Attitudinal and Organisational Barriers to the Introduction of Long-Stay Services

Abstract

This chapter presents and discusses findings from interviews and focus groups with staff working in the field of forensic psychiatry. It identifies some changes happening in service provision for ‘long-stay’ patients, although the extent of formalisation and codification in relation to these new ways of working have been, at best, patchy. Implementing change in organisations is a difficult process. Embedding and sustaining change so that it becomes institutionalised requires a great deal of effort. The chapter uses ‘institutional theory’ to examine change and barriers to change in the field of forensic psychiatry. Institutional theory is concerned with understanding how the routines, norms and actions become established and taken for granted (i.e. institutionalised) by those who work in organisations, as well as in the wider field in which they are situated. A number of barriers to more extensive and formalised change are identified.