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Forensic mental health services play a key role in the diversion, treatment, rehabilitation, and supervision of offenders with mental health problems in Europe. Private sector providers are increasingly commissioned to provide secure care for service users. Questions have been raised about the effectiveness of the private sector providers. A sample of 229 patients from low, and medium secure psychiatric services in the United Kingdom was analyzed to determine differences in restrictive practices, adverse service user incidents, and service user characteristics between service users admitted to private sector or publicly funded hospitals. Service users with a diagnosis of a personality disorder, and those who had multiple psychiatric diagnoses were disproportionately placed in the private sector. Greater prevalence of seclusion, physical restraint, verbal aggression toward staff, physical violence toward staff and other service users, property damage, and self-harm were observed in private sector service users. Further attention is warranted around the decision-making processes that allocate people to private versus publicly funded care, potential sources of bias in admission characteristics should be taken into account when interpreting poorer clinical outcomes in the private sector. [ABSTRACT FROM AUTHOR]

Accessible Summary What is known on the subject What the paper adds to existing knowledge What are the implications for practice Introduction Aims Method Results Discussion Implication for Practice Secondary traumatic stress (STS) is the indirect traumatisation of a person through the stress of helping or knowing about other's trauma. Burnout is gradual exhaustion in response to long‐term work‐related stress. Both have negative psychological, physiological and/or organisational consequences; however, the existing research in forensic health care professionals (FHCPs) is limited. One study explored STS in FCHPs and found that lower psychological flexibility (ability to adapt) was a predictor of greater STS. Existing research on burnout in FHCPs suggests that individual differences, such as the ways in which we cope (talking to people vs. using substances), may predict burnout levels. Prevalence findings add to the recent evidence base, which also found moderate levels of burnout. However, this study is the first to find high levels of secondary traumatic stress in FHCPs. Similar to existing literature, the study's findings suggest that FHCP's with lower levels of psychological flexibility and more maladaptive coping strategies may experience greater STS and burnout symptoms, while staff who use more adaptive coping strategies may experience less burn‐out. Unexpectedly, staff who reported a more anxious attachment style were burnt‐out; however, there are limitations to this finding. Policies and practices in forensic settings should reflect the risk of STS and burnout. Practices or interventions should enhance adaptive coping strategies and psychological flexibility, such as Resilience Enhancement Programmes or Acceptance and Commitment Therapy (ACT). Secondary traumatic stress (STS) and burnout literature in inpatient forensic health care professionals (FHCPs) is limited, despite the psychological, physiological and organisational consequences.This study aimed to further this limited evidence base, investigating predictors of STS and burnout in FHCPs.98 healthcare professionals working in two UK forensic inpatient settings completed measures assessing: burnout, STS, psychological flexibility, coping style, attachment style and a demographic questionnaire recording length of service and the sex of staff.Results indicated high STS and moderate burnout levels. The main predictors of STS and burnout were poorer psychological flexibility and greater maladaptive coping styles, whereas lower burnout was predicted by greater adaptive coping styles and an anxious attachment style.This study has contributed towards a limited evidence base and indicates poorer psychological flexibility and greater maladaptive coping may be risk factors for STS and burnout in FHCPs, whereas greater maladaptive coping may be a protective factor.The findings suggest that interventions such as Acceptance and Commitment Therapy (ACT) and coping skills interventions, may offer protective benefits to inpatient forensic healthcare professionals. [ABSTRACT FROM AUTHOR]

