Medium secure mental health care for young people: decisions to detain
Bibliographic record
Abstract
Medium secure units are one component of secure mental health care for young people across the UK. No research has previously examined the appropriateness of admissions. This is a retrospective cohort study of all patients admitted to one unit by examining clinical notes for demographic, mental health and criminological variables. Descriptive data was statistically analysed to then characterise the cohort, audit against admission criteria and examine changes over time. There were 149 admissions. All patients admitted were male, most were 17 years old and from racialized groups. Most were detained under forensic sections with a primary diagnosis of psychosis. Four of five admissions met all 4 admission criteria. There were notable changes in use of forensic sections and risk over time. Our cohort differs from previous historical and contemporaneous cohorts in terms of diagnosis, legislation determining admission and ethnic breakdown. Our analysis relies on an interpretation of existing admission criteria but it suggests that not all admissions were appropriate, raising important practical, ethical and cost benefit questions. We suggest greater transparency about admission decisions to ensure that patients are admitted to the least restrictive setting needed and that national service planning is responsive to changes in demand.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".