The development of a district-based psychiatric service for difficult and offender patients

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Abstract
This paper is concerned with an alternative approach to the development of single regional secure units (RSUs) for the treatment of mentally disordered offenders. This different approach has been pursued over the last ten years in the South West Thames region. The plan has been to develop a district-based inpatient service for both difficult and offender patients within the framework of existing local psychiatric facilities. The development was felt to be a prerequisite for an RSU if such a specialized facility was to work properly. The paper describes the rationale, methodology, and problems of setting up the service.