Inpatient ward social climate and sense of community can influence the recovery and care experiences of forensic mental health patients. This research evaluated an intervention designed to improve social climate and sense of community within a high-secure psychiatric hospital in the UK. The intervention was offered across six wards: two wards received the full intervention, two received the partial intervention, and two received no intervention (control). Social climate and sense of community were measured prior to the start of the intervention 6 and 18 months into the intervention, using the Essen Climate Evaluation Schema and the Sense of Community Index-2. Changes in frequency of disruptive behaviour were also monitored across time points. Results revealed that the full and the partial intervention groups reported greater feelings of social climate than the control group. This effect was also observed across time points, with higher social climate scores in the full and partial intervention groups compared to control group at 6 and 18 months. Furthermore, social climate scorespredicted a significant reduction in frequency of incidents across time in the full intervention. These findings provide longitudinal evidence of the importance of developing ward social climate and sense of community within forensic inpatient settings. [ABSTRACT FROM AUTHOR]

Seclusion is one of the extreme measures of managing violence and aggression. Despite the evidence base for the effectiveness and therapeutic value of seclusion being limited, there arguably remains a compelling case for its use. This qualitative study aimed to explore forensic nurse's experiences and perspective on the use of seclusion in clinical practice and establish: •What are the factors that influence and inhibit the use of seclusion? •What skills are required when caring for patients in seclusion? A purposive sample of 12 registered and non-registered nurses from a UK high-security hospital consented to engage in a focus group. Thematic analysis was used to interrogate the data. The results included two emerging themes: 'Keeping everyone safe' and 'The challenges', including the identification of binary oppositions. A rationale for the use of seclusion; it's a last resort. Evidence of challenges to the therapeutic relationship and communication barriers. Findings illustrate the need to critically examine the practise of seclusion, accuracy of risk assessment, also to balance safety and security proportionately and ensure therapeutic value. The use of a daily dynamic risk assessment and staff relational training is recommended to improve communication and reduce excessive and prolonged use of seclusion What is known on the subject Over the last decade, significant headway has been made across the globe in relation to reducing restrictive practices such as seclusion. Early intervention and staff confidence in managing violence and aggression have been identified as factors that influence the occurrence of seclusion. What the paper adds to the existing knowledge Findings support the necessity to utilise objective assessment routinely. The binary oppositions described within the presenting results are as relevant today as they were almost two decades ago when published by Mason (2002) This paper provides new knowledge on forensic nurses' perception use of seclusion and draws attention specifically to the impact of the therapeutic relationship and communication challenges during a seclusion event. What are the implications for practice The provision of a daily dynamic risk assessment within nursing practice will effectively identify patients who are imminently at risk of engaging in violence and aggression and reducing excessive and/or prolonged use of seclusion. Staff development and development that includes relational skills training in how to manage complex relationships to improve positive communication and reduce the need for seclusion being required. The findings suggest the need for future research and senior managers and health-care professional leaders to gain a better understanding of the factors that influence the clinicians' decisions in the use seclusion, in order to achieve long-term reductions in its use. [ABSTRACT FROM AUTHOR]

Background: People with an intellectual disability who commit a criminal offence can be detained, by a court, in a forensic inpatient facility. There is limited understanding of how inpatients with an intellectual disability and their nurses navigate risk in U.K. forensic services. Methods: A traditional literature review design was followed to map evidence (2000–2021) around the forensic and health and wellbeing risks faced by inpatients with an intellectual disability, nurses' perceptions of managing risk, and patient experiences of informing risk assessment and management. Papers were analysed thematically. Results: Findings suggest that restrictive measures to mitigate forensic risks (e.g., violence) can exacerbate the risk of poor health and wellbeing outcomes. There was some limited evidence of direct patient involvement in risk assessment and management. Conclusion: Further research is required to explore how forensic inpatients with an intellectual disability can have input in care planning, risk assessment and management. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your awareness of the physiological effects and potential complications of exposure to Taser • To acknowledge recent changes to the assessment and management of people who have been 'tasered' • To understand the role of nurses in post-Taser assessment and management in custodial and emergency settings The use of conducted energy devices – better known under the brand name Taser – by police officers is subject to scrutiny. Consequently, the clinical assessment and management of people who have been exposed to Taser discharge is also subject to scrutiny. In 2021 the Conducted Energy Device Joint Working Group published a new guideline on assessment in police custody after Taser discharge. The guideline enables any appropriately trained and competent healthcare professional, including nurses, to undertake post-Taser assessments and determine the person's fitness to be detained in police custody. This would be done in the first instance by nurses working in police custody suites, but emergency department (ED) nurses may also be involved, as people who have been 'tasered' may need referral to the ED. This article explains how Tasers work, their physiological effects and potential complications, and the required approaches to clinical assessment and management as outlined in the new guideline. [ABSTRACT FROM AUTHOR]

