Bridging the gap in secure provision: Evaluation of a new local combined locked forensic/ intensive care unit

This study examines the first 15 months of a new 40-bedded local 'hybrid' mixed forensic and intensive care locked unit, set up to fill an identified gap between local intensive care and regional medium secure units. It examines the function of the unit in terms of patient profile, security and case selection and its admission rate and length of stay. Advantages and difficulties of such a model are considered. The results show that the unit deals successfully with both intensive care and offender patients, between which a considerable overlap is apparent. More than a third of the 255 admissions were on Pan III orders. Remand orders constituted 22% of all admissions and 17% of admissions were admitted under a restriction order. In contrast to local locked wards, index offences included serious charges such as homicide, rape and attempted murder. Compared with regional secure units, there was more direct access to beds, a higher admission rate and shorter lengths of stay. It is argued that such units have a unique and important role in filling the current gap in secure provision, especially in the rapid diversion of the mentally disordered offender from the criminal justice system.