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There are many notable drama series where forensic psychiatry plays a high profile role on TV where the portrayal of how forensic psychiatrists work is totally fallacious. Do you think that the patients who are in Broadmoor for sexual offences are curable? In essence, there are two parts to treatment, firstly the underlying mental disorder then secondly the circumstances leading to admission, commonly a violent offence.

David Could Dr Chatw comment on the multi million pound development of Broadmoor's physical security fences etc.

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In fact, as you might see, it is of the greatest importance that the clinical services responsible for patients when they've moved on are very well-versed in their patients' backgrounds. The real causes of most psychological difficulties are not severe stresses but severe stress combined with poor coping.

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However where there is active family contact families are invited to attend care-planning meetings and often have very valuable contributions to make. I'm not sure that for the emotionally disturbed in their childhood to receive psychotherapy would be the answer. Having worked as visiting psychiatrist at one of the London prisons for some years, I know that the general prison culture is quite hostile to acknowledgement of mental disorder, and prisoners generally resent psychiatric referrals being made.

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Dr Kevin Murray The first answer is no, patients do not have "new identities". Angharad Law, All in the Mind Producer Unfortunately due to the time mufray of a 28 minute programme, we could not include interviews with everybody we spoke to. Though in many cases, particularly children who come from very disturbed backgrounds would benefit. Also, what provision for child psychotherapy is provided by the NHS?

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Should it not now be recognised that this anachronistic institution needs to be closed and replaced by smaller, more manageable local units? Keith With Munchausen's Syndrome by proxy in the news at the moment, is this a problem common within the forensic hospital arena and if so, is it an easily successfully treated problem.

We do recognise that some patients will spend many years with us - but only those for whom our current treatments have not reduced the risks that they pose to a level which allows their safe onward movement. Sarah I live very close to Broadmoor and can hear the alarms go off every Rreal morning.

I think for all sorts of reasons, contact with nature, gardening, and contact with animals, there are many aspects of the farm experience with would be therapeutic. I hope however, like so much in psychiatry, that in the future we will come full circle yet again and reintroduce farms into hospitals because the Victorians actually knew a thing rdal too about creating viable institutions.

Most patients who come mruray Broadmoor have a background of major social disadvantage: broken homes, periods in care, ificant substance misuse, violent and sexual abuse as they are growing up etc. Julia I was wondering why the farm closed, and if it was purely arable, or had livestock. I'm not sure, therefore, whether a "disease model" of prevention and cure is applicable. In fact it was very common murraay the large Victorian asylums 2 centuries ago for there to be a farm as part of the grounds.

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Discharge is either by a tribunal, headed by a judge, or by agreement with the Home Office. We do have patients, as I've mentioned, with severe, relatively treatment-resistant psychotic illnesses, and we do have patients with severe persistent personality disorders.

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Dr Kevin Murray I think your question represents quite a common concern. Is this in fact pursued at Broadmoor? If a mentally disordered defendant is sent to hospital for treatment, it is likely to be on a "restricted" hospital order.

Is it because patients have escaped from Broadmoor. Having worked with the social work department at Broadmoor, I am aware that the social histories collated by them at the point of admission are a pivotal part of the treatment planning process.

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For those of you who've written in with reference to specific patients, I'm afraid we're unable to answer those in this public forum. Raj Many are convinced that psychiatrists and doctors are regularly hoodwinked by patients.

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It is the case that as the oldest of the special hospitals, there may have been more to do at Broadmoor than the others. Is the system being chatts Esther It was mentioned toward the end of your Horny singles in Strafford NH on Tuesday evening that psychotherapy for patients was, though enormously beneficial, too late in the sense that it only took place after a crime had been committed.

Carolyne via text Do you think that prisoners consider Broadmoor to be an easy option, as mentioned in one of your interviews? I know that several years ago patients who were admitted to Broadmoor with an original diagnosis of Schizophrenia have since been diagnosed as having Asperger Syndrome which is not a mental condition nor, in many cases, a learning disability.

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To what extent do you think psychotherapy for the emotionally disturbed in their childhood might have a preventative effect in reducing crime rates? Jason People often seem to think that Broadmoor patients are desperate to escape at all costs, but do you ever find patients who are scared about living in the outside world and readjusting when released, having been inside for a long time? The reduction in Broadmoor's size has meant that we have been able to reduce ward sizes down to about a maximum of 20 and to provide more focused treatment regimes.

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