|West London Mental Health (NHS) Trust|
Broadmoor in 2006
|Location||Crowthorne, Berkshire, England, United Kingdom|
|Care system||Public NHS|
|Emergency department||No Accident & Emergency|
|Lists||Hospitals in England|
Broadmoor Hospital is a high-security psychiatric hospital at Crowthorne in the Borough of Bracknell Forest in Berkshire, England. It is the best known of the three high-security psychiatric hospitals in England, the other two being Ashworth and Rampton. Scotland has a similar institution at Carstairs, officially known as the State Hospital but often called Carstairs Hospital, which serves Scotland and Northern Ireland.
The Broadmoor complex houses about 260 patients, all of whom are men since the female service closed with most of the women moving to a new service in Southall in September 2007, a few moving to the national high secure service for women at Rampton and a few elsewhere. 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 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 for the total population is about six years, but this figure is skewed by some patients who have stayed for over 30 years; most patients stay for considerably less than six years.
The catchment area for the hospital underwent some rationalisation of the London area in the early 21st century, and now serves all of the NHS Regions: London, Eastern, South East and South West.
The hospital was previously known as the Broadmoor Criminal Lunatic Asylum; the change of name reflects a change in attitude towards mental illness, criminals and the word "asylum".
The hospital was built to a design by Sir Joshua Jebb, an Officer of the Corps of Royal Engineers, and covers 53 acres (210,000 square metres) within its secure perimeter. The first patient was a female admitted for infanticide, on 27 May 1863. Notes described her as being 'feeble minded', it has been suggested by modern doctors upon analysis of notes, that she was most likely also suffering from congenital syphilis. The first male patients arrived on 27 February 1864. The original building plan of five blocks for men and one for women was completed in 1868. A further male block was built in 1902.
Due to overcrowding at Broadmoor, a branch asylum was constructed at Rampton Secure Hospital and opened in 1912. Rampton was closed as a branch asylum at the end of 1919 and reopened as an institution for mental defectives rather than lunatics. During World War I Broadmoor's block 1 was also used as a prisoner-of-war camp, called Crowthorne War Hospital, for mentally ill German soldiers.
After the escape and the murder of a local child in 1952 by John Straffen the hospital set up an alarm system, which is activated to alert people in the vicinity, including those in the surrounding towns of Sandhurst, Wokingham, Bracknell and Bagshot, when any potentially dangerous patient escapes. It 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. It is tested every Monday morning at 10 am for two minutes, after which a single tone 'all-clear' is sounded for a further two minutes. All schools in the area must keep procedures designed to ensure that in the event of a Broadmoor escape no child is ever out of the direct supervision of a member of staff. Sirens are located at Sandhurst School, Wellington College, Bracknell Forest council depot and other sites.
As well as providing patient care Broadmoor is a centre for training and research.
Following the Peter Fallon QC inquiry into Ashworth Special Hospital, which reported in 1999 and 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. Until this time each special hospital was responsible for maintaining its own security policies.
This review was made the personal responsibility of Sir Alan Langlands who at the time was Chief Executive of the National Health Service (England). The report that 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 must adhere to. These directions are then updated or modified as needed.
This has resulted in upgraded physical security at Broadmoor from approximately category 'C' to category 'B' prison standards. Higher levels of security than this are then placed around certain buildings. New standards have also been formulated to increase procedural security and safety for the staff and other patients; these include procedures and equipment for reducing the amount of contraband smuggled into the hospital.
Before the Langlands report, it had been an anathema in modern psychiatry to think of enclosing the mentally ill behind razor wire. As this type of security measure had been seen as unnecessary, it was thought that it would only serve to reinforce the stigma against psychiatric patients if it were to be employed.
Misconceiving it as a prison
Because of the outside appearance of the buildings, especially its high walls and other visible security features, and the inaccurate news reporting it has in the past received, it is occasionally presumed by some members of the general public that Broadmoor Hospital is a prison. Many of its patients are indeed referred to it by the criminal justice system, and its original design brief incorporated an essence of addressing criminality in addition to mental illness; however, the layout inside and the daily routine are designed to assist the therapy practiced there rather than to meet the criteria necessary for it to be run along the lines of a prison in its daily functions. Nearly all staff were members of the Prison Officers Association, as opposed to the health service unions like UNISON.
Jimmy Noak, Broadmoor's director of nursing, in response to claims that criminals were being given unfairly pleasant treatment in the facility, commented, "It's not fair, but what is the alternative? If these people committed crimes because they were suffering from an acute mental illness then they should be in hospital."
