Is there a need to safeguard specialist psychiatric units in the NHS? Henderson Hospital: a case in point

Abstract

For the purpose of this article, a specialist psychiatric unit refers to any community project, out-patient clinic, hospital ward or, as in the case of Henderson, a whole hospital which specialises in providing a specific type of treatment or treatment to a particular patient group(s). Specialist psychiatric units may be particularly vulnerable at this time when, because of the implications of Working for Patients, many psychiatrists' minds are focused on the need to justify and define their ‘core services’. Many specialist psychiatric units are directly funded by their hosting Region. If Regional Health Authorities do not maintain special psychiatric units directly then a high financial risk will be put on any District Health Authority or self-governing hospital which hosts them. If the latter fail to accept the financial risk, or take the risk and then suffer financially, there is the possibility that both a wealth of specialist expertise will be lost from the psychiatric profession as a whole and that certain patients will receive substandard or no treatment. It may be, therefore, that there is now a need specifically to justify the continued existence of specialist psychiatric units. Henderson Hospital, a therapeutic community specialising in the treatment of severely personality disordered young adults, is a case in point.