ABSTRACT
The perplexing or shocking behaviours that can lead patients, psychotic or otherwise, to be treated in secure settings may have contributed to the tendency of forensic psychiatry teams in particular to incorporate a psychoanalytic approach. This chapter describes in a general way how clinical psychiatric teams in high-secure hospital settings approach the problem of patients who have been violent. Patients in special hospital or high security are, by definition, considered to be "dangerous". It is important to consider the public perception of mentally disordered offenders and how this influences policy-makers, particularly those involved with the high-secure hospital patient population. A psychoanalytic approach can contribute by offering a view of the patient's mind and how his or her past dangerous behaviour resides in that mind. The term "risk containment" is used to describe the multifaceted approach required when considering a patient who has been dangerous.