Readmission from secure forensic services has significant implications for individuals and providers. Whilst there is research on readmission for forensic services internationally and for medium secure services in the UK, little is known about rates of readmission to low secure services, and there is no research examining predictors of readmission in low secure services specifically. This study aimed to examine rates and predictors of readmission of 94 individuals discharged from UK-based low secure services. A retrospective quantitative design was employed to assess the rate of readmission. Treatment, demographic, clinical and forensic factors were considered to compare readmitted and non-readmitted groups and examined as possible predictors of readmission. In total, 34% patients were readmitted with an average time to readmission of 524 days. Readmitted patients differed significantly from non-readmitted on prescribed antipsychotic medication, previous forensic admissions, psychology intervention and group psychology intervention. Previous secure forensic admissions, scoring present on HCR-20 historical problems with violence and employability were significantly associated with a shorter time to readmission. Deterioration in mental state was the most common reason for readmission. Time to readmission post-discharge from low secure services can be predicted by several factors that are readily available to clinical teams. This novel exploratory investigation is imperative in furthering understanding of factors associated with readmission to LSFS. [ABSTRACT FROM AUTHOR]

The landscape of mental health recovery is changing; there have been calls for a shift from the clinical expertise being the dominant voice within mental healthcare towards a more personalised and collaborative service that supports those in need of mental healthcare to define what recovery is for the individual. Within this new recovery movement, there has been a recognition of the importance of the social environment in which individuals are situated and the relationship of this to mental health and wellbeing. Included in this is the importance of an individual's role within society and the ways in which knowledge, such as experts by experience, can hold an important value. The argument then, is that social connectedness forms part of the recovery journey and that relationships can help us develop or re-connect with who we are in powerful ways. Such a view has only been strengthened by the recent and ongoing global COVID-19 pandemic. Within the UK, discussions of the importance of our wellbeing have become commonplace within the context of restricted social contact. With this heightened awareness of how the social contributes to wellbeing, it is important to consider the environments in which those in receipt of mental healthcare are situated. One of which is institutionalised care, where it is commonplace to restrict social contact. For example, by virtue of being within a locked environment, individuals' freedom of movement is often non-existent and thus contacts with those not residing or working within the institution is restricted. While such restrictions may be deemed necessary to protect the individual's mental health, such environments can be unintentionally toxic. Data are presented from an ethnography that was conducted within an inpatient forensic mental health hospital in the UK to highlight the problematic social environment which some individuals experience. Key interpersonal issues are presented, such as, trust, racism, the threat of physical violence and bullying that was experienced by staff and residents at the hospital. Consideration is given to the coping strategies enacted by residents and the pathologising of such behaviour. The consequences on interpersonal wellbeing are explored. [ABSTRACT FROM AUTHOR]

The forensic care needs of females have received increased attention over recent years, with Department of Health (DOH) initiatives highlighting the need for gender-sensitive service provision. However, little is understood about how women experience such services. This review aimed to systematically review and synthesise the findings of existing qualitative literature exploring female service users' experiences of secure care in the UK. A systematic search of four databases and subsequently applied inclusion and exclusion criteria resulted in fifteen papers that have qualitatively explored female service users' views on secure care provision. The methodological quality of each paper was appraised before employing a Thematic Synthesis approach to integrate the findings. The resultant papers were appraised to be of varying quality although it was often unclear whether this was due to differing methodological rigour or the reporting of such. The synthesis revealed three overarching themes: 'Safety and Containment', 'Empowerment and Acceptance' and 'Making Change'. The findings provide a valuable synthesis of a limited area of qualitative research and highlight areas of importance for female forensic service users. They fall in line with current guidance, as well as indicating new areas for service improvement to ensure positive experiences and outcomes. [ABSTRACT FROM AUTHOR]

