Adult Low Secure Mental Health Services: Information Guide

Adult Low Secure Mental
Health Services
easy
Information Guide read
About this document
This document was made by

CHANGE, a charity led by people with
learning disabilities.
This document uses easy words and

pictures to help you understand
more about what a low secure
mental health service for adults is.
You might want to read through

it with someone else to help
you to understand it more.
There is a Word Bank at the back

of the booklet to help with hard
words. Any words in bold you can
find in the Word Bank on page 30.
Adult Low Security Mental Health Services 2

Introduction
This document is about Low secure

mental health services for Adults.
It gives you information about

how the services are run.
It explains the journey a patient

would go through from entering
to leaving the service.

Description
Low secure mental health services
care for and treat patients who are a
serious risk to others.
These patients need physical

security to prevent them from
leaving.
Some patients have been either

charged or convicted of a criminal
offence.
Before they are admitted, each

patient is assessed and a report is
made about how they need to be
managed because of their mental
illness.

This document is about low
secure mental health services
for both men and women over 18,
suffering from mental illness (MI),
personality disorders (PD) and
neurodevelopmental disorders
(NDD), including learning disabilities
(LD).

focus on helping patients get better
so that they are no longer a risk to
others.
They treat everyone equally and do

not discriminate.
Sometimes some liberties of

patients must be controlled. This is
done to make sure other patients
and members of staff are safe.

Patients in Low secure mental
health services arrive here from
different places:
From higher secure services, when

they get better and become less of a
risk to others.
They also might come from the

Criminal Justice System.
Directly from the community, if they

become an increased risk to others.
From Secure Child and Adolescent

Mental Health Services.

There are three main patient
groups in Low secure mental
health services:
1. Patients who need low physical

security, as established by a court,
to help them get better.
This group includes patients who

have been sent from other secure
services, who are convicted of a
serious crime.
Some have come from prison.
Others may have not have committed

a crime but are a serious threat to
others and need help to get better.

2. Patients who need low security
admission.
They come straight from prison or

court.
Some have been charged with

a crime while in the community
or in hospital.

3. Patients from Psychiatric Intensive
Care Units
These patients need care for a longer

period of time in a locked / secure
setting.
These patients usually are treated in

locked rehabilitation centres, but
some of them can be admitted to
low secure mental health
services.

are the bridge between secure services
and the community.
Multidisciplinary Teams (MDT)

provide the care. They offer specialist
help for patients.
The aim is to help patients get better

so that they can go safely back to
the community or prison and enjoy
a better life.

Care Pathway
Each patient is assessed before they
are admitted. They are assessed by
looking at:
What their mental disorder is?
How much of a risk they are to

others?
How much care and supervision

they need?

How much support do they need
from specialist services and staff?
Do they need therapy for

risk / offence behaviour?
How involved are they with their

treatment / care plan?
How involved are they in

activities?

Do they misuse drugs / alcohol?
Based on this assessment, the service,

patient and carer decide on the Care
Pathway together.
This is a plan which sets out the

journey the patient will go through
from entering to leaving secure
services.

can be described in four stages:
1. Referral and Assessment
Secure services may talk to other

mental health services to see if they
can support them so that the patient
doesn’t have to be admitted to
secure services.
At this stage the patient is assessed,

and he / she will be told about
where they may be admitted.
He / She will also be told about the

assessment they are going through
and what are the results of this
assessment.

2. Pre-admission
This stage is where the patient is

introduced to the secure service and
to the staff there, and is told about
what is going to happen.
3. Admission, Care and Treatment
The patient is assessed, treated and

managed according to his/her needs.
They may receive special treatment to

help them with offence/risk related
behaviours.
Services treat patients under the

lowest level of physical security
possible.

Patients have access to social and
educational activities which support
their rehabilitation.
Patients have regular checks to see

how their health is. This is part of the
patient journey.
Ongoing support is provided for all

patients including those who are
involved with the Criminal Justice
System
4. Discharge/Transition
Discharge of the patient is kept in

sight at the admission stage and
throughout the process.

Patients are also told about the
chance they might go back to prison
when they are discharged.
When patients leave the service and

go back into the community, the
Community Mental Health Services
receive a community care plan.
This is to make sure their care is

continued correctly.
When patients leave the service and

go back to prison, low security
mental health services work with
prison mental health services to make
sure their care is continued.

Many local and national services
work together to make sure that
each patient is ready to be
discharged.
The patient can then be moved

to another secure service,
in to the community, or prison.
Forensic Outreach and Liaison Service (FOLS)
These services are very important.

More details about them are in
Appendix 2.

Security
To keep patients and public safe,

patients in low secure mental
health services need:
Physical security measures
within their environment.
Good relationships between

staff and services.
Special procedures put into place.

Risk Management
Low secure mental health

services do risk assessments to
measure improvement of the care
and reduce risk.
Services learn from each other by

sharing their knowledge and
experience gained from incidents
and assessments.
Recovery and Involvement

encourage the patient to get better
by involving them in their treatment,
in the decisions made about them.

make all information about patients
or the services available in accessible
formats.

