A System of Education and Training for the Care and Management of People with Special Needs who Display Violent or Dangerous Behaviours

Abstract

The provision of effective therapeutic nursing care within a multi-disciplinary context, for people with mental health problems and/or learning disabilities who may present with dangerous criminal and/or violent propensities, requires a skilled and specialist nursing staff. The need for education specific to this area of practice has been apparent from at least 1971 (Department of Health and Social Security) when the Revised Report of the Working Party on Security in Psychiatric Hospitals (Glancy Report) noted that the lack of appropriate educational opportunities was hindering attempts to improve quality of care. This observation was echoed more recently in the Reed Report (Department of Health and Home Office 1992), which suggested that inadequate educational provision at specialist level continued to be a problem. This sentiment found support in the conclusions of NE Thames and SE Thames RHAs (1994) Report of the Inquiry into the Care and Treatment of Christopher Clunis (Clunis Report), which stated that:

The assessment of the risk of violence should never be a hasty guess following a simple examination of the patient’s current mental state at interview. It is a skill to be learned and refreshed from time to time by anyone who has responsibility to respond to the needs of people showing disturbed behaviour. Psychiatrists and other mental health workers need to be trained in this skill as do, at the appropriate level, general practitioners and other members of the primary health care team, social workers, police and probation officers. At the very least they should be given sufficient training to recognise the limits of their personal knowledge and to understand the role of forensic services. (p. 119)