Resources for Secure Environments

NHS England Health and Justice mental health services: Safer use of mental health medicines (2017)

This document provides a background to mental health medicines, medicines’ optimisation and prescribing in secure environments. It provides some clarity on the prescribing responsibility for initiating, continuing, reviewing or repeat prescribing of mental health medicines by specialist mental health prescribers.

NICE guideline (NG66) Mental health of adults in contact with the criminal justice system (2017)

This guideline covers the assessment, diagnosis and management of mental health problems in adults (aged 18 and over) in contact with the criminal justice system. It includes recommendations on psychological and pharmacological interventions, co-ordinated care planning and service organisation.

NICE Quality standard (QS163) Mental health of adults in contact with the criminal justice system (2018)

This NICE quality standard covers the recognition, assessment and management of mental health problems in adults (aged 18 and over) in contact with the criminal justice system. There are four quality statements which refer to: police response towards people with mental health problems, their referral for mental health assessment and appropriate information sharing of care and risk management plans between services.

NICE Quality standard (QS189) Suicide prevention (2019)

This quality standard covers ways to reduce suicide and help people bereaved or affected by suicide. There are five quality statements, three of which relate to the role of multi-agency suicide prevention partnerships, one about information sharing and confidentiality for adults at risk of suicide and one about tailored support for people bereaved or affected by suicide.

NICE Quality standard (QS34) Self harm (2013) 

This quality standard covers the initial management of self-harm and the provision of longer-term support for children and young people (aged 8 to 18) and adults (aged 18 and over) who self-harm. There are eight quality statements covering: caring with compassion and respect for patients, assessment, monitoring, safe environments, risk management plans, psychological interventions and transitions between services.

NICE Quality standard (QS154) Violent and aggressive behaviours in people with mental health problems (2017)

This quality standard covers short-term prevention and management of violent and physically threatening behaviour among adults, children and young people with a mental health problem. It applies to settings where mental health, health and social care services are provided. There are five quality statements which include identifying triggers and de-escalation techniques to support patients, requirements around physical health monitoring when patients are restrained or given rapid tranquilisation, and provision of post-incident debrief for patients.

Mental Health and immigration detention

It is important that healthcare staff working in immigration detention are aware of the potential negative impact immigration detention can have on the mental health of immigration detainees (von Werthern et al (2018) & Bosworth, M (2016)). The limitations of immigration detention as a therapeutic environment are set out in the The Royal College of Psychiatrists “Position Statement on detention of people with mental disorders in Immigration Removal Centres”,.