Forensic Mental Health Research
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National policy makers and international experts meet at the IMH to discuss long-stay in secure psychiatric institutions



Forensic-psychiatric services provide care and treatment for individuals who have committed serious crimes linked to their mental condition. These services are offered at different levels of security – high (e.g. Rampton Hospital), medium and low. They are very costly – e.g. the stay of one person in a high secure hospital for one year costs about £275 000 -- and very restrictive to residents. It is therefore paramount that patients do not stay in such settings for longer than necessary. Nevertheless, there has been some concern that this is not always the case, and that a number of individuals remain for too long in highly restrictive and expensive settings.

On the other hand, a proportion of patients may require long-term, potentially life-long, secure psychiatric care but their mental health and needs may not be adequately met by existing service provision designed for faster throughput. Other countries, e.g. the Netherlands and Germany, have developed services for this patient group that are more cost efficient and provide care tailored to the needs of long-stay patients.

Current research

A group of researchers, led byClinical Associate Professor Dr Birgit Völlm, is currently conducting a three-year study, funded by the National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme to explore how many patients of the current high and medium secure forensic-psychiatric population are long-stayers and describe their characteristics. The researchers will also interview patients, carers and staff about their experience with long-stay and explore whether different services are needed for this population.

Initial findings

Initial findings suggest that between 15 and 20% of patients in secure settings stay for more than 5 years in a medium secure hospital or for more than 10 years in a high secure hospital.

International collaboration

This research is part of a European network on long-stay in forensic-psychiatric care, funded through the EU. This network includes leaders in the field from 16 different countries who meet regularly to develop research projects and share best practice.

Meetings in Nottingham

The researchers have organised the first of a series of one day conferences in Nottingham on 2 October 2014 at the Institute of Mental Health. The meeting will see over 60 stakeholders (senior policy makers and commissioners, clinical directors, doctors, service users and international researchers) come together. The day will focus on service models from the Netherlands, Germany and Italy. Afternoon workshops will explore ethical and legal issues of long-term detention of mentally disordered offenders.

On 3-4 October. the European network on long-stay will also meet in Nottingham – this will be attended by 34 delegates from 16 countries.

For further information please contact: 

Birgit Völlm DiplForPsych MRCPsych MD PhD
Clinical Associate Professor and Reader in Forensic Psychiatry
Head of Section Forensic Mental Health
Institute of Mental Health
University of Nottingham Innovation Park
Triumph Rd
Nottingham NG7 2TU
Phone: 0115-8231266


  1. The National Institute for Health Research Health Services and Delivery Research (NIHR HS&DR) Programme was established to fund a broad range of research. It builds on the strengths and contributions of two NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which merged in January 2012. The programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services, including costs and outcomes. The programme will enhance the strategic focus on research that matters to the NHS. The HS&DR Programme is funded by the NIHR with specific contributions from the CSO in Scotland, NISCHR in Wales and the HSC R&D Division, Public Health Agency in Northern Ireland.
  2. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government’s strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (
  3. This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Posted on Wednesday 1st October 2014

Forensic Mental Health Research

The University of Nottingham
School of Medicine
Division of Psychiatry and Applied Psychology

telephone: +44 (0) 115 823 1266