An evaluation of the staff training within the trauma and self injury (TASI) programme in the National High Secure Healthcare Service for Women (NHSHSW)

Publication Date10 May 2013
DOIhttps://doi.org/10.1108/14636641311322322
Pages141-150
AuthorKate Robertson,Sue Elcock,Chris Milburn,Phyllis Annesley,Jane Jones,Birgit A. Völlm
subjectMatterHealth & social care,Public policy & environmental management,Sociology
An evaluation of the staff training within the
trauma and self injury (TASI) programme in
the National High Secure Healthcare
Service for Women (NHSHSW)
Kate Robertson, Sue Elcock, Chris Milburn, Phyllis Annesley, Jane Jones and Birgit A. Vo
¨llm
Abstract
Purpose – Patients in the National High Secure Healthcare Service for Women have a high prevalence
of trauma and self injury. This highlights the need for specialised training of staff dealing with such
women. The aim of this study was to evaluate the trauma and self injury (TASI) training programme on
staff knowledge and skills.
Design/methodology/approach – A total of 135 nurses and nursing assistants participated in the TASI
two-day training course. Questionnaires allowing for quantitative and qualitative data collection were
completed before and after the training. Training and confidence levels in dealing with women who
self-harm prior to the training were identified and the impact of the programme was assessed.
Findings – The majority of staff had not received any previous training on trauma and self injury. There
was an increased level of confidence in working with trauma and self injury following training and staff
reported an increased ability to ask for support. Self-perceived competence improved to a greater
extent in those who had not received previous training compared to those who had.
Research limitations/implications The authors’ data is limited to self-report. Future research should
use objective measures to evaluate the impact of staff training.
Practical implications A relatively short training programme focusing on trauma and self injury
appears to improve staff confidence, understanding and competence in working with women patients in
a high secure setting. Similar training programmes might also be beneficial in different patient groups
with complex backgrounds and behaviours.
Originality/value – This is the first report on a training programme focussing on women in high secure
care who self-harm and have experienced trauma.
Keywords Self harm, High secure, Women, Trauma, Staff training, Injuries
Paper type Research paper
Introduction
The National High Secure Service for Women (NHSHSW) provides 50 beds for women
deemed to pose a ‘‘grave and immediate’’ risk to others in England and Wales. Security is
considered within three domains: physical, procedural and relational. Physical security
describes material methods primarily aimed at preventing the escape of patients, such as
specified locks and fencing. Procedural security describes the policies enforced, such as
mail and telephone monitoring within the auspices of the Mental Health Act, and searching
requirements. Relational security is achieved through the therapeutic milieu and the nature
of the therapeutic relationship with the patient (Exworthy and Gunn, 2003). Taking into
account the quality of care high secure services offer, relational security has been regarded
as the leading principle in the review of forensic services by the Department of Health and
Home Office, ‘‘safety lies in the treatment of the patient’’ (The Reed Report, 1992). Relational
security can be achieved through an enhancement of staff competence and confidence in
DOI 10.1108/14636641311322322 VOL. 15 NO. 2 2013, pp. 141-150, QEmerald Group Publishing Limited, ISSN 2050-8794
j
JOURNAL OF FORENSIC PRACTICE
j
PAGE 141
Kate Robertson is a
medical student at
School of Community
Health Sciences,
University of Nottingham,
Nottingham, UK.
Sue Elcock is Consultant
Forensic Psychiatrist at
Nottinghamshire
Healthcare NHS Trust,
Woodbeck, UK.
Chris Milburn is Forensic
Psychologist at
Nottinghamshire
Healthcare NHS Trust,
Woodbeck, UK.
Phyllis Annesley is
Consultant Clinical
Psychologist at
Nottinghamshire
Healthcare NHS Trust,
Woodbeck, UK.
Jane Jones is Psychologist
at Nottinghamshire
Healthcare NHS Trust,
Woodbeck, UK.
Birgit A. Vo
¨llm is Clinical
Associate Professor at
Section of Forensic
Mental Health, Division of
Psychiatry, University of
Nottingham, Nottingham,
UK.

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