Unpaid carers, in the UK, are estimated to contribute 132 billion pounds to society, often at a cost to their own physical and mental wellbeing. Therefore, various governmental directives since 1995 have focused on recognizing the significant contribution made by carers by improving their involvement in services. Carer research within mental health has focused primarily on general mental health and acute settings. Relatively little is known about the experiences and needs of carers of forensic psychiatric inpatients currently using inpatient care. This qualitative study aimed to examine the experiences of this group and ascertain their needs. Four carers took part in a focus group and two carers were interviewed individually. Thematic analysis was used and identified four themes: navigating the mental health system, impact of caring, what helps? and experience of current inpatient forensic service. Findings suggest that some improvements have occurred over the past few years in support for carers and in service provision for their loved one's treatment. However, more improvements are urgently needed because carers continue to experience emotional burden, feeling excluded by services, and strain from their caring responsibilities. Implications for future research and guidance for service providers and policymakers are discussed. [ABSTRACT FROM AUTHOR]

Background: Sexual violence is a profoundly disempowering experience. It is essential that survivors are offered access to comprehensive medical care, psychological support, and follow-up in a way that offers them a high level of choice and control., Aims: There has been little research into how practitioners working in the context of immediate postassault understand empowerment and reflect this in their care delivery. This study sought to explore how crisis support workers and forensic nurse examiners conceive how they enact an "empowerment approach" in a sexual assault referral center (SARC) in the United Kingdom., Methods: A phenomenological approach was taken, and data were gathered through focus groups and interviews., Findings: Themes were identified under the headings of "indicators of empowerment," "empowerment as a process," and "the empowerment approach.", Conclusion: As part of providing person-centered care that enacts an empowering approach within the SARC setting, professionals need the skills and resources to be able to respond flexibly to their clients. They have a role in addressing victim blaming of those subjected to sexual violence and in promoting the accessibility of SARC services., Competing Interests: The author declares no conflict of interest., (Copyright © 2024 International Association of Forensic Nurses.)

