The film shows the experience of staff and patients from admission to Broadmoor, through different units and treatments to discharge.
All new patients spend time on an admissions ward, where their mental health and risks can be assessed by a multi-disciplinary team, including doctors, psychologists, nursing staff, occupational therapists and social workers. Patients spend between 3-9 months here, while the team prepare them for further treatment and build a care plan tailored to their needs. They then move to a ward best suited to their treatment.
This small, purpose-built unit is designed for acutely disturbed patients, with an imminent risk of violence. Here they are treated in a highly-structured, secure environment, with the specialist psychiatric intensive care they need.
These are small wards – 12-15 beds – providing a highly structured environment, with much of the therapy provided on the ward. The aim is to stabilise the patient’s mental state, manage the risks they pose and, ultimately, enable them to transfer to a lower dependency ward.
Here patients can take part in a wide range of treatment, including programmes away from their ward. Staff provide support and help patients stay motivated; patients are encouraged to play an active role in their care. Patients have usually come from a high-dependency ward and this is a step forward in their recovery.
These wards, usually between 15-20 beds, are where most patients spend the longest period of treatment at Broadmoor, working towards transfer to a place of lesser security. Here, in a stable, low-stress environment, staff encourage patients to take individual responsibility for their care, which can include a wide range of therapy and rehabilitation, including programmes away from their ward.
A recent innovation is Broadmoor’s recovery college. Launched in 2013 it helps people develop their strengths through a wide range of courses, from adult literacy to an Open University degree, and the annual Koestler Art awards. People who have themselves been through the experience of a secure environment work alongside professionals to produce a range of courses to help people’s recovery, from understanding care plans to spirituality, and from reading groups to talks from individuals who have recovered having been in secure settings themselves.
Occupational therapy and group therapy
Broadmoor Hospital’s primary goal is to produce rounded, more balanced individuals and to this end patients are encouraged to participate in a wide range of activities, from art to gardening to football. Time away from more conventional forms of treatment helps them process what they are learning, and the activities help build confidence in themselves and trust in the people they work with – a key part of recovery. Staff are proud of the fact that there are very few violent episodes in the rehab areas.
As a hospital, Broadmoor also looks after patients’ physical health. Life expectancy for mental health patients can be up to 20 years shorter and the trust is a national leader in trying to improve their physical health. Smoking was completely banned at Broadmoor in 2008 and alcohol and other substances are not allowed. However, the medications that many patients take can increase appetite so weight can be an issue. Physical healthcare is therefore particularly important to help patients control weight and to tackle the increased risk of obesity-related conditions such as diabetes and heart disease.
Leaving Broadmoor Hospital
Some patients make a rapid recovery, for others progress is very slow, but for all patients leaving Broadmoor is based on an assessment of recovery and of risk. Tribunals composed of a panel wholly independent of the hospital also consider individual patient cases and may make recommendations for discharge or transfer to conditions of lesser security.
A third of patients move to an NHS medium-secure unit, possibly one that is also part of the West London Mental Health Trust and with which Broadmoor has close working links. Another third go to a medium-secure unit in the independent sector and 15% are returned to prison.