Trading within secure forensic inpatient units
Research type
Research Study
Full title
The nature, prevalence, and frequency of patient-reported voluntary trading behaviour and coercive trading behaviour on low and medium secure forensic units across South London and an exploration of patient variables associated with being a victim of coercive trading behaviour: A cross-sectional study.
IRAS ID
292669
Contact name
Heloise Mongue Din
Contact email
Sponsor organisation
South West London & St George’s Mental Health NHS Trust
Duration of Study in the UK
0 years, 7 months, 1 days
Research summary
Research Summary
Trading (exchanging, lending, loaning, borrowing, or gifting personal property, money, or services) between patients is strictly prohibited on secure forensic units as it can be associated with disputes, illicit behaviour, and exploitation. Trading amongst patients is difficult to monitor on secure forensic units as it can be easily hidden from, or overlooked by, staff. As such, it is difficult to acurately measure or estimate the scale of trading related behaviour.
There is presently no published research focusing on trading behaviour in secure hospital settings. This study aims to ascertain the nature, prevalence, and frequency of patient-reported voluntary and coercive trading behaviour on low and medium secure forensic units across South London. A secondary aim is to determine whether there is a relationship between being the victim of coercive trading behaviour and specific patient characteristics (e.g. age range, number of admissions to hospital, previous custodial sentence, leave status).The study population will include all patients detained on low- and medium-secure units across the South London Partnership (SLP) who have been admitted to hospital for more than one week and, can read and write in English, and have capacity to consent to participate. The study will take place on the low- and medium secure units across the three NHS Mental Health Trusts within the SLP. Eligible patients who agree to participate will be presented with an anonymous questionnaire consisting of 19 multiple choice questions relating to the participant’s experience of trading with other patients on the ward during their current admission to hospital. The questionnaire will also include an additional five multiple-choice questions relating to specific patient characteristics. Participants will be given up to an hour to complete the questionnaire and all eligible patients will be given two opportunities to participate in the study over the course of the study period.
Summary of Results
Ninety-six (46.6%) of 206 eligible patients participated and provided data.
70.2% of participants reported engaging in some form of unauthorised voluntary trading behaviour (VTB) while 38.3% reported engaging in more than 5 different behaviours (although most carried out each behaviour only ‘once’ or ‘occasionally).
VTB was more commonly reported by male (74.7%) than female (36.3%) participants (OR=4.93, CI=1.28,19.05, p=0.021).
Engagement in any coercive trading behaviour (CTB) was reported by fewer patients (31.9%), although when it was, frequency of engagement was widely distributed. Participants were more likely to report themselves as victims of CTB (8.6-14.0% across different behaviours) rather than instigators (1.1-5.5% across behaviours). Involvement in CTB was more common in patients reporting VTB (39.4%) compared to those not involved in VTB (14.3%; odds ratio (OR)=3.90, 95% confidence interval (CI)=1.21,12.54).
These results suggest that covert patient trading is commonplace in secure psychiatric inpatient settings and that VTB participation may be linked with CTB engagement.
The findings of this study raise awareness of the high prevalence rate of covert patient trading on secure psychiatric units. It is hoped that the findings can prompt the development of hospital policies to better monitor and regulate covert patient trading thereby reducing the incidence of CTB
REC name
East of England - Essex Research Ethics Committee
REC reference
21/EE/0023
Date of REC Opinion
19 Jan 2021
REC opinion
Favourable Opinion