This study aimed to evaluate a mentoring programme embedded in a work‐based personal resilience enhancement intervention for forensic nurses. This qualitative study formed part of a wider mixed‐methods study that aimed to implement and evaluate the intervention. Twenty‐four semistructured interviews were carried out with forensic nurse mentees and senior nurse mentors; these explored their experiences of the mentoring programme and any benefits and challenges involved in constructing and maintaining a mentor–mentee relationship. Qualitative data were analysed thematically using the Framework Method. Four key themes relating to the initiation and maintenance of mentor–mentee relationships were identified: finding time and space to arrange mentoring sessions; building rapport and developing the relationship; setting expectations of the mentoring relationship and the commitment required; and the impact of the mentoring relationship for both mentees and mentors. Study findings highlight the benefits of senior nurses mentoring junior staff and provide evidence to support the integration of mentoring programmes within wider work‐based resilience enhancement interventions. Effective mentoring can lead to the expansion of professional networks, career development opportunities, increased confidence and competence at problem‐solving, and higher levels of resilience, well‐being, and self‐confidence. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known about this subject?: Burnout is a prominent issue in psychiatric nursing and associated with significant adverse consequences for staff, service users and at an organizational level.Exploration of the extent and predictors of burnout in secure settings has received little research attention. It is not fully understood why prevalence rates of burnout in forensic settings are not elevated in comparison to other settings, despite the presence of known risk‐related correlates. What this paper adds to existing knowledge?: In contrast to previous research, findings suggest that clinical supervision may not be an effective, stand‐alone intervention to support staff experiencing burnout. Thus, the current focus on clinical supervision to mitigate burnout may be insufficient in forensic services.The ward environment (specifically how safe staff feel, how therapeutic the ward feels and how well service users relate to one another) was found to be more important than clinical supervision in terms of burnout for forensic psychiatric nursing staff. What are the implications for practice?: Policies regarding staff health and well‐being should be developed with due consideration given to the association between burnout and the working environment.It should not be assumed that clinical supervision is sufficient to mitigate burnout in practice. Further research assessing all types of support and the ward environment is needed to gain a better understanding of its relationship to burnout. Introduction: Despite extensive research examining burnout in psychiatric nursing staff, literature exploring key predictors of burnout in secure psychiatric settings has been relatively neglected. Research has yet to explore burnout in these settings by adopting previously identified predictors such as support or the ward environment. Aim: The current study aimed to reduce this gap by exploring burnout, the perceived effectiveness of clinical supervision and ward environment. Method: In 2014, nursing staff working in a medium secure forensic psychiatric unit in the United Kingdom (N = 137) provided demographic information and completed the measures assessing: Burnout, clinical supervision and the ward environment. Results: Approximately 10% of nursing staff could be classed as "burnt‐out". The main predictors of burnout were age and ward environment. Clinical supervision had minimal association with burnout. Discussion: The current study sheds doubt on clinical supervision as a potential intervention for burnout and results appear comparable to research within other settings. The implications of the ward environment, supervision and burnout are discussed herein. Implication for Practice: Interventions may need to focus on a positive ward environment (including patient cohesion, experienced safety and enhancing the therapeutic atmosphere). Organizations should support younger nursing staff as they appear particularly vulnerable to burnout. [ABSTRACT FROM AUTHOR]

Sexual and gender-based violence (SGBV), and particularly intimate partner violence (IPV), has spiked dramatically during the COVID-19 pandemic. At the same time, the pandemic is impacting and interrupting SGBV and IPV services of all kinds. This paper focuses on the impact of the COVID-19 pandemic on clinical care and forensic medical documentation for SGBV survivors, including an analysis of the response in the UK and Kenya, and provides recommendations for safe implementation of these services during the pandemic. [ABSTRACT FROM AUTHOR]

Victims of violence often seek assistance from emergency departments, so emergency nurses are ideally placed to identify them, and other 'forensic' patients, and protect the evidence that could support any ensuing legal process. Emergency nurses who are trained to identify, collect and preserve forensic evidence can support the identification, elimination and prosecution of suspects. This article gives an overview of forensic evidence, and explains how emergency nurses can preserve and collect samples effectively. [ABSTRACT FROM AUTHOR]

Aim To identify and discuss the competencies required by learning disability nurses to work effectively with people with an offending background in low, medium, high secure and community settings. Background Research into the competencies required by nurses working with individuals with an offending background, particularly those with a learning disability, is limited. There is some uncertainty as to whether there should be differentiation according to specific setting. Design A qualitative study addressing the perceptions of nurses on the knowledge, skills and competencies required to effectively work with people with learning disabilities and an offending background in different settings. Methods Seven focus groups were conducted across the four settings to inform the construction of the semi-structured interview schedule. Thirty-nine interviews were subsequently undertaken with nurses across settings to develop a fuller understanding of the competencies and ascertain if these were influenced by the specific setting where the nurses worked. Data were collected over 1-year in 2010 and analysed using a structured thematic analysis supported by the software package MAXqda. Findings The thematic analysis produced four over-arching competencies: knowledge assimilation and application; team working; communication skills; and decision-making. A further competency around personal attributes constitutes the basis of a future paper. Conclusion The first three competencies combine well to inform the work of nurses and appear transferable across settings, but the fourth appears more complicated, specifically in terms of the role of risk in supporting or detracting from decision-making capacity. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to complete a thorough needs assessment that would enable the development of a robust pathway of care for adults with a learning disability requiring secure care, and to assist commissioners to make informed planning decisions. Design/methodology/approach – The paper identified people with a learning disability originating from London who were in secure care, and collected data about them. The paper used reference groups to inform the analysis. Findings – The paper identified 249 people in secure services and was able to include 136 patients in the analysis. In all, 64 were in NHS provision and 72 in independent sector provision; 109 (80.1 per cent) were male and 27 (19.9 per cent) female; on average, patients were cared for 61.5 miles away from their homes; NHS patients were far closer to home; 69.1 per cent had a mild learning disability; 82.3 per cent had a history of violence; approximately one in six patients could not progress due to a lack of an appropriate ward, facility, resource and/or intervention. Practical implications – Secure care for this population is a major public health issue. Many are placed a long way from home. Local services should be developed, and there should be sufficiently robust “step down” places for patients to be discharged to. Originality/value – Systematic identification of the needs of a marginalised group to enable better more appropriate care pathways to be developed in the future. [ABSTRACT FROM AUTHOR]

