Abstract

In the UK, mentally ill offenders can be assessed and given treatment and rehabilitation in a secure health care setting rather than in a correctional facility. Beds in such health care facilities are limited and evidence suggests that only the most serious offenders, such as those who have committed a homicide, are given priority. This paper examines the role of the Regional Secure Unit, a National Health Service provision, in the assessment and treatment of these offenders. A number of issues facing the multidisciplinary team are raised. A case study is presented to illustrate some of these points.

References

1.
Department of Health/Home Office, Provision for Mentally Disordered Offenders
, London, Home Office, Circular 66/90,
1990
.
2.
Taylor
,
P. J.
and
Gunn
,
J.
, “
Violence and Psychosis: I. Risk of Violence Among Psychotic Men
,”
British Medical Journal
 0007-1447, Vol.
288
,
1984
, pp.
1945
-
1949
.
3.
Gunn
,
J.
,
Madden
,
A.
, and
Swinton
,
M.
, “
Treatment Needs of Prisoners with Psychiatric Disorders
,”
British Medical Journal
 0007-1447, Vol.
303
,
1991
, pp.
338
-
340
.
4.
Snowden
,
P.
, “
A Survey of the Regional Secure Unit Programme
,”
British Journal of Psychiatry
 0007-1250, Vol.
147
,
1985
, pp.
499
-
507
.
5.
Coid
,
J. W.
, “
Mentally Abnormal Offenders on Remand. Rejected or Accepted by the National Health Service
,”
British Medical Journal
 0007-1447, Vol.
296
,
1988
, pp.
1779
-
1782
.
6.
Berry
,
M. J.
, “
Evaluating Secure Units: Some Methodological Difficulties
,” Paper presented at the
Spring Quarterly meeting of the Royal College of Psychiatrists
,
05
1986
.
7.
Department of Health and Social Security
,
Report of the Review of Rampton Hospital (Boynton report)
Cmnd 8073.
HMSO
, London,
1980
.
8.
Department of Health
,
Report of Committee of Enquiry into Complaints about Ashworth Hospital
, (Vols.
I and II.
, Cmnd 2028-I).
HMSO
, London,
1992
.
9.
Hospital Advisory Services
,
Report on Broadmoor Hospital, Social Services Inspectorate
,
1975
.
10.
Hospital Advisory Services
,
Report on Broadmoor Hospital
, London,
DHSS
,
1988
.
11.
Bluglass
,
R.
, “
The Special Hospitals Should Be Closed
,”
British Medical Journal
 0007-1447, Vol.
4
,
1992
, pp.
94
-
96
.
12.
Dell
,
S.
, “
Murder into Manslaughter—The Diminished Responsibility Plea in Practice
,”
Maudsley Monograph No. 27
,
Oxford University Press
,
Oxford
,
1984
.
13.
Department of Health and Social Security, “
Report of the Committee on Mentally Abnormal Offenders
,” (Butler Report), Cmnd 6244,
HMSO
, London,
1975
.
14.
Department of Health/Home Office
,
Review of Health and Social Services for Mentally Disordered Offenders and Others Requiring Similar Services: Reports of Advisory Groups on Finance, Services for People with Special Needs
,
Academic Development, Research
, London,
Department of Health/Home Office
,
1991
.
15.
Earp
,
J.
, “
The Role of the Regional Secure Unit
,” in
Psychiatric Disorders and the Criminal Process
,
R.
Mackay
and
K.
Russell
, Eds.,
Leicester Polytechnic Law School Monographs, Leicester Polytechnic Law School
,
Leicester
,
1988
.
16.
