The Psychosis Research Group invites you to attend a seminar in the department of Mental Health & Wellbeing on Friday 23rd September (3 to 4pm).
Title: Co-production in secure settings: Challenges and early ‘solutions’.
Speaker: Frank Reilly, Director of the Scottish Recovery Network
Chair: Prof. Andrew Gumley
The seminar will be held in Lecture Room 1 on the Ground Floor of the Administration Building at Gartnavel Royal Hospital. Please RSVP to save a seat.
Secure facilities – hospitals and clinics that provide treatment to patients with severe mental illness and a degree of 'dangerousness' to themselves or others- balance therapy with the duty to maintain the safety of patients, staff and the general public. This requires staff to maintain the various types of security in that environment. In these circumstances this level of control, including restricting a patients access to information about their risk and therefore the rationale for limiting freedoms (Davies 2012), contributes to ‘people pleasing’/strategic accommodation (Moore 2009). Co-production, in contrast, may be a means to develop qualified trust between professionals and patients, support autonomy and to transfer power- in the form of knowledge and understanding- to and from both parties. The establishment of ‘talking groups’ (Perry 2014 unpublished)-a one hour per week open forum that is attended by staff and patients on an equalised- but not equal- basis; with no compulsion to attend, no assessment of behaviour and no tariff for not attending; suggests that the coproduced nature of the group has enabled treatment resistant patients to engage in a humanized relationship with the staff who attend. An evaluation of the impact of the talking groups on the wider hospital, particularly the levels of violence, is ongoing.
In secure mental health care security and therapy can sit uneasily beside one another. This paper reports on a literature review which looked at the contradictions between generating a positive therapeutic relationship with patients with the need to protect the safety of other patients, staff and the public. Within these environments staff have the certainty of procedure and the safety of fences and locked doors, and the uncertainty of ‘relational security’: a term used to describe the complex assessment of self, environments, other patients and colleagues for issues of safety.
The complexity of this task makes reliance on physical security and procedures easier and more predictable. This paper examines the potential to use co-production- specifically an exchange of knowledge, conditional power and trust- to enhance the therapeutic alliance between staff and patients and to provide a concrete structure upon which to base relational security approaches.