Domains of Need in a High Secure Hospital Setting:A Model for Streamlining Care and Reducing Length of Stay

There are financial and humanitarian consequences to unmet need amongst service users of high secure hospital care, not least in terms of length of stay. This article presents two reviews of high secure service user needs. They provide support for the sequencing of interventions to meet service user needs and the utility of a structured framework for their review. Through analyses of these reviews, eight domains of need were identified: Therapeutic Engagement, Risk Reduction, Education, Occupational, Mental Health Recovery, Physical Health Restoration, Cultural and Spiritual Needs, Care Pathway Management. A model is presented, within which logically sequenced, timely and relevant interventions could be framed in order to provide a comprehensive and streamlined pathway through a high secure hospital