Langevin
,
R.
,
Paitich
,
B.
,
Orchard
,
B.
,
Handy
,
L.
, and
Russon
,
A.
,
Diagnosis of Killers Seen for Psychiatric Assessment
,”
Acta Psychiatrica Scandinavica
 0001-690X, Vol.
66
,
1982
, pp.
216
-
228
.
17.
Gottlieb
,
P.
,
Gabrielsen
,
G.
, and
Kramp
,
P.
, “
Psychotic Homicides in Copenhagen from 1959–1983
,”
Acta Psychiatrica Scandinavica
 0001-690X, Vol.
76
,
1987
, pp.
285
-
292
.
18.
Coid
,
J.
, “
The Epidemiology of Abnormal Homicide and Murder Followed by Suicide
,”
Journal of Psychological Medicine
, Vol.
13
,
1983
, pp.
855
-
860
.
19.
Fraser
,
K. A.
, “
Bereavement in Those Who Have Killed
,”
Medicine, Science and the Law
 0025-8024, Vol.
28
,
1988
, pp.
127
-
130
.
20.
Criminal Statistics for England and Wales 1986, HMSO, London,
1987
.
21.
Lorr
,
M.
and
Vester
,
N. D.
, “
Psychotic Inpatient Profile
,”
Western Psychological Services (WPS)
,
Minneapolis
,
University of Minnesota
,
1968
.
22.
Peterson
,
G. W.
,
Clark
,
D. A.
, and
Bennett
,
B.
, “
The Utility of MMPI Subtle, Obvious Scales for Detecting Fake Good and Fake Bad Response Sets
,”
Journal of Clinical Psychology
 0021-9762, Vol.
45
,
1989
, pp.
575
-
583
.
23.
Nichols
,
D. S.
,
Greene
,
R. L.
, and
Schmolck
,
P.
, “
Criteria for Assessing Inconsistent Patterns of Item Endorsement on the MMPI: Rationale, Development and Empirical Trials
,”
Journal of Clinical Psychology
 0021-9762, Vol.
45
,
1989
, pp.
239
-
250
.
24.
Walters
,
G. D.
, “
Assessing Dissimulation and Denial on the MMPI in a Sample of Maximum Security, Male Inmates
,”
Journal of Personality Assessment
 0022-3891, Vol.
52
,
1988
, pp.
465
-
474
.
25.
McNiel
,
K.
and
Meyer
,
R. G.
, “
Detection of Deception on the Millon Clinical Multiaxial Inventory
,”
Journal of Clinical Psychology
 0021-9762, Vol.
46
,
1990
, pp.
755
-
764
.
26.
Gillis
,
J. R.
,
Rogers
,
R.
, and
Bagby
,
R. M.
, “
Validity of the M Test: Simulation-Design and Natural-Group Approaches
,”
Journal of Personality Assessment
 0022-3891, Vol.
57
,
1991
, pp.
130
-
140
.
27.
Hawk
,
G. L.
and
Cornell
,
D. G.
, “
MMPI Profiles of Malingerers Diagnosed in Pretrial Forensic Evaluations
,”
Journal of Clinical Psychology
 0021-9762, Vol.
45
,
1989
, pp.
673
-
678
.
28.
Lezak
,
M. D.
, “
Neuropsychological Assessment. Examining for Functional Complaints, [2] Special Techniques
,”
Oxford University Press
,
1983
, pp.
618
-
622
.
29.
Maier
,
G. J.
, “
Relationship Security: The Dynamics of Keepers and Kept
,”
Journal of Forensic Sciences
 0022-1198, Vol.
31
,
1986
, pp.
603
-
608
.
30.
Hambridge
,
J. A.
, “
Treating Mentally Abnormal Killers in a Regional Secure Unit: Some Suggested Guidelines
,
Medicine, Science and the Law
 0025-8024, Vol.
34
,
1994
, pp.
237
-
242
.
31.
Falloon
,
I. R. H.
,
Boyd
,
J. L.
, and
McGill
,
C. W.
,
Family Care of Schizophrenia
,
Guilford, N. Y.
,
1984
.
32.
Bishay
,
N. R.
,
Petersen
,
N.
, and
Tarrier
,
N.
, “
An Uncontrolled Study of Cognitive Therapy for Morbid Jealousy
,”
British Journal of Psychiatry
 0007-1250, Vol.
154
,
1989
, pp.
386
-
389
.
This content is only available via PDF.
You do not currently have access to this content.