Aim and objective. To understand better the skills and competencies for forensic and non-forensic nursing of psychopathic and personality disordered patients. Background. In the UK, there has been growing interest in service provision for this client group, but with little research to support the nursing skills required. Design. A non-experimental design, using a postal survey to 990 forensic and 500 non-forensic nurses. Method. An information gathering schedule was used to generate data about the most desirable skills and competencies and least desirable weaknesses and nursing attributes to nurse this group. Results. The results for the forensic nurses. Main strengths and skills: being firm, setting limits and defining boundaries. Main weaknesses: inability to engage, inability to resolve conflict and impatience. Main skills and competencies: being non-threatening, non-judgemental and able to expect anything. Least desirable qualities: over-reacting, being judgemental and over-confrontational. The results for the non-forensic nurses. Main strengths and skills: being non-judgemental, listening skills and good risk assessment. Main weaknesses: frustration with the system, a fear of aggression and no skills to engage. Main skills and competencies: being open-minded, non-judgemental and forming relationships. Least desirable qualities: a supercilious attitude, cynicism and being judgemental. Conclusion. The results highlight the importance of forming therapeutic relationships as the bedrock of both forensic and non-forensic nursing, and they also highlight the important differences with regard to the significance of therapeutic action and therapeutic verbal interaction. Relevance to clinical practice. The provision of better care for this client group will rely on appropriate training for nurses. This research highlights the need for training that supports the development of engagement skills, communication skills and an ability to use reflection in action as a means of providing therapeutic care. It also highlights the different emphasis on the use of these skills by forensic and non-forensic nurses. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to examine the nature and prevalence of violence in a medium secure unit and to evaluate a personal defence training programme for staff working with mentally disordered offenders. Design/methodology/approach – The paper identifies an existing training gap associated with traditional breakaway techniques and describes a process of piloting a new educational module known as the spontaneous protection enabling accelerated response (SPEAR) system. Structured questionnaires were used to collect demographic data and analyse staff confidence and perceptions of the training module. Clinician confidence in coping with patient aggression was measured before, immediately after and at three months following participation in the new programme. Findings – A significant change in staff confidence was observed at two time scales after the training had been administered when compared with the pre-test baseline total scores. Over 90 per cent of staff either agreed or strongly agreed that training in the new personal defence module provided a credible defence against sudden episodes of high-risk violence. Originality/value – The paper describes a proposed module of training that may provide a credible tertiary strategy for those frontline clinicians currently exposed to the risk of sudden, spontaneous episodes of close proximity violence where traditional breakaway techniques are likely to be ineffective. This paper would interest managers, trainers and specialist practitioners that are involved in the preparation and delivery of violence reduction initiatives aimed at promoting safer and therapeutic services. [ABSTRACT FROM AUTHOR]

