Disturbed female offenders: Helping the ‘untreatable’

Gorsuch, Nikki

doi:10.1080/09585189908402142

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…Though there are dedicated staff working within mainstream psychiatric services who have made it their business to develop the skills to provide effective help to women (e.g. Watson et al, 1996;Gorsuch, 1999), our impression is that they are far fewer than service providers would like to imagine. Meanwhile women are passed from service to service some through increasing levels of security.…”

Section: Limitations In Trainingmentioning

confidence: 99%

Mental Health Services for ‘Difficult’ Women: Reflections on Some Recent Developments

Williams¹,

Scott²,

Waterhouse³

2001

Feminist Review

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The provision of mental health services to women has come sharply into focus for providers of secure psychiatric services in the UK. Women's services are being developed in response to the known risks of mixed-sex provision, and a growing appreciation of the ways that women in secure services can be further disadvantaged by their minority status. Our intention here is to present evidence and reflections to help inform this development. The evidence is drawn from our recent work in this field, which includes carrying out a review of local mental health services for ‘difficult’ women, and developing and piloting a national training programme for staff working with women in secure services. The reflections we offer are informed by the conviction that taking social inequalities into account is central to making sense of women's mental health difficulties, and improving service responses to women's needs. While there are signs that many mental health workers in secure services are beginning to share these convictions, the challenge now is to provide the necessary authorization, training and support that will enable them to translate these understandings into empowerment practice with women.

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Section: Limitations In Trainingmentioning

confidence: 99%

Mental Health Services for ‘Difficult’ Women: Reflections on Some Recent Developments

Williams¹,

Scott²,

Waterhouse³

2001

Feminist Review

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“…These patients require care that is relatively routine, consistent and holds few surprises. Gorsuch (1999) argues that services which attend to attachment needs by providing the consistency and reliability of a secure base, create a sense of safety which is necessary for new cognitive, emotional and practical experiences to be attempted and distress and anxiety to be effectively managed following failure.…”

Section: Discussion: Implications For Practicementioning

confidence: 99%

Meeting the needs of women in secure mental health: a conceptual framework for nurses

Parkes

Freshwater

2015

Journal of Research in Nursing

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Within the wards of Britain’s high and medium secure mental health services, the needs of the female population differ significantly from those of their male counterparts. Although much smaller in number, the vast majority of female patients formally detained in secure services are young, Caucasian women, who are less likely to be prone to criminality and have a propensity to suffer from psychological distress. Many have experienced extensive trauma and exhibit both internally and externally driven violence. Drawn from the women’s own narratives and analysed using a descriptive phenomenological approach, the findings provide the basic structure for a new ‘humanistic conceptual framework for care’ which could be used by mental health practitioners to both inform and structure the daily provision of care and to better understand the physical and mental health needs of this unique patient group within secure mental health services.

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“…However, several of the authors are clinicians working within the London Pathways Partnership (LPP), a consortium of NHS trusts delivering services within the OPD pathway, and are aware of several individuals that no OPD service, in prison or the NHS, is prepared to accept. Anecdotally, this seems to be for several reasons, for example, the nature or degree of risk posed; disagreement about diagnosis; the offender's unwillingness to engage in a therapeutic intervention; or, linked to this, a perception of being untreatable [27] or difficult [28], both psychosocial labels with a complex causality. The nonacceptance of offenders into OPD services on the OPD pathway is likely related to issues of engaging high-risk…”

Section: The Offender Personality Disorder Pathwaymentioning

confidence: 99%

Offenders With Personality Disorder Who Fail to Progress: A Case-Control Study Using Partial Least Squares Structural Equation Modeling Path Analysis (Preprint)

Mathlin¹,

Freestone²,

Taylor³

et al. 2021

Preprint

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BACKGROUND Offenders with personality disorder can be challenging to engage and retain in treatment. The UK offender personality disorder (OPD) pathway aims to proactively and responsively identify and engage offenders with personality disorder. However, a sub-population of offenders on the pathway have been found to not be accepted into any OPD service and therefore fail to progress. OBJECTIVE This study aimed to identify and describe offenders on the OPD pathway who fail to progress as well as understand the causal drivers by which individuals fail to progress in the pathway. METHODS A sample of 50 offenders on the OPD pathway who had been refused from at least two OPD services (non-progression group) were compared to 100 offenders accepted into OPD services (control group). Partial least squares structural equation modelling (PLS-SEM) was used to model the causal factors involved in not being accepted into OPD services. RESULTS The path coefficients in the structural model showed that the most influential factor in non-progression was attitude towards treatment (β = 0.41, P <.001, f2 = 0.25) alongside those with psychopathology (β = 0.41, P <.001, f2 = 0.25); specifically, psychopathy, psychosis and co-occurring personality disorder. CONCLUSIONS The findings of the study provide a basis of how to work with this population in the future to increase the likelihood of acceptance into OPD services.

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Disturbed female offenders: Helping the ‘untreatable’

Cited by 8 publications

References 20 publications

Mental Health Services for ‘Difficult’ Women: Reflections on Some Recent Developments

Mental Health Services for ‘Difficult’ Women: Reflections on Some Recent Developments

Meeting the needs of women in secure mental health: a conceptual framework for nurses

Offenders With Personality Disorder Who Fail to Progress: A Case-Control Study Using Partial Least Squares Structural Equation Modeling Path Analysis (Preprint)

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