Episode 4: Jess is shocked by the plans for the Psychological Treatment Unit

In episode 4 of Shadow of the Wing Jess meets the General Manager of Hilgram Lodge. Sheila Margoleyes – who would once upon a time have been called the ‘Matron’ of the hospital - is not all she at first seems. She learns of plans for a new treatment unit, plans which Jess believes could have deadly consequences…

All of the special hospitals in the UK have designated services to treat ‘psychopathic disorders’. They are challenging environments to work in and have a high staff to patient ratio – to protect both staff and patients from manifesting disturbed behaviours such as self harm and attack on others. The treatment approaches are varied and come from a number of theoretical perspectives such as psychodynamic and behaviourism. Approaches aim to both understand the patient and develop a variety of treatment options which can vary from, for example, art therapy, anger management and relaxation therapies to more invasive drug treatments. However, the very nature of the environment and how it impacts upon treatment approaches has been questioned1. Women in high security hospitals - the group Jess believes she has been recruited to work with - are a minority and it is recognised that providing treatment suitable for their particular needs is difficult.

As Mason (2006)2 points out, trauma is often a key element of what leads to offending behaviour for women and it is essential in any treatment programme that women patients are enabled and facilitated in feeling safe. The majority of women in secure psychiatric services have experienced physical, sexual or psychological abuse and eating disorders, contemplation of suicide, depression and low self esteem are common. The hospital senior management team have decided to develop a mixed sex unit. Can abused women really be safely treated alongside rapists and men who are in the system because of their abuse of women? Jess has grave concerns which get her on the wrong footing with her new boss.

Listen to Episode 4:

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  1. Grounds, A. Quayle, M., France, J., Brett, T., Cox, M. & Hamilton, J. (1987). A Unit for “psychopathic disorder” patients in Broadmoor Hospital. Medicine, Science and the Law, 27, 21-31. 

  2. Mason, F.L. (2016) Services for Women Offenders with Personality Disorder in Newrith, C., Meux, C., Taylor, p. (2016) Personality Disorder and Serious Offending. CRC Press.