Patient perceptions of medium secure care.

Research into patients' experience of medium secure psychiatric services is in its infancy despite growing interest in user involvement in mental health care as a whole. The work reported here aimed to provide an opportunity for patients to reflect upon their understanding of their route into secure psychiatric provision and their time spent in one large unit in the West Midlands. Most (65%) of the patients taking part were admitted to medium security through the criminal justice system. The average length of stay was 18 months (range, two months to two years six months). The experience of being admitted to secure care was generally described as frightening though many patients expressed relief that they were now receiving help. Half of those interviewed thought they had no choice about treatment. Nevertheless, eight said they trusted their doctors to make the right decision about medication. Generally patients thought their relationships with multi-disciplinary team members were positive and felt able to approach them with any concerns. Overall, patients who participated in this study were optimistic about their experience of medium secure care. They felt the advantages of hospital care compensated for the disadvantages, particularly as their mental state stabilised and they gained insight into their illness. Areas of concern for patients were lack of privacy and uncertainty about how long they were likely to remain in hospital.