From its opening until 1948 Broadmoor was managed by a Council of Supervision, appointed by and reporting to the Secretary of State for the Home Department (Home Secretary). Thereafter, the Criminal Justice Act of 1948 transferred ownership of the hospital to the Department of Health (and the new NHS) and oversight to the Board of Control for Lunacy and Mental Deficiency established under the Mental Deficiency Act 1913. It also renamed the hospital Broadmoor Institution. The hospital remained under direct control of the Department of Health - a situation which reportedly "combined notional central control with actual neglect" until the establishment of the Special Hospitals Service Authority in 1989, with Charles Kaye as initial Chief Executive.
In 1996 the SHSA itself was abolished, being replaced by individual special health authorities in each of the High Secure Hospitals. The Broadmoor Hospital Authority was itself dissolved on 31 March 2001. Then on 1 April 2001 West London Mental Health (NHS) Trust took over the responsibility for this hospital. This Trust reports to the NHS Executive through the London Strategic Health Authority.
A new unit called the Paddock Centre was opened on 12 December 2005 to treat patients with a dangerous severe personality disorder (DSPD). This was a new and much debated diagnosis or label that had two criteria. The first criterion is that the individual be 'dangerous', i.e. they are considered to be or represent a 'Grave and Immediate Danger' to the general public. It has been suggested that the threshold for this criterion be set at a greater than 50% chance of that individual committing serious harm upon another, from which the victim is unlikely to recover.
The second DSPD criterion was that the individual suffers from a 'severe personality disorder', meaning that he or she has:
- 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; or
- A significant score (i.e. 30 or higher) on the Hare Psychopathy Check list – Revised (PCL-R); or
- A slightly lower score (i.e. 25 to 29) on the Hare Psychopathy Check list and with one or more personality disorders but not including an Antisocial personality disorder diagnosis.
The DSPD service in the Paddock Centre was limited to men, as it was not yet scientifically agreed whether any women meet this criterion.
The Paddock Centre was designed to eventually house 72 patients, but never opened more than four of its six 12 bedded wards. The Dept of Health and Ministry of Justice National Personality Disorder Strategy published in October 2011 concluded that the resources invested in the DSPD programme should instead be used in prison based treatment programmes and the DSPD service at Broadmoor was required to close by 31 March 2012. The patients were transferred variously back to prison, on to medium secure units to continue treatment, some to the residual national DSPD service at the Peaks Unit in Rampton, and finally some remaining in Broadmoor in the Personality Disorder direcorate.
The Paddock now, in 2013, provides admission wards and high dependency wards for both mental illness and personality disorder direcorates: all 72 beds are in use.
Jimmy Savile sexual abuse allegations
From the 1970s onwards, the TV presenter and disc jockey Jimmy Savile undertook voluntary work at the hospital, raised funds for it, and was allocated his own room there. In August 1988, he was appointed by junior health minister Edwina Currie to chair an interim task force overseeing the management of the hospital, following the suspension of its board. After the ITV1 documentary Exposure: The Other Side of Jimmy Savile was broadcast in October 2012, allegations of sexual abuse by Savile at the hospital, and elsewhere, were made by former patients and staff. It was reported that the civil servant who proposed Savile's appointment at Broadmoor was investigated by police and prevented from working with children. The Department of Health announced that a former practising barrister, Kate Lampard, would chair and oversee the Department's investigations into Savile's activities at Broadmoor and at other hospitals and facilities in England.
Notable patients of Broadmoor Hospital - past and present
- Ashworth high-security psychiatric hospital
- Forensic psychiatry
- Rampton high-security psychiatric hospital
- West London Mental Health NHS Trust, which holds the commission from the Secretary of State for the Home Department to run this hospital.
- Writer Arthur Koestler founded the Koestler Trust with the aim of promoting the arts in special institutions, encouraging creativity and the acquisition of new skills. See "The Koestler Trust". Retrieved 2007-05-17.
- Berkshire Record Office catalogue of Broadmoor Hospital records, introduction
- BBC - h2g2 - The Broadmoor Siren
- The Broadmoor siren. WLMHT. Accessed 2012-07-01
- Fallon, Peter; Bluglass, Robert; Edwards, Brian; Daniels, Granville (January 1999) Report of the Committee of Inquiry into the Personality Disorder Unit, Ashworth Special Hospital. published by the Stationery Office. Accessed 2007-11-12
- Langlands, Alan (22 May 2000). Report of the review of security at the high security hospitals. Department of Health. Accessed 2007-11-12
- Department of Health (February 2000). Report of the Review of Security at the High Security Hospitals sec 5, page 13 paragraph 6.3. Accessed 2009-02-21
- Press Complaints Commission (9 Jan 2009) Broadmoor Hospital Accessed 2009-03-01
- Lemlij, Maia (November 2005) Broadmoor Hospital: Prison-like hospital or hospital-like prison? A study of a high security mental hospitals within the context of generic function. pages 155, 156. Space Syntax Laboratory, UK. Accessed 2009-02-21
- Charles Kaye and Alan Franey (1998). Managing High Security Psychiatric Care. Jessica Kingsley. pp. 31,40. ISBN 9781853025815. Retrieved 28 October 2012.
