The transition from high secure, to medium secure, services for people with personality disorder: Patients and clinicians experiences

Tetley, Amanda; Evershed, Sue; Krishnan, Gomathi

doi:10.1080/14789949.2010.528011

Cited by 5 publications

(6 citation statements)

References 25 publications

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“…Previous research into unsuccessful discharge from high security supports this finding (e.g. Tetley et al, 2011). …”

Section: Discussionsupporting

confidence: 74%

“…Some patients go through the discharge process and find themselves returning to high security after unsuccessful "trial" leaves in medium security. Tetley et al (2011) explored the challenge of this transition process within a high secure personality disorder service with patients who had experienced unsuccessful trial leaves. The authors concluded that discharge preparation for patients needed to improve, as did the liaison and communication between the two services.…”

mentioning

confidence: 99%

“…The existing literature related to patient discharge from high security hospitals offers information on factors that influence unsuccessful transfer (Skelly, 1994;Tetley et al, 2011). However, there has been no research that has qualitatively explored the discharge preparation experiences of patients from all clinical directorates within high secure services.…”

mentioning

confidence: 99%

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“I couldn’t have done it on my own.” Perspectives of patients preparing for discharge from a UK high secure hospital

Madders

George

2014

Mental Health Review Journal

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Purpose -Discharge preparation from high to medium levels of security has received little attention from researchers to date, but is a critical stage in a patient's pathway. This paper aims to capture the perspectives of patients who are preparing to move on from high to medium security. Design/methodology/approach -Nine patients who were in the "discharge preparation" stage of their pathway were interviewed to capture their perspectives on the process. Interview transcripts were analysed using thematic analysis. Findings -Nine themes were identified as representing the patient interviews: trust and support, feeling empowered, journey of self-acceptance, skilling-up, getting to know the Medium Secure Unit (MSU), feeling disempowered and unvalued, issues with the system, anxiety about endings, and stigma and society. Originality/value -This paper gives voice to patients across clinical directorates at a UK high secure hospital regarding their perspectives on what has helped and hindered their discharge preparation. It presents some new findings, and recommended good practice, which should be of use to clinicians and managers who wish to enhance discharge preparation interventions for patients within high secure services.

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“…Previous research into unsuccessful discharge from high security supports this finding (e.g. Tetley et al, 2011). …”

Section: Discussionsupporting

confidence: 74%

mentioning

confidence: 99%

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“I couldn’t have done it on my own.” Perspectives of patients preparing for discharge from a UK high secure hospital

Madders

George

2014

Mental Health Review Journal

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“…Challenging and inappropriate behaviour by PDOs was also thought to be draining, stressful and to inspire a degree of fear [ 33 ]. Such behaviour could also lead to splits within the staff team itself [ 34 ] or difficulties with communication [ 35 ] that could deepen over time.…”

Section: Resultsmentioning

confidence: 99%

The Impact on Staff of Working with Personality Disordered Offenders: A Systematic Review

et al. 2015

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BackgroundPersonality disordered offenders (PDOs) are generally considered difficult to manage and to have a negative impact on staff working with them.AimsThis study aimed to provide an overview of studies examining the impact on staff of working with PDOs, identify impact areas associated with working with PDOs, identify gaps in existing research,and direct future research efforts.MethodsThe authors conducted a systematic review of the English-language literature from 1964–2014 across 20 databases in the medical and social sciences.Results27 papers were included in the review. Studies identified negative impacts upon staff including: negative attitudes, burnout, stress, negative counter-transferential experiences; two studies found positive impacts of job excitement and satisfaction, and the evidence related to perceived risk of violence from PDOs was equivocal. Studies demonstrated considerable heterogeneity and meta-analysis was not possible. The overall level of identified evidence was low: 23 studies (85%) were descriptive only, and only one adequately powered cohort study was found.ConclusionsThe review identified a significant amount of descriptive literature, but only one cohort study and no trials or previous systematic reviews of literatures. Clinicians and managers working with PDOs should be aware of the potential impacts identified, but there is an urgent need for further research focusing on the robust evaluation of interventions to minimise harm to staff working with offenders who suffer from personality disorder.

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“…Newton-Howes et al (2008) found that those people with a diagnosis of Personality Disorder were perceived to be more difficult to manage and that their label created a stigma by mental health clinicians working in community mental health teams. Tetley et al (2011) investigated the experience of clinicians who worked in medium secure services with people with Personality Disorder (PD) through semi structured interviews analyzed using thematic analysis. They reported that staff found the following behaviors difficult to work with in this group: complaints, physical and verbal aggression, being hostile, intimidation and manipulation, and a tendency to challenge boundaries.…”

Section: Introductionmentioning

confidence: 99%

An Interpretative Phenomenological Analysis on the Experience of Probation Officers in Managing People With Antisocial Personality Disorder

Lad

Walker

2022

Int J Offender Ther Comp Criminol

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People who are managed by the National Probation Service and convicted of high risk offences will often meet criteria for antisocial personality disorder and have complex psychosocial needs; this group of people present with high risk behavior which may professionals have been reluctant to work with in the past who are associated with higher rates of recidivism. This study investigated the experiences of probation officers in managing people who meet the criteria for Anti Social Personality Disorder. Semi structured interviews were conducted with six participants to capture their experiences of working with this population, the challenges they faced, and coping mechanisms employed, through analysis using Interpretative Phenomenological Analysis (IPA). Three superordinate themes were identified which revealed participants internal feeling, strategies employed, and external challenges. They spoke about internal negative feelings, specifically feeling controlled, having mistrust, a lack of confidence, being overwhelmed with emotion, and experiencing a fear of risk behaviors. Other themes involved external pressures as well as different coping responses. Implications are discussed to help probation officers to understand this population, for the organization to support staff to work with challenging behaviors and prevent burn out, to enable positive outcomes, and for potentially reducing reoffending.

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The transition from high secure, to medium secure, services for people with personality disorder: Patients and clinicians experiences

Cited by 5 publications

References 25 publications

“I couldn’t have done it on my own.” Perspectives of patients preparing for discharge from a UK high secure hospital

“I couldn’t have done it on my own.” Perspectives of patients preparing for discharge from a UK high secure hospital

The Impact on Staff of Working with Personality Disordered Offenders: A Systematic Review

An Interpretative Phenomenological Analysis on the Experience of Probation Officers in Managing People With Antisocial Personality Disorder

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