ABSTRACT
Medium-secure units are for those with mental disorder whose disruptive and/or dangerous behaviour requires psychiatric treatment in conditions of greater security than is provided in ordinary hospitals, including locked local secure and intensive care units, but less than in special hospitals. Medium-secure units are generally funded for their in-patient services, much of their work involves the assessment elsewhere of mentally abnormal offenders, often for courts, or of other individuals who are not formally charged with offences. Violence can arise directly from positive symptoms of mental illness. Violence is multifactorially caused and is a bio-psycho-social-environmental phenomenon. If there are compounding problems, such as personality disorder, drug abuse, post-traumatic stress symptoms or disorder, brain damage, or epilepsy, control of positive psychotic symptoms of mental illness alone may not be sufficient to remove the risk of violence. Violence may be a form of communication, or a symptom of high emotional arousal, or it may have a psychodynamic meaning.