Carers
Where needed, special arrangements

will be made for support from friends
or family.
Advocacy
Low security services will provide

an Independent Mental Health
Advocacy (IMHA) service to
oversee equal rights and
safeguarding.

Leave
A patient can often be given leave.

This is planned and involves a task.
There are a number of reasons for

leave. Leave helps to evaluate pro-
gress, and informs the risk
assessment.
Leave is very helpful in the

rehabilitation process.

A patient may or may not have an
escort with them during leave.
Closer to moving from medium

to low secure mental health
services, or to being discharged
into the community overnight leave
might be given, in special conditions.

Observations
Sometimes patients may have to

be kept under closer observation.
The service will make sure that the

length of observation is no longer
than it needs to be.
The service will also make sure that

the patient is being treated with
dignity, respect and care.
Acceptable Criteria
To be accepted in a low secure
mental health service you need
to fit ‘specific criteria’ which look at
your mental disorder and how likely
you are to cause harm to others.

Exclusion Criteria
You can be excluded from a

low secure mental health service
if you do not fit the acceptance
criteria.
Such as if your mental disorder only

happens for a short time and is very
unlikely to happen again.
Or if you are of risk of harm to

yourself but not to others.

Working with other services

works closely with a wide range of
services to make sure that the care
pathway of a patient has the best
possible outcome.
The services all share information on

the patient and his/her treatment
and care.
These services include the NHS, social

services, other secure services, courts,
the police and housing associations.

Population covered and population needs
A diverse range of people may

require care and treatment in Low
secure mental health services:
Individuals who are deaf.
Individuals with
neurodevelopmental
disorders (NDD)

Individuals with a diagnosis
of Personality Disorder.
All clinical and non-clinical staff

will have specific training in
working with patients with a
personality disorder.
Women’s Services
Women who go to Low Secure

Services have different mental health
and offending profiles than men.
Services for women are different

so that they can offer appropriate
care and treatment.

Outcomes
Low secure mental health

services aim to provide treatment
and care to people with mental
disorders who are a serious risk of
harm to others.
The services focus on recovery and

positive outcomes.

aim to work
together as part of a connected
group of services.

Word bank
Admitted
When you go into stay at a hospital
or service.
Care Programme Approach (CPA)

A way that services are assessed,
planned, and reviewed for someone
with mental health problems.
Discriminate
To treat someone differently in a
negative way.
Liberties
Personal freedom and choices.

Low Secure Mental Health
Services
These are secure services that
provide care and treatment for
people with mental health problems.
Multidisciplinary Teams (MDT)

Groups of staff who have different
areas of training.
Neurodevelopmental disorder
(NDD)
These are disorders that affect the
growth and development of the
brain. Examples are: mild
learning disability, autism.
Observation
When a medical professional keeps
an eye on a patient to understand
their condition or keep them safe.

Personality disorder (PD)
A condition in which someone is
quite different in the way they think,
understand, feel or relate to others.
Physical security
A way to keep a patient in one safe
place, such as a locked door.
Rehabilitation
When someone improves or gets
better.
Risk assessment
A document that looks at the risks of
harm for a patient and what can be
done to prevent them.

This easy read document has been produced by CHANGE
www.changepeople.org

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Adult Low Secure Mental

This document was made by

This document uses easy words and

You might want to read through

There is a Word Bank at the back

Adult Low Security Mental Health Services 2

This document is about Low secure

It gives you information about

It explains the journey a patient

Adult Low Security Mental Health Services 3

These patients need physical

Some patients have been either

Before they are admitted, each

Adult Low Security Mental Health Services 4

Low secure mental health services

They treat everyone equally and do

Sometimes some liberties of

Adult Low Security Mental Health Services 5

From higher secure services, when

They also might come from the

Directly from the community, if they

From Secure Child and Adolescent

Adult Low Security Mental Health Services 6

1. Patients who need low physical

This group includes patients who

Some have come from prison.

Others may have not have committed

Adult Low Security Mental Health Services 7

They come straight from prison or

Some have been charged with

Adult Low Security Mental Health Services 8

These patients need care for a longer

These patients usually are treated in

Adult Low Security Mental Health Services 9

Multidisciplinary Teams (MDT)

The aim is to help patients get better

Adult Low Security Mental Health Services 10

What their mental disorder is?

How much of a risk they are to

How much care and supervision

Adult Low Security Mental Health Services 11

Do they need therapy for

How involved are they with their

How involved are they in

Adult Low Security Mental Health Services 12

Based on this assessment, the service,

This is a plan which sets out the

Adult Low Security Mental Health Services 13

1. Referral and Assessment

Secure services may talk to other

At this stage the patient is assessed,

He / She will also be told about the

Adult Low Security Mental Health Services 14

This stage is where the patient is

3. Admission, Care and Treatment

The patient is assessed, treated and

They may receive special treatment to

Services treat patients under the