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Obesity and associated morbidity and mortality are major challenges for people with severe mental illness, particularly in secure (forensic) mental health care (patients who have committed a crime or have threatening behaviour). This study aims to explore experiences of weight management in secure mental health settings.

This study used a mixed-methods approach, involving thematic analysis. A survey was delivered to secure mental health-care staff in a National Health Service (NHS) mental health trust in Northern England. Focus groups were conducted with current and former patients, carers and staff in the same trust and semi-structured interviews were undertaken with staff in a second NHS mental health trust.

The survey received 79 responses and nine focus groups and 11 interviews were undertaken. Two overarching topics were identified: the contrasting perspectives expressed by different stakeholder groups, and the importance of a whole system approach. In addition, seven themes were highlighted, namely: medication, sedentary behaviour, patient motivation, catered food and alternatives, role of staff, and service delivery.

Secure care delivers a potentially “obesogenic environment", conducive to excessive weight gain. In future, complex interventions engaging wide-ranging stakeholders are likely to be needed, with linked longitudinal studies to evaluate feasibility and impact.

To the best of the authors’ knowledge, this is the first study to involve current patients, former patients, carers and multidisciplinary staff across two large NHS trusts, in a mixed-methods approach investigating weight management in secure mental health services. People with lived experience of secure services are under-represented in research and their contribution is therefore of particular importance.

This chapter discusses how attachment theory, a theory that provides insight into the processes through which psychological and emotional bonds are developed in relationships, can be useful for understanding mentoring relationships. We develop a conceptual model emphasizing how attachment-related constructs and their relationships with mentors’ and protégés’ behaviors and emotions influence each phase of a mentoring relationship. Recognizing reciprocity in the mentoring process, the model also explains how the interpersonal dynamics of the mentor–protégé relationship influence the benefits gained by both partners. Propositions for future research on mentoring relationships are provided. We contend that examining mentoring through the lens of attachment theory can increase our understanding of the underlying factors or mechanisms that determine individuals’ involvement in mentoring relationships and differentiate successful from unsuccessful mentoring relationships. The research and practical implications are discussed.

Substantial developmental psychology research on attachment theory documents that children with secure affectional ties (attachments) to caregivers are more likely to excel in psychosocial and behavioral performance than their peers with insecure attachments. We review attachment theory and research in the developmental psychology literature and propose causes of secure short-term attachments to workgroups. Whereas traditional attachment research has documented social–emotional antecedents, we propose social–emotional and task-related antecedents of secure attachment to workgroups. Suggestive data are presented to illustrate our propositions. We discuss theoretical and practical contributions of our attachment theory-based perspective on workgroups, as well as areas for future research.

Mentor secure-base support, characterized as mentor availability, noninterference and encouragement of growth, has important implications for newcomer socialization. Drawing on attachment theory, this paper aims to examine the relationship between mentor secure-base support and newcomers' workplace courage.

Data were collected at three time points with a new police officer sample (n = 124). A cross-lagged panel design was used to test the hypotheses.

Mentor secure-base support is causally precedent to newcomers' workplace courage, whereas the reverse relationship from workplace courage to mentor secure-base support was not held.

To help newcomers integrate into their organization and enhance their workplace courage, organizations should actively promote and foster mentoring relationships in which mentors can provide a secure base for mentees.

The authors' findings support that newcomers' workplace courage can be cultivated by mentor secure-base support. It provides insight for organizations to explore workplace courage development for newcomers.

The SECURE STAIRS framework for integrated care is a trauma-informed approach to supporting staff and young people within the Children and Young People’s Secure Estate (CYPSE) in the UK. Within secure settings, therapeutic climate is a concept that encapsulates an individual’s perception of safety, connectedness with others and level of support within the environment. To support evaluation of the SECURE STAIRS framework, a Secure Children’s Home (SCH) within the North East of England examined therapeutic climate for staff and young people annually using the Essen Climate Evaluation Schema (EssenCES) over a three-year period. This paper aims to present the findings.

Over the three years, a total of 71 young people and 214 staff EssenCES questionnaires were administered. Between 2020 and 2021, the setting also experienced significant changes resulting from the COVID-19 pandemic. Numbers of young people also decreased within the setting over the three-year period.

Results indicated a positive trend for therapeutic climate sub-scores. For example, Experienced Safety for young people significantly increased from 2020 to 2021. Additionally, therapeutic hold for staff was significantly higher in 2020 and 2021 in comparison to 2018.

Findings are discussed in relation to implementation of the SECURE STAIRS framework and providing trauma-informed care for vulnerable young people within secure settings. Implications for practice are explored.

