Northampton Electronic Collection of Theses and Research

Aggression in specialist secure and forensic inpatient mental health care: incident across care pathways

Dickens, G., Picchioni, M. and Long, C. G. (2013) Aggression in specialist secure and forensic inpatient mental health care: incident across care pathways. Journal of Forensic Practice. 15(3), pp. 206-217. 2050-8794.

Item Type: Article
Abstract: Purpose - To describe how aggressive and violent incidents differ across specialist gender, security and mental health/ learning disability pathways in specialist secure care. Design/methodology/approach - A retrospective survey of routinely collected incident data from one 207-bed UK independent sector provider of specialist medium and low secure mental health care for male and female adults with primary diagnosis of mental illness or intellectual disability. Findings - In total, 3,133 incidents involving 184/373 (49.3%) patients were recorded (68.2% other-directed aggression, 31.8% self-harm). Most incidents occurred in the medium secure wards but more than half of the most severely rated self-harm incidents occurred in low security. Men were disproportionately involved in incidents, but a small number of women were persistently involved in multiple acts. Incidents were most common in the intellectual disability pathway. Research limitations/implications - Incidents, especially those of lower severity, can be under-reported in routine practice. Information about incident severity was limited. Practical implications - Aggressive incidents do not occur homogenously across forensic and secure mental health services but differ substantially in their frequency and nature across security levels, and gender and mental health/ intellectual disability pathways. Different approaches to training and management are required to ensure appropriate prevention and intervention. Future practice should draw on emerging theories of differential susceptibility. Originality/value - This paper extends current knowledge about how incidents of violence and aggression differ across secure settings
Uncontrolled Keywords: Aggression, violence, self-harm, forensic, secure, intellectual disability
Subjects: R Medicine > RA Public aspects of medicine > RA1001 Forensic Medicine. Medical jurisprudence. Legal medicine > RA1151 Forensic psychiatry
R Medicine > RC Internal medicine > RC435 Psychiatry > RC450 Psychiatric hospitals
R Medicine > RC Internal medicine > RC435 Psychiatry > RC554 Personality disorders. Behavior problems
Creators: Dickens, Geoff, Picchioni, Marco and Long, C G
Publisher: Emerald
Faculties, Divisions and Institutes: University Faculties, Divisions and Research Centres - OLD > Faculty of Health & Society > Mental Health and Learning Disability
Faculties > Faculty of Health & Society > Nursing
Date: 2013
Date Type: Publication
Page Range: pp. 206-217
Journal or Publication Title: Journal of Forensic Practice
Volume: 15
Number: 3
Language: English
ISSN: 2050-8794
Status: Published / Disseminated

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