Ageing patients in forensic psychiatric settings: A review of the literature

The Journal of Forensic Psychiatry & Psychology

2019

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Section: Discussionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

The characteristics and needs of older forensic psychiatric patients: a cross-sectional study in secure units within one UK regional service

Lorito

Völlm

The Journal of Forensic Psychiatry & Psychology

2019

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“…Forensic mental health services are facing an increasingly ageing population; around 20% of patients in forensic mental health settings are over 50 1,2 and, as people live longer, this percentage will increase. 3,4 Service provision and care packages for older forensic patients can be difficult. This population sits across criminal justice, forensic psychiatry and psychology, and old age psychiatric services, 5 and patients require integrated support.…”

Section: Introductionmentioning

confidence: 99%

Staff perspectives on barriers to and facilitators of quality of life, health, wellbeing, recovery and reduced risk for older forensic mental-health patients: A qualitative interview study

Walker

Yates

J Health Serv Res Policy

et al. 2022

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Objectives There is a lack of research informing service delivery for older forensic mental health patients. This study explored service provision in forensic mental health inpatient and community services in England, investigating what is required for progress in terms of quality of life, health, wellbeing, recovery and reduced risk, and the barriers and facilitators associated with this. Methods Semi-structured interviews were undertaken with 48 members of staff working with older forensic mental health patients in secure inpatient units or the community in England. Data were analysed using thematic analysis. Results Two global themes ‘What works’ and ‘What doesn’t work’ were identified comprising themes representing environmental, interpersonal and individual factors. ‘What works’ included: positive social support and relationships; individualised holistic patient-centred care; hub and spoke approach to patient care; and suitable environments. ‘What doesn’t work’ included: absence of/or maladaptive relationships with family and friends; gaps in service provision; and unsuitable environments. Conclusions For older patients to progress to improved quality of life, health, wellbeing and reduced risk, multilevel and comprehensive support is required, comprising a range of services, interventions, and multidisciplinary input, and individualised to each patient’s needs. The physical environment needs to be adapted for older patients and provide a social environment that seeks to include supportive families, friends and expert professional input. A clear patient progression pathway is required; this must be reflected in policy and provision.

“…• Systematic reviews around older forensic populations carried out as preliminary groundwork for the project (Di Lorito, Vӧllm, & Dening, 2018).…”

Section: Data Collectionmentioning

confidence: 99%

Ageing in forensic psychiatric secure settings: the views of members of staff

Lorito

The Journal of Forensic Psychiatry & Psychology

Völlm

2018

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Background. Although the prevalence of older patients in forensic psychiatric services is increasing, research around service provision for this population is very limited. We aimed to gather the views of members of staff on how well secure services are meeting the challenges of an ageing population.Methods. Three focus groups were carried out with 13 members of staff working with older patients in secure services. A topic guide, based on the research team's previous research, guided the sessions. The focus groups were audio-recorded, transcribed and analysed through thematic analysis.Results. Two themes were identified: (i) Identifying patients' needs, which focused on how promptly any emerging issues in the older patients are identified and reported; (ii) addressing patients' needs, which focused on how the unique needs of the older patients are addressed, once established. Conclusions.There are unique age-related issues that may have an impact on the older patients' opportunities for recovery, including a lack of specialist training for members of staff, prolonged stay in secure care and a limited number of age-relevant activities. Far from optimal, provision requires improvement through the active involvement of the primary stakeholders.