Leader secure-base support, consisting of leader availability, noninterference and encouragement of growth, has important implications for stimulating employee proactivity. This study is aimed at examining whether, why and when leader secure-base support may motivate employees to engage in approach job crafting behavior. Drawing upon regulatory focus theory, we propose leader secure-base support is positively associated with employee approach job crafting via employee state promotion focus. Based on cue consistency theory, we further examine the moderating role of organizational learning culture in the associations of leader secure-base support with employee state promotion focus and subsequent approach job crafting.

Two-wave data were collected from 281 Chinese workers. Path analyses with Mplus 7 were conducted to test the hypotheses.

As predicted, we found that leader secure-base support was positively related to employee state promotion focus and, in turn, facilitated employee approach job crafting. Moreover, organizational learning culture accentuated the impact of leader secure-base support on employee job crafting process.

This study is the first to examine the influence of leader secure-base support on employee job crafting. It also identifies a boundary condition for such an influence.

There is substantial evidence that young people moving from child and adolescent mental health services to adult services are more likely to experience poor transitions. However, little is known about the care pathways of young people transitioning from forensic services. This retrospective case note review sought to examine the clinical characteristics, transition pathways and psychosocial indicators of transition outcomes amongst young people in forensic medium secure services discharged to adult services.

The electronic records of 32 young people, who transitioned from six adolescent medium secure units in England to adult services between May 2015 and June 2016, were examined.

Approximately 65% of young people were between 18 and 19 years at the time of transition and the average waiting time from referral to discharge was six months. A total of 63% young people transitioned to community placements and adult medium secure services. Four pathways describing the journey into and out of adolescent medium secure services were identified in a subsample of 12 young people. A total of 25% young people with neurodevelopmental problems moved to specialist services.

The results suggest that diagnosis, severity of offence and clinical background are associated with transition pathway. Promoting a person-centred approach and gradual independence of the young person may improve current practice.

These results inform existing policy and clinical practice in an effort to reform transition guidelines around young people’s needs during transition times. Further studies in adolescent forensic services are needed to understand complex neurodevelopmental problems and comorbidities.

Low security is a poorly understood concept, particularly in relation to people with an intellectual disability. Characteristics of patients offered an admission to low secure intellectual disability settings have not been robustly demonstrated. The same applies to staff perceptions of low security. The aims of the study were to ascertain the characteristics of patients referred to a low secure intellectual disability unit which lead to an offer of admission, identify the views of staff working on the unit on the concept of low security, and use both sets of data to discuss low secure provision for people with intellectual disability. A case‐controlled study was carried out for 33 patients referred to the unit over 42 months. The characteristics of 18 patients offered an admission were compared with those of 15 patients not offered an admission, and five of the staff working on the unit were interviewed about the concept of low security. Patients offered an admission were more able than those not offered an admission, posed more risks and were more complex diagnostically. Staff working on the unit agreed that their patients were complex, but felt that they were appropriately placed overall. The challenges of low secure provision were discussed by staff. Patients sampled were complex and heterogeneous, but not necessarily ‘forensic’. Their complexity requires sophisticated care plans and management strategies. This study has implications for referrers, staff, patients and managers, and highlights areas for future research.

A survey was undertaken to determine the number of young people needing secure psychiatric inpatient care as at 1st January 2001. Twenty‐three individuals were identified who were placed in a variety of settings. However, few of the placements could be considered ideal. There was a wide range of diagnoses, and most young people had additional problems of social and education deficits and offending behaviour.Specialist resources need to be made available to local secure and residential facilities to reduce the need for secure placements. However, there may be a case for developing a regional secure service although, given the wide range of needs presented, it is unlikely that a single secure resource could meet them all.

The aim of the present study is to explore the psychometric properties of the EssenCES measure (patient report) of social climate in a secure service for people with intellectual disabilities.

Patients (37 men, 14 women, Mean age=33.24 years, SD=11.29, age range: 18‐71 years) residing in a secure intellectual disabilities service completed the EssenCES as part of routine clinical practice.

Reliability analysis revealed acceptable reliability for all three subscales (α=0.76‐0.88). In order to consider one aspect of the construct validity of this measure, a predicted group difference regarding the impact of security level on ratings of social climate was investigated. Analysis revealed that social climate ratings were more positive on low secure wards than medium secure wards as measured by the combined EssenCES subscales F(3, 31)=4.71, p=0.008; Λ=0.69; η²=0.31, and the Experienced Safety subscale, F(1, 33)=7.41, p=0.01.

Future research should consider the link between social climate and treatment outcome within forensic secure intellectual disability services.

Results provide preliminary evidence to suggest that the EssenCES subscales (patient report) are reliable in this previously unconsidered population. However the validity of the measure is still unclear and requires further investigation.