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The management of the secure psychiatric services is under increasing scrutiny. In Managing High Security Psychiatric Care the contributors examine the management of these services in the light of their experiences and involvement with the Special Hospitals throughout the lifetime of the Special Hospitals Service Authority.The book illustrates the problems faced by the Special Hospitals and the techniques and action employed to effect major change in these large, enclosed institutions. It illustrates the difficulties and obstacles encountered and focuses on themes which dominated and influenced management and clinical initiatives. Key messages that emerge include close collaboration between managers and clinicians, planning and delivering real change in institutional settings, challenging and restructuring unacceptable attitudes influencing the wider debate about care for mentally disordered offenders.The book provides a realistic description of the role and purpose of the High Security Psychiatric Service and the key dilemmas it still faces. It also makes suggestions concerning the direction any future service needs to pursue.The book will be of interest to all those involved in the forensic psychiatric service, other large, closed institutions, and the Criminal Justice system.