fdc9ab9842329006efccce1a54a32023-03-09T12:29:07ZengCambridge University PressBJPsych Open2056-47242021-07-01710.1192/bjo.2021.928Managing returns to prison from medium-secure services: qualitative studySarah-Jayne Leonard0https://orcid.org/0000-0002-1729-0556Caroline Sanders1Jennifer J. Shaw2Offender Health Research Network, Centre for Mental Health and Safety, University of Manchester, UKNIHR School for Primary Care Research, University of Manchester, UKCentre for Mental Health and Safety, University of Manchester, UKBackground Little is known about factors that influence discharge decision-making for people admitted to medium-secure services from prison, particularly for those who are returned to prison following treatment. Aims To explore the organisational influences on care pathways through medium-secure services for those admitted from prison. Method We recruited 24 clinicians via purposive and snowball sampling; 13 shared their experiences via a focus group, and 11 shared their experiences via individual semi-structured interviews. A thematic analysis was conducted, producing three overarching themes: maintenance of throughput and service provision, class of two systems, and desirable and undesirable patients. Results Data indicated external factors that direct and, at times, limit clinicians’ pathway decisions, including commissioning criteria and legal status under the Mental Health Act 1983 and within the criminal courts system (i.e. whether on remand or sentenced). These factors also influence how clinicians view the role and function of medium-secure services within the wider forensic mental health system, and therefore the types of patients that are deemed ‘appropriate’ for continued treatment when making discretionary pathway decisions. Conclusions There remains a deficit in adequate resources to meet the mental health needs of prisoners who are admitted to medium-secure services. To meet the clinical need of all admissions, criteria for prolonged treatment in medium-secure services needs to be reconsidered, and it is likely that provision for the medium-secure hospital estate will need to increase substantially if effective rehabilitation of those who transfer from prison is to take place. https://www.cambridge.org/core/product/identifier/S2056472421009285/type/journal_articleForensic mental health servicesprison mental healthoffender pathwaysecure services |
| spellingShingle | Sarah-Jayne Leonard Caroline Sanders Jennifer J. Shaw Managing returns to prison from medium-secure services: qualitative study BJPsych Open Forensic mental health services prison mental health offender pathway secure services |
| title | Managing returns to prison from medium-secure services: qualitative study |
| title_full | Managing returns to prison from medium-secure services: qualitative study |
| title_fullStr | Managing returns to prison from medium-secure services: qualitative study |
| title_full_unstemmed | Managing returns to prison from medium-secure services: qualitative study |
| title_short | Managing returns to prison from medium-secure services: qualitative study |
| title_sort | managing returns to prison from medium secure services qualitative study |
| topic | Forensic mental health services prison mental health offender pathway secure services |
| url | https://www.cambridge.org/core/product/identifier/S2056472421009285/type/journal_article |
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