- Ashworth Special Hospital: Report of the Committee of Inquiry
- National Archives, Office of Public Sector Information. Broadmoor Hospital Authority (Abolition) Order 2001. ISBN 0-11-029108-5. Accessed 2007-06-14
- "Dangerous & Severe Personality Disorder Programme". National Personality Disorder Organisation (UK). Archived from the original on 2007-02-24. Retrieved 2007-05-15.
- DSPD Programme Useful Information: DSPD Assessment Process Accessed 2009-03-02
- Daily Telegraph, "Broadmoor staff said Jimmy Savile was a 'psychopath' with a 'liking for children'", 1 November 2012. Accessed 1 November 2012
- Adam Sweeting. ""Sir Jimmy Savile obituary" at guardian.co.uk". The Guardian. Retrieved 1 October 2012.
- The Earl of Dundee (7 November 1988). "Mentally Ill Offenders: Treatment". Hansard (Lords). HL Deb 7 November 1988 vol 501 c525. Retrieved 13 October 2012.
- "Edwina Currie - 'nothing to hide' on Savile". BBC News. 21 October 2012. Retrieved 21 October 2012.
- "Sir Jimmy Savile: fourth British TV personality accused in sex allegations". The Telegraph. Retrieved 11 October 2012.
- "Jimmy Savile scandal: government could face civil claims". The Guardian. 12 October 2012. Retrieved 13 October 2012.
- "Jimmy Savile's relatives speak of their turmoil". The Telegraph. Retrieved 30 October 2012.
- "Jimmy Savile scandal: Kate Lampard to lead NHS investigation". BBC News (BBC). 17 October 2012. Retrieved 17 October 2012.
- Facts related in non-fictional book Savage Grace by Natalie Robins and Steven M.L. Aronson [1985, ISBN 978-0-688-04373-5], and more recently in the Tom Kalin's film Savage Grace (2007)
- Daily Times of Pakistan, Terrorists planning chemical hit on European targets, 19 December 2002
- BBC News | England | Devon | Failed bomber's recruiters hunted
- Daily Times of Pakistan, Euro judges rule that terror suspect wanted in America CAN'T be deported from Britain to the U.S. because it would be bad for his mental health
- Dell, Susanne; Graham Robertson (1988). Sentenced to hospital: offenders in Broadmoor. Oxford; New York: Oxford University Press. ISBN 0-19-712156-X. OCLC 17546264. Dewey Class 365/.942294 19. Sum: authors describe the treatment of some Broadmoor patients and together with their psychiatric and criminal histories.
- Partridge, Ralph (1953). Broadmoor: A History of Criminal Lunacy and its Problems. London: Chato and Windus. OCLC 14663968.
- The Sainsbury Centre for Mental Health (2006).First steps to work – a study at Broadmoor Hospital (119KB). Accessed 2007-06-15
- Stevens, Mark (2011). Broadmoor Revealed: Victorian Crime and the Lunatic Asylum. Broadmoor Revealed. Accessed 2011-07-15
- Official website
- Berkshire Record Office's Broadmoor History pages Accessed 2011-04-18
- Fallon, Peter; Bluglass, Robert; Edwards, Brian; Daniels, Granville (January 1999) Report of the Committee of Inquiry into the Personality Disorder Unit, Ashworth Special Hospital. published by The Stationery Office. Accessed 2007-11-12
- Paddock centre. DSPD service. West London Mental Health Trust. Accessed 2007-05-15
- Home Office. National offenders management service. Dangerous People with Severe Personality Disorder Programme. Accessed 2007-06-07
- All in the mind (Wednesday 3 March 2004, 5.00 pm). BBC – Live chat:The rehabilitation of the mentally ill in Broadmoor and elsewhere. Accessed 2007-05-19
- BBC News background on Broadmoor Hospital
- Landscapes & Gardens (2002) Architectural listing for Broadmoor Hospital. University of York. Accessed 2007-05-19
- BBC News story on scandals and controversy regarding Broadmoor and other secure hospitals
- "NHS in England". Broadmoor Hospital Site Summary Information. Retrieved 2006-03-26.
- Together-UK Independent Patients' Advocacy Service, for Broadmoor Hospital. Accessed 2007-06-15
- Fallon, Peter; Bluglass, Robert; Edwards, Brian; Daniels, Granville (January 1999) - overview of the History of the Hospitals in the context of the Ashworth Inquiry  Accessed June 2008