RT Article
T1 Medium secure mental health care for young people: decisions to detain
JF The journal of forensic psychiatry & psychology
VO 34
IS 3/4
SP 401
OP 415
A1 Balasubramaniam, Sinthujah
A2 Smith, Jared G
A2 Hales, Heidi
A2 Bartlett, Annie
LA English
YR 2023
UL https://krimdok.uni-tuebingen.de/Record/185771850X
AB Abstract Medium secure units are one component of secure mental health care for young people across the UK. No research has previously examined the appropriateness of admissions. This is a retrospective cohort study of all patients admitted to one unit by examining clinical notes for demographic, mental health and criminological variables. Descriptive data was statistically analysed to then characterise the cohort, audit against admission criteria and examine changes over time. There were 149 admissions. All patients admitted were male, most were 17 years old and from racialized groups. Most were detained under forensic sections with a primary diagnosis of psychosis. Four of five admissions met all 4 admission criteria. There were notable changes in use of forensic sections and risk over time. Our cohort differs from previous historical and contemporaneous cohorts in terms of diagnosis, legislation determining admission and ethnic breakdown. Our analysis relies on an interpretation of existing admission criteria but it suggests that not all admissions were appropriate, raising important practical, ethical and cost benefit questions. We suggest greater transparency about admission decisions to ensure that patients are admitted to the least restrictive setting needed and that national service planning is responsive to changes in demand.
K1 Forensic psychiatry
K1 Mental Health
K1 Development
K1 Adolescence
DO 10.1080/14789949.2023.2245365