Treatment Environments in Secure Psychiatric Units: A Case Study

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Abstract
The recent development of regionally based interim andpurposebuilt secure psychiatric units in England and Wales is described, highlighting certain factors which are expected to influence their mode of operation. A case study of one such Interim Secure Unit is reported, using questionnaire measures of "social climate" to describe the evolving milieu in the new Unit from both staffs' and patients' perspectives. Comparisons across time, within staff and patient groups, and between secure settings, are effected to reveal the "character" of the treatment environment and discern practical implications for the operation of the Unit. It is argued that social climate measures offer a salient method for studying the evolution of these new forensic psychiatric facilities, whose idealform and comparative efficacy are as yet uncertain.

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