Wathwood Hospital

PurposeThe purpose of this paper is to explore the experiences of both staff and patients in a medium-secure mental health unit of the self-harm and/or suicidal behaviour of others. Suicide and self-harm is highly prevalent in forensic settings and evidence suggests that experiencing other people’s self-harm and suicidal behaviour can lead to negative outcomes, both for staff and patients. This is particularly important in hospitals where patients are highly dependent on staff for support.Design/methodology/approachSemi-structured interviews were conducted with five staff members and six patients in a medium-secure male mental health unit in the North of England. Data were analysed following interpretative phenomenological analysis guidelines.FindingsThree dominant themes were identified during analysis: the impact of suicide and self-harm; the role of others; and the importance of understanding and experience. Various impacts were discussed including desensitization, negative emotions and the desire to help. Other people played an important role in protecting against negative impacts, with shared experiences and peer support reported as the biggest benefits. Experiences of self-harm and suicide were found to increase understanding resulting in more positive attitudes. Additionally, the importance of training and education was highlighted.Originality/valueThis paper provides an insight into the experiences of staff and patients in medium-secure male mental health unit, which has benefits to practitioners when considering support mechanisms.

Evidence suggests a complex relationship between substance misuse, mental health, and violence in forensic populations, however, the majority of existing research and interventions focus on these factors individually. This paper reports an evaluation of the first module of an integrated poly-substance misuse group delivered within a medium secure mental health hospital, which was designed to address these factors collectively. Qualitative and quantitative approaches were used to assess participant's subjective views of the program and to gather pre and post quantitative measurement of change. The concordance between self report and observer reports was explored. Recommendations for the development of the treatment and for further evaluation and research are discussed.

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The supervision of mentally disordered offenders at risk of harm to themselves or others is universally practised, but there is little research evidence in the literature as to how, in what circumstances, with which patients, to what end and with what results for the patient and/or staff. This article reviews the available evidence on the practice and calls for evidence based guidelines for the role inherited by nurses to inform effective practice. It concludes:• empirical evidence is lacking on the supervision of mentally disordered offenders as an effective nursing intervention• there is evidence of ambiguity as regards psychiatric nursing interventions• supervision of mentally disordered offenders is subject to covert and inconsistent practice• there is a need for research on which to base training, skill mix decisions and the general management of supervision.