Introduction to the updated ALACRITy study; a long-term follow-up of a Medium Secure Unit (MSU) cohort
Gibbon, Simon D.
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Poster from the Trent Study Day 2019The safe management and appropriate care of mentally disordered offenders (MDOs) is a concern for mental health practitioners, commissioners and the general public alike. In the UK, the provision of secure mental health care is currently undergoing significant change. Under the ‘New Care Model’, medium secure units (MSUs) will continue to provide essential care for MDOs and non-offender patients, who are not suitable for treatment in general mental health hospital or the community due to the risk they pose to themselves or to others, but who do not require the level of security provided by the high secure hospital estate. MSUs first opened in the 1980s and there have been a number of MSU follow-up studies that have contributed to the modest literature on the outcomes of patients discharged from secure psychiatric hospital,. Many of the early MSU follow-up studies were methodologically weak in that they failed to account for the time that participants were not in hospital or in prison; most focused primarily on reconviction. The original ALACRITy study of admissions to Arnold Lodge from 1983 to 2003 was one of the few follow-ups to address patients’ ‘time at risk’ in the community and consider mortality as an outcome. The unit now has seven wards providing care in three care streams: Male Personality Disorder, Male Mental Illness and Women’s services (both standard and enhanced). There is evidence that the complexity of patients admitted to the unit has increased over time, as the service has responded to changes in commissioning priorities.