Broadmoor High Secure Psychiatric Hospital, Crowthorne, RG457EG, Berkshire, United Kingdom.
Res Dev Disabil. 2020 May;100:103615. doi: 10.1016/j.ridd.2020.103615. Epub 2020 Feb 26.
BACKGROUND/AIMS: To explore the role of high secure psychiatric care (HSPC) in the assessment and management of individuals with an Autism Spectrum Disorder (ASD) using published studies and clinical experience. Key areas of exploration include the prevalence of ASD within HSPC, some autism specific issues including clinical and cognitive characteristics, psychopathy and emotional regulation, presence of incompatibilities and use of seclusion, as well as experiences of being detained in HSPC. Developing best practice and a specialist ASD service in HSPC is also discussed.
A discussion of available literature, supported by clinical experience.
Although individuals with an ASD admitted to HSPC comprise a small group, they are likely to be overrepresented relative to the general prevalence of ASD in the population and present with specific issues. Whilst individuals report a generally positive experience of HSPC, therapeutic outcomes are variable and the factors influencing them poorly understood. Staff knowledge and application of ASD theory and practice appears to have a significant influence on outcomes.
Although best practice concerning ASD secure services will continue to be improved and developed, the role of HSPC in the assessment and management of some individuals with an ASD who present with complex needs and high risk behaviours remains clear.
背景/目的：通过已发表的研究和临床经验，探讨高度安全精神病学护理（HSPC）在评估和管理自闭症谱系障碍（ASD）个体中的作用。探索的重点领域包括 HSPC 中 ASD 的患病率，一些自闭症特定问题，包括临床和认知特征、精神病态和情绪调节、不兼容的存在以及隔离的使用，以及在 HSPC 中被拘留的经历。还讨论了在 HSPC 中制定最佳实践和专业 ASD 服务的问题。
对现有文献进行讨论，并辅以临床经验。
尽管被 HSPC 收治的 ASD 个体构成了一个小群体，但他们相对于 ASD 在人群中的一般患病率可能过高，并存在特定问题。尽管个体报告了对 HSPC 的普遍积极体验，但治疗结果存在差异，其影响因素了解甚少。工作人员对 ASD 理论和实践的了解和应用对结果有重大影响。
尽管有关 ASD 安全服务的最佳实践将继续得到改进和发展，但 HSPC 在评估和管理具有复杂需求和高风险行为的某些 ASD 个体中的作用仍然明确。
