Asylums or crude cauldrons of containment? The future of the Special Hospitals

From homicide inquiries to high secure hospital inquiries: a decade of social and political restrictive pressure on forensic psychiatry

“…The option of replacing the Special Hospitals with more numerous, geographically distributed, NHSintegrated units has been championed e.g. Bluglass (1992), although this approach has been criticised as unrealistic given the formidable expense, the predicted repetition of the difficulties facing the established institutions, and lack of empirical support for this alternative (Tidmarsh, 1998;Gunn, 1999). The controversy surrounding the High Secure Hospitals has been accentuated by recent Inquiries (see later).…”

“…Others have highlighted the demand for high-secure beds, the inability of medium levels of security to contain significant numbers of patients, treatment-resistant patients, serious re-offenders (all negative reasons), and the asylum function i.e. catering for minority groups and diversity of meaningful daytime activity (positive reasons), as indications for the continuation of the High Secure Hospitals (Tidmarsh, 1998). The option of replacing the Special Hospitals with more numerous, geographically distributed, NHSintegrated units has been championed e.g.…”