English vs Dutch high secure hospitals: service user perspectives
| Date | 14 May 2018 |
| DOI | https://doi.org/10.1108/JFP-12-2016-0054 |
| Pages | 112-121 |
| Published date | 14 May 2018 |
| Author | Birgit Völlm,Shaz Majid,Rachel Edworthy |
| Subject Matter | Health & social care,Criminology & forensic psychology,Forensic practice,Sociology,Sociology of crime & law,Law enforcement/correctional,Public policy & environmental management,Policing,Criminal justice |
English vs Dutch high secure hospitals:
service user perspectives
Birgit Völlm, Shaz Majid and Rachel Edworthy
Abstract
Purpose –The purposeof this paper is todescribe service users’perspectiveson the differencebetween high
secure long-stay forensic psychiatric services in the Netherlands and high secure forensic psychiatric care in
England. These perspectives are relevantin considering the benefits of a similarlong-stay service in England.
Design/methodology/approach –A current in-patient detaine d in a high secure hospital in England and
other mental health service users and carers with experience in forensic-psychiatric settings were asked to
watch a documentary on a Du tch high secure long-sta y service. Then they wer e invited to make
comparisons between this service and high secure care in England. These perspectives were gained in the
context of their membership of the Service User Reference Group of an externally funded study on
long-stay in forensic-psychiatric settings in England.
Findings –The small group of partic ipants highlighted the i mportance of relational s ecurity, meaningful
occupation, autonomy , positive therapeutic relationships with sta ff and a homely environme nt for those
with lengthy admissions and perceived these to be better met in the Dutch service. These factors might
contribute to improved qu ality of life that services s hould strive to achieve, es pecially for those with
prolonged admissions.
Practical implications –Perspectives of service users with lived experience of long-stay in forensic
settings are important in informing service developments. Lesso ns can be learnt from initiatives to improve
the quality of life in long-stay services in other countries and consideration be given on how to best
manage this unique group.
Originality/value –To the authors’knowledge this is the first study asking service users about their view on
forensic services in other countries. The findings suggest that service users have valuable contributions to
make to aid service developments and should be involved in similar such exercises in the future.
Keywords Quality of life, Dutch, Forensic service, Long-stay, Service user perspective, TBS
Paper type Viewpoint
1. Introduction
Detention in a secure forensic psychiatric setting can be expensive for society and highly
restrictive for patients (Adshead, 2000; Centre For Mental Health, 2011; Farnworth et al., 2004),
particularly those experiencing long-term care. In this paper, we discuss the views of five mental
health service users, including one currently residing in a high secure hospital in England and a
carer for someone who has spent time in such setting, to whom we showed a DVD entitled
“Long-stay forensic care in the Netherlands: A film by Maria Mok and Meral Uslu”(www.youtube.
com/watch?v=iCMt7ynK9jg). Participants were asked to make comparisons between the high
secure long-stay hospital in the Netherlands and their experience of high secure care in England.
There are important d ifferences in the str ucture of forensic se rvices between the N etherlands
and England. In England services are organised according to three levels of security: high,
medium and low. Most hospitals provide services at one security level only. As each hospital
has its own referral system and gatekeeping process, transfers between hospitals and
step-down throug h security levels ca n be problematic, re sulting in waiting li sts and delays in
treatment (De Boer and Gerrits, 2007). In contrast, forensic psychiatric services in
the Netherlands in corporate all lev els of security in on e institution, inc luding community
services (Mcinerny, 2000). This provides greater continuity as the same clinical team maintains
Received 28 December 2016
Revised 1 May 2017
2 September 2017
10 September 2017
Accepted 12 September 2017
Birgit Völlm is a Professor in
Forensic Psychiatry,
Shaz Majid is a Research
Assistant and Rachel Edworthy
is a Research Assistant, all at
the University of Nottingham,
Nottingham, UK.
PAGE112
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JOURNAL OF FORENSIC PRACTICE
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VOL. 20 NO. 2 2018, pp. 112-121, © Emerald Publishing Limited, ISSN 2050-8794 DOI 10.1108/JFP-12-2016-0054
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