Special Hospitals

Special Hospitals exist for treatment of patients with mental disorder, mainly psychosis, sociopathy, or learning disability, who have committed violent crimes.

They comprise Broadmoor, Rampton, and Ashworth in England, and Carstairs in Scotland. All patients are compulsorily admitted and detained under the Mental Health Act 1983, the majority from the courts, and some from prisons or psychiatric hospitals. Violence to others, sex offences, and arson are the most frequent reasons for admission. Prospective admissions are assessed by Special Hospital staff, the main criteria being the presence of mental disorder and a 'grave and immediate' risk to others. Most patients stay several years, but about 50 per cent eventually become fit for transfer to a local psychiatric unit in preparation for discharge to the community.

These hospitals have been staffed jointly by prison and health staff. There has been some confusion over how much of their purpose was care, and how much confinement. Recently, there have been moves to bring the Special Hospitals within the mainstream of health services, so that, for example, at the time of writing, Broadmoor Hospital is now part of a London Mental Health Trust.

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