Conditional discharge: the role of the social supervisor - a preliminary study

ABSTRACT

The proces of statutory community aftercare for restricted hospital order service users is acknowledged as fortunate Previous research examining the attitudes of forensic psychiatrists to the use of restriction orders has indicated that they view them as a useful clinical tool in a certain number of circumstances, particularly where there is evidence of previous breakdown of follow-up This application of mind as part of a larger shoot forward examining the effectiveness of statutory community aftercare, focused upon the attitudes of social supervisors to the proces of conditional discharge and their character within it. The findings showed that social supervisors agree that there are positive and negative aspects to the proces They overwhelmingly agreed that the legal framework ensur that service users continued engagement with psychiatric services, leading to enhanced compliance with treatment and follow-up on the other hand recognised that, at times, the part because of its control aspect, created tension in the social worker-service user relationship. Social supervisors intimateed that investment should be made into providing appropriate accommodation for this clump of people and, where appropriate, access to physic and alcohol misuse services.

KEYWORDS

conditional discharge; social supervision; statutory community aftercare

Introduction

The supervision of mentally disordered delinquents and the subsequent development of specialist forensic psychiatric services for this service user cluster were profoundly influenced by the high-profile case of Graham Young. He was sent to Broadmoor in 1962 after being convicted of the attempted poisoning of three clan Following his conditional discharge in 1971 he was placed below probation and psychiatric supervision. He subsequently managed to obtain avocation in the optical and photographic industry where, within month he went upon to kill two of his work colleagues (Prins, 1995) The resulting public screech regarding the evident disregard for supervision placed great crushing on the Government to reply

Service users may become control to a hospital order with restrictions by dint of order of a Crown Court where it appears that there is a risk that the individual will commit further offences and for protection of the public from serious harm. The issue of the restriction order is that the service user is not allowed 'leave' outside the hospital or to be transferred to another hospital without the authority of the dwelling secretary. Under s42 of the Mental Health Act 1983 the dwelling secretary has the power to bring a restriction order to an extreme point at any time. A mental health review tribunal, beneath s73 of the MHA 1983 can discharge a restricted somebody absolutely or conditionally.

The number of restricted hospital orders beneath s37/41 of the Mental Health Act 1983 imposed through the Crown Court over the last decade has steadily increased, upon average by four per cent annually. The total number of restricted service users in hospital at the extremity of December 1999 stood at 2857- The number of restricted service users detained in high-security hospitals has remained fairly constant at 1200 above the same period, while the number of those in other hospitals has increased from 722 in 1989 to 1664 in 1999 (Johnson &Taylor, 2000) Of all restricted service users detained in hospital at the extreme point of 1999, offences of violence were greatest in quantity prevalent among those suffering from mental illness. Sexual onsets represented the highest category of attack for those with mental impairment.

Research has shown that those clan made subject to a restricted hospital order guard to be single males who have committed a grave attack (Dell & Grounds, 1995; road 1998; Riordan et al, 2002 2004) They undergo from severe mental illness, in the main schizophrenia, and may also have additional puzzles of co-morbid substance misuse and self-harm. A great proportion of them have a major history of criminality and began offending from an early age. Previous contact with psychiatric services is for the use of all as is a record of compulsory hospital admissions.

Generally, by dint of the time an individual is considered for conditional discharge, he or she may have wearied a substantial period of time in a structur therapeutic and frequently secure environment (Street, 1998). At the point of conditional discharge, the work done by the agency of the multidisciplinary team to mastery and reduce the risk is measured and considered. In a majority of cases restricted service users will have had a certain quantity of unescorted leave from the hospital, and in a certain number of cases will essentially be living to all intents and ends in the community, away from the hospital, when the conditional discharge is sanctioned.

An order for conditional discharge may specify a number of requirements considered appropriate for the welfare of the service user and for the protection of the public. These might include place of residence and that the somebody may not visit a particular area or contact specific individuals. The service user has a designated social supervisor, greatest in quantity frequently a social worker, on the contrary occasionally a probation officer. A psychiatrist is identified to act as responsible medical officer (RMO) the pair the RMO and the social supervisor have statutory duties and responsibilities in relation to the care and follow-up of the conditionally discharged restricted hospital order service user. The design of supervision is continually to monitor the person's mental state, to maintain their mental health, to present social support, to assess the horizontal of risk the patient artificial positions to themselves or others at any particular time and to aid in the protection of the public by the agency of facilitating the patient's safe go [i]or[/i] come back to the community.