Citation

Tolland H, McKee T, Cosgrove S, Drysdale E, Gillespie M, Paterson L, Totten C. J. Forensic Psychiatry Psychol. 2019; 30(4): 570-593.

Copyright

(Copyright © 2019, Informa - Taylor and Francis Group)

DOI

10.1080/14789949.2019.1627387

PMID

unavailable

Abstract

Women in secure forensic mental health care require therapy and care that is responsive to their specific needs. Despite the policy recognition that women require a distinct service, evidence based practice is not available for this population. This review was undertaken in response to a clinical need within a medium secure unit in Glasgow that was experiencing high levels of challenging behaviour, in a female ward. The review aimed to identify effective strategies or interventions for the management of challenging behaviour in women in secure services and, therefore, improve practice and patient care. A synthesis of the findings from the 11 identified studies revealed variability in the approaches used to support women in forensic services, including: behavioural programmes; organisational change with a focus on staff training and support; medication; ECT and mechanical restraint. The challenging behaviours assessed included self-harm; physical and verbal aggression; suicide attempts and arson/fire setting. The majority of articles suggested some improvement in aspects of challenging behaviour, however this was limited by the lack of control groups and small sample sizes. Further investigation is required to find out whether interventions identified in this review can sustain a reduction in challenging behaviours in the long-term. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.

Language: en

Keywords

human; systematic review; female; aggression; burnout; schizophrenia; psychosis; women; mindfulness; suicide attempt; suicidal behavior; clozapine; mental health care; personality disorder; job satisfaction; behavior disorder; automutilation; patient care; priority journal; electroconvulsive therapy; high risk behavior; learning disorder; social status; methylphenidate; work environment; risk reduction; Article; descriptive research; verbal hostility; disruptive behavior; anger management therapy; challenging behaviour; Forensic mental health