How many high security beds are needed? Implications from an audit of one region's Special Hospital patients

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Abstract
This paper describes an audit of patients from the North West Thames (NWT) region in the maximum-security Special Hospital (SH) system on 1 October 1992. The aim of the study was to identify for each patient the least restrictive setting in which their treatment might continue, thereby estimating the real demand for SH care from this region, and, by extrapolation, the future size of the SH system. The study was undertaken primarily in order to assist local service planning; preliminary results were also made available to the high security' working party set up following the completion of the joint Home Office and Department of Health review (the Reed Report) of services for mentally disordered offenders (Department of Health and the Home Office, 1991). Dr Kevin Murray, MRCPsych, consultant forensic psychiatrist, Three Bridges Unit, St Bernard's Wing, Eating Hospital, Uxbridge Road, Southall, Middlesex UB13EU DrShauna Rudge, MRCPsych, locum senior registrar, Three Bridges Unit, St Bernard's Wing, Eating Hospital, Uxbridge Road, Southall. Middlesex UB13EU Dr Sarah Lack, MRCPsych, senior registrar, Three Bridges Unit, St Bernard's Wing, Eating Hospital, Uxbridge Road, Southall, Middlesex UB13EU Dr Robert Dolan, MRCPsych, consultant forensic psychiatrist, Three Bridges Unit, St Bernard's Wing, Eating Hospital, Uxbridge Road, Southall, Middlesex UB13EU