Although available for over a decade, use of nonoccupational postexposure prophylaxis (nPEP) remains controversial in the United States. There are concerns over sexual assault survivors' adherence, or lack thereof, leading to increased costs without an appreciable decrease in human immunodeficiency virus (HIV) transmission. This review examines and synthesizes the available literature from the past 10 years to determine the true rates of provision and adherence to nPEP regimens in sexual assault survivors in low HIV prevalence, industrialized nations. Findings suggest that further prospective research is necessary to better understand the process of post-assault nPEP evaluation and subsequent follow-up and adherence. [ABSTRACT FROM AUTHOR]

dickinson t. & hurley m. (2012) Exploring the antipathy of nursing staff who work within secure healthcare facilities across the United Kingdom to young people who self-harm. Journal of Advanced Nursing 68(1), 147-158. Abstract Aims. This paper is a report of a study that compared relevant attitudinal dimensions of Registered Nurses and nursing aides working within a Young Offenders' Institute and two young people's forensic units in the United Kingdom towards young people in their care who self-harm. Background. Nurses caring for young people within secure environments may engage at some point with patients who harm themselves. These staff often experience strong negative emotional reactions which can lead to antipathy and alienation. Methods. Forty seven Registered Nurses and 22 nursing aides completed the Self-Harm Antipathy Scale, which consists of 30 attitudinal self-report items. The data were collected between June 2008 and December 2008, and analysed using spss version 17. Results. Results displayed that age per se, length of service with self-harming clients, and whether the participant was a Registered Nurse or nursing aide, and number of self-harming clients worked with did not influence the Self-Harm Antipathy Scale score or any of its component sub-scores. However, field of nursing the nurse was registered under, previous study of self-harm, year first registered and gender showed significant effects. Conclusions. Given that responses reflect a degree of both empathy and apathy it seems that there is a need to promote greater therapeutic alliances and communication; for example, the use of positive regard to help reduce the incidence of labelling and the negative effects this has upon relationships. There is a significant need for nursing staff working with young people who self-harm to have access to relevant educational programmes. A focus on harm minimization could be key areas for further development. [ABSTRACT FROM AUTHOR]

The devastating emotional impact of homicide on the families, friends and close associates of the primary victims is not well understood, and secondary victims receive little specialist support from mental health practitioners. This article reviews the present state of theory and research concerning homicide and health, seeks to explain the meaning of the term 'devastation' when applied to secondary victims' emotional experiences, and describes a link between bereavement and post-traumatic stress disorder. The authors argue that further work is needed to provide appropriate support and that mental health nurses have an important role to play, particularly in assessing the health consequences for secondary victims of homicide. [ABSTRACT FROM AUTHOR]

This article reports on a study carried out on the role constructs of forensic and nonforensic Learning Disability Nursing in relation to six binary themes. The aims were to identify if there were differences in perceptions of forensic learning disability nurses and nonforensic learning disability nurses in relation to the six binary themes of the role construct framework and then to establish if there were differences between the two groups of nurses. The method was a survey design with the sample drawn from high, medium and low security settings and nonsecure settings in the UK. From 400 questionnaires distributed, response rates of 46% and 49% were achieved from secure and nonsecure settings, respectively. The results indicate that the forensic nurses group show a significant difference between ranked scores on a number of themes but no significant difference was found between scores on one of the themes. The nonforensic nurses group also showed a significant difference between scores on a number of the themes but no significant difference was found between scores on a number of themes. Finally, the results of the between group analysis show a significant difference between forensic and nonforensic groups scores on several themes but these are few in number. The conclusions drawn are that whilst there is some support for the relevance of the themes in relation to learning disabilities in the forensic setting, there is less support for nonforensic settings. [ABSTRACT FROM AUTHOR]

This paper reports on an investigation into the skills and competencies of forensic learning disability nurses in the United Kingdom. The two sample populations were forensic learning disability nurses from the high, medium, and low secure psychiatric services and non-forensic learning disability nurses from generic services. An information gathering schedule was used to collect the data; of 1200 schedules, 643 were returned for a response rate of 53.5%. The data identified the 'top ten' problems that forensic learning disability nurses may encounter, the skills and competencies necessary to overcome them, and the areas that need to be developed in the future. The results indicated that the forensic learning disability nurses tended to focus on the physical aspects to the role whilst the non-forensic learning disability nurses tended to perceive the forensic role in relational terms. This has implications for practice, policy, and procedures. [ABSTRACT FROM AUTHOR]

