Broadmoor Hospital

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Map sources for Broadmoor Hospital at grid reference SU8464

Broadmoor Hospital is a maximum secure psychiatric hospital in Crowthorne in Berkshire. It is the best known of the three high-security psychiatric hospitals in England, the other two being Ashworth and Rampton. The complex houses 326 patients – of whom about 49 are women, although work is currently under way to expand capacity elsewhere so that women no longer need be admitted to Broadmoor. At any one time there are also approximately 36 patients on trial leave at other units. Most of the patients there suffer from severe mental illness. Many of the patients also have personality disorders. Most have either been convicted of serious crimes, or been found unfit to plead in a trial for such crimes. The average stay is about 8 years.

Previously known as the Broadmoor Asylum for the Criminally Insane, the change of name reflects a change in attitude to mental illness and criminals, and usage of the word "asylum".

The hospital was built in 1863, to a design by Sir Joshua Jebb, and covers 210,000 square metres (53 acres) within its secure perimeter.

Broadmoor Hospital is now part of the West London Mental Health NHS Trust. In 2002 the Trust expanded to include mental health provision in Hounslow. The Trust reports to the NHS Executive through the London Strategic Health Authority.

It provides not only patient care but is also a centre for training and research.

A new unit called the Paddock was opened on the 3rd April 2005 to treat patients with a dangerous severe personality disorder (DSPD).^[1] This is a new and much debated diagnosis or label, but can be defined as any of the following:

A diagnosis of two or more personality disorders that meet the criteria as laid out in the Diagnostic and Statistical Manual of Mental Disorders DSM IV –TR.
A significant score on the Hare Psychopathy Check list – Revised (PCL-R)
A slightly lower score on the Hare Psychopathy Check list and with one or more personality disorders but not including an Antisocial personality disorder diagnosis.

Overall, they will be those individuals that are considered to be or represent a 'Grave and Immediate Danger' to the general public. It has been suggested that the threshold for admittance to be set at a greater than 50% chance of the individual committing serious harm upon another.

Rather than create a new Mental Health Act, it may now only require the existing laws to be updated in order that people can be assessed for this condition before they have been committed to the forensic services by another route. Also, this will be limited to males, as it is not yet scientifically agreed as to whether any women meet this criterion. Individuals who do meet this criterion will be admitted to the new Paddock unit only as and when sufficient staff have been trained, to be able to provide and maintain the right therapeutic programs and environment. The Paddock Unit is designed to eventually house 70 patients and is just one of four units being set up in England and Wales. As the West London Mental Health NHS Trust already carries out research, the Trust hopes that Broadmoor will become a centre of learning for this new type of therapy. The ultimate aim of this work is to reduce the cost to society that would accrue if no treatment was provided.

Due to the potentially violent nature of some of the patients, the hospital has an alarm system to alert nearby institutions in the surrounding towns of Wokingham and Bracknell if any dangerous patient escapes. This alarm system is based on World War II air-raid sirens, and a two-tone alarm sounds across the whole area in the event of an escape. The system is tested every Monday morning at 10:00 GMT for 2 minutes, after which a single tone 'all-clear' is sounded for a further 2 minutes. During the early 1990s, at least one nearby school maintained, and on occasion used, procedures designed to ensure, in the event of a Broadmoor escape, that no child was ever out of the direct supervision of a member of staff.

Following the Peter Fallon QC inquiry into Ashworth Special Hospital, which found (amongst other things) serious concerns about security and abuses that came about from poor management, it was decided to review the security at all three special hospitals. This review was made the personal responsibility of Sir Alan Langlands, who at the time was Chief Executive of the National Health Service. Up until this time, each special hospital was responsible for drawing up its own security policies. The report which came out of the review initiated a new partnership to be formed whereby the Department of Health sets out a policy of safety and security directions that all three special hospitals need to adhere to. These directions are then updated or modified when it is seen fit to do so. This has resulted in a costly upgrade in the physical security at Broadmoor from what was approximately category 'C' to category 'B' prison standards. Higher levels of security than this is then placed around certain buildings. Up until then, it had been anathema to think of enclosing the mentally ill behind razor wire and thereby reinforcing the stigma against them. Also, new standards have been formulated to increase procedural security and safety for the staff and other patients; this includes procedures and equipment for reducing the amount of contraband smuggled into the hospital.

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