Forensic psychiatry is a specialised branch of psychiatry where the medical and the legal worlds overlap. It is a fascinating sub-speciality within mental ill health that involves the application of medical psychiatric expertise in legal contexts.
The word ‘forensic’ relates to the courts of law and the legal system. Our service supports people who, as a consequence of their mental health problems, have had contact with the legal system. They may require a safe and secure environment that enables them to receive a wide range of treatments, therapies and care.
What do we offer?
We provide assessment, treatment and recovery-based rehabilitation for patients who need medium security during their treatment. We have strong links with other statutory organisations and agencies. The care we provide includes relapse prevention work and health promotion, including a smoking cessation programme.
Where are we based?
We provide a regional service to all of Norfolk, Suffolk and Cambridgeshire for both male and female adult patients.
The Norvic Clinic is at St Andrew’s Business Park, Thorpe St Andrew, Norwich, and is the main inpatient base for the service. The unit has just marked its 25th anniversary and has 45 beds, split between four wards. Facilities include a physiotherapy department and gymnasium, occupational therapy department, workshop facilities, horticulture garden, large external recreation and activity area, adult education room, physical examination and treatment room, dining area, staff and patient libraries, administration area and offices.
Meadowlands is a 17-bed rehabilitation unit that opened in March 1998 and is across the road from the Norvic Clinic. Set in a two-storey building, facilities include individual bedrooms, sitting room, meeting room, and a dining room which doubles as a physiotherapy/exercise area. The first floor provides more bedrooms, adult education room, occupational therapy kitchen, art therapy and general-purpose activity room, as well as a chapel, and office space for social workers, doctors and the community team. Inside the building there is a self-contained courtyard. The landscaped gardens and vegetable area outside are both maintained by the patients.
Highlands is a detached 5-bed house near the Norvic Clinic that opened in 1994. Although it is staffed, patients live as independently as possible before moving back into the community.
Coastlands is an 8-bed unit on the Northgate Hospital site, in Great Yarmouth. Facilities include patient lounge areas, gym equipment, dining room, external garden area, adult education and general-purpose therapy room, occupational therapy kitchen and office.
Where do our patients come from?
Patients may be referred or transferred into our care from various places, including courts, prisons, general psychiatric services, and also as a step-down from high security hospitals.
Our inpatients are on various assessment and/or treatment phases in line with the Mental Health Act. The majority are also under Ministry of Justice restriction orders. Admitting a patient to a secure psychiatric unit ensures that the person receives the treatment and care required.
We have recently joined The Quality Network for Forensic Mental Health Services to work together with other secure units across the country to continue to improve and develop services.
Are patients allowed to leave the secure premises?
Yes, patients do go outside the secure units as part of their individual rehabilitation programmes. This is known as 'leave'.
We believe it is safer to go slowly and in small stages. Patients start by going on leave with staff escorts. During a gradual process the clinical team assesses the patient’s behaviour, mental state, and any risks presented. Thorough risk assessments on all patients are a central part of the rehabilitation and care programme, and these take into account patient and public safety.
We also have to follow restrictions and procedures laid down by the Mental Health Act, the Department of Health and the Ministry of Justice.
On average, individuals use our inpatient services for just over two years as part of an overall care pathway. Thereafter they move into the community and are cared for by our specialist community team.
What kind of staff work in a forensic mental health service?
Exactly the same staff that you would find in any mental health hospital or community setting - nurses, doctors, psychologists, occupational therapists, physiotherapists, community nurses, social workers, adult education tutors and administrative staff.