Assessing the needs of patients in secure settings: A multi-disciplinary approach

The mental health service needs of all North London patients in medium (N = 97) and maximum security (N = 79) were assessed. Patients and key nurses were interviewed using validated measures and, for patients in maximum security, the respective responsible medical officers (RMOs) also completed a standard enquiry form. Multi-disciplinary panels from the catchment areas then rated immediate and future needs for security and treatment. Unlike previous studies, we found only 25% of patients ready for an immediate move to lower security and a greater disparity between those thought ready for discharge by their Special Hospital RMO and those thought ready for discharge by the local panels. We identified a particular unmet need for long-term, 24-hour, nurse-staffed accommodation, rather than long-term medium security.