Forensic mental health nursing is a complex role and there is a tension between maintaining safety and promoting a therapeutic and patient centred approach. The use of restrictive practises such as seclusion is an issue. Two focus groups with registered nurses exploring attitudes and factors used in decision-making about seclusion use were analysed using interpretive description. Participants described the need to reduce the use of seclusion and the problematic nature of its utility as an ongoing intervention in contemporary mental healthcare. It was clear that there were complexities and competing variables involved in the decision-making process.

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Purpose The purpose of this paper is to explore the experiences of prison staff working with imprisoned women who self-harm in English prisons. In this small-scale study, 14 prison staff in three English prisons were interviewed to examine the strategies currently used by them to support imprisoned women who self-harm. Design/methodology/approach Thematic analysis (Braun and Clarke, 2006) was used to identify three key themes: “developing a relationship”, “self-help strategies” and “relational interventions”. Findings Many staff expressed some dissatisfaction in the techniques available to support the women, and felt their utility can be restricted by the prison regime. Research limitations/implications This study suggests that there is currently a deficit in the provision of training and support for prison staff, who are expected to fulfil a dual role as both custodian and carer of imprisoned women. Further research into prison staff’s perception of the training currently available could highlight gaps between current theory and practice in the management of self-harm and thus indicate content for future training programmes. Research exploring the impact of working with imprisoned women who self-harm is suggested to identify strategies for supporting staff. It must be acknowledged that this is a small-scale qualitative study and the findings are from only three prisons and may not apply to staff in other settings. Originality/value Currently few studies have focussed on the perspective of prison staff. This study is one of very few studies which focusses on the techniques and resources available to support the women, from the perspective of the prison staff.

IntroductionSelf-harm in prison is a major public health concern. Less than 5% of UK prisoners are women, but they carry out more than a fifth of prison self-harm. Scars resulting from self-harm can be traumatising and stigmatising, yet there has been little focus on recovery of women prisoners with self-harm scarring. Medical skin camouflage (MSC) clinics treat individuals with disfiguring skin conditions, with evidence of improved well-being, self-esteem and social interactions. Only one community study has piloted the use of MSC for self-harm scarring.Methods and analysisWe describe an acceptability and feasibility pilot randomised controlled trial; the first to examine MSC for women prisoners who self-harm. We aim to randomise 20–25 women prisoners to a 6-week MSC intervention and 20–25 to a waitlist control (to receive the MSC after the study period). We aim to train at least 6–10 long-term prisoners with personal experience of self-harm to deliver the intervention. Before and after intervention, we will pilot collection of women-centred outcomes, including quality of life, well-being and self-esteem. We will pilot collection of self-harm incidents during the intervention, resources used to manage/treat self-harm and follow-up of women at 12 weeks from baseline. Data on recruitment, retention and dropout will be recorded. We aim for the acceptability of the intervention to prison staff and women prisoners to be explored in qualitative interviews and focus groups.Ethics and disseminationEthical approval for COVER has been granted by the North East–York Research Ethics Committee (REC) for phases 1 and 2 (reference: 16/NE/0030) and West of Scotland REC 3 for phases 3 and 4 (reference: 16/WS/0155). Informed consent will be the primary consideration; it will be made clear that participation will have no effect on life in prison or eligibility for parole. Due to the nature of the study, disclosures of serious self-harm may need to be reported to prison officials. We aim for findings to be disseminated via events at the study prison, presentations at national/international conferences, journal publications, prison governor meetings and university/National Health Service trust communications.Trial registration number NCT02638974; Pre-results.

This report is the result of quantitative and qualitative inquiry into the workings of community learning disability teams with particular reference to the handling of caseloads and specifically discharge procedures. The study focused on four teams in the West Yorkshire area. Quantitative data to represent professionals within the teams, their caseload sizes and waiting lists were analysed. Qualitative information with respect to caseload management strategies was gathered via semi-structured interviews and the findings were validated by a focus group. The professionals identified the decision-making processes they employed regarding maintaining service users or discharging service users from their caseload. The management and structures within each of the teams were found to be complex and varied. The implications of these findings and recommendations for further investigations into the nature of caseload management practices in community learning disability services are discussed.

Findings show the positive impact the letters had for the women following therapy. The preliminary impressions suggest that letters may be a helpful tool enhancing the benefits of brief PIT therapy with imprisoned women who self-harm.

This study aims to explore the experiences of people who have attended Saint Mary's Sexual Assault Referral Centre (SARC) for a forensic medical examination (FME). Within the United Kingdom, SARCs support complainants following a sexual assault, delivering specialised care and gathering medico-legal evidence for court proceedings. To date, there has been limited research evaluating SARCs responses towards complainants. 863 Feedback and Evaluation forms, from a three-year period, completed by clients who accessed Saint Mary's SARC's forensic medical examination service were evaluated. Descriptive statistical analysis found a large majority of clients were 'very satisfied' with the crisis worker, forensic physician and police. Content analysis of the free text responses found more nuanced experiences, which impacted clients overall experience within the SARC. These comments were split into two themes, 'Compliments' and 'Suggestions for improvement'. There were 404 comments focusing on compliments of the service and the staff. Compliments included messages of thanks, with praise for professionalism of the staff and importance of the service. Clients noted in particular that the FME service was delivered in challenging circumstances i.e. the immediate aftermath of a sexual assault. There were 34 comments which made suggestions for improvements. These suggestions focused on pragmatic and logistic issues.