The article reports on a seven-year study at the Humber Centre for Forensic Psychiatry in Hull, England, regarding violence in its medium-secure psychiatric unit. It was observed that a multi-professional working environment, structured activity programs, training in violence management, user participation and flexibility of the medical environment, resulted in a reduction in violent behavior in patients.

ABSTRACT This paper outlines the development and convergence of forensic science and secure psychiatric services in the UK, locating the professionalization of forensic nursing within a complex web of political, economic, and ideological structures. It is suggested that a stagnation of the therapeutic enterprise in high and medium security provision has witnessed an intrusion of medical power into the societal body. Expanding technologies of control and surveillance are discussed in relation to the move from modernity to postmodernity and the ongoing dynamic of medicalized offending. Four aspects of globalization are identified as impacting upon the organization and application of forensic practice: (i) organized capitalism and the exhaustion of the welfare state; (ii) security versus danger and trust versus risk; (iii) science as a meta-language; and (iv) foreclosure as a mechanism of censorship. Finally, as a challenge for the profession, some predictions are offered about the future directions or demise of forensic nursing. [ABSTRACT FROM AUTHOR]

The increasing development of forensic services has seen the numbers of Forensic Community Mental Health Nurses (FCMHNs) mushroom. Community mental health nursing (CMHNs) has been found to be a stressful occupation. FCMHNs have largely been ignored in research into occupational stress. The current study identified and surveyed all FCMHNs (n = 104) in England and Wales who were attached to NHS Medium Secure Units using measures of occupational stress. A response rate of 76.9% was achieved. Findings from this study showed that a substantial portion (44.3%) of FCMHNs were experiencing high burnout in relation to emotional exhaustion. A number (31.2%) of FCMHNs reached or exceeded the threshold for psychiatric caseness on one measure. Concerns of FCMHNs included 'not having facilities in the community to refer patients on to' and 'interruptions in the office'. Dealing with violent patients did not feature in the top 10 stressors, although dealing with suicidal patients did. As a group FCMHNs appear to feel supported by their managers and colleagues. [ABSTRACT FROM AUTHOR]

(2011) Journal of Nursing Management , 302-304 To consider ethical propositions relating to nursing in UK forensic settings. A previous paper considered behavioural programmes with a Canadian forensic population. Some literature and personal reflections are presented. Whilst some similarities with the nature of Canadian forensic settings are identified, the UK is developing its' own cognitive-behavioural tradition of working. The skills necessary for working with forensic patients are a development of a wider mental health nursing and therapy skill-set. Nurse managers within forensic services need to be clear about the values of their services and ensure that therapeutic approaches are consistent with these values. Managers must consider how to support nurses acquire the requisite skill-set. [ABSTRACT FROM AUTHOR]

The article reports on the development of a nursing research culture in forensic psychiatry in Great Britain. As part of government efforts to encourage the participation of psychiatric nurses, a high secure Scottish psychiatric hospital was commissioned to devise a two-year research strategy. Its aim is to help encourage mental health nurses to take a more active role in research and dispel the myths surrounding the research process.

A letter to the editor is presented in response to an article about the ethical implications of behavioral modification programs among disadvantaged forensic and correctional populations, by Holmes and Murray, published in the 2011 issue.

The article reports on the launch of the UK Association for Forensic Nurses (UKAFN) at King's College Hospital National Health Service Foundation in London, England. The group aims to bring together forensic nurses across Great Britain and improve conviction rates for sexual offenses. According to Jo Delaforce, the association's chairman, UKAFN will develop guidelines for safe and secure collection of forensic evidence.