Firesetting in secure settings : theory, treatment and management

Firesetting confers substantial costs on society. In 2010/2011 there were 36 000 deliberately set fires in Great Britain resulting in 72 fatalities and 1700 non-fatal casualties. Around one in five deliberate fires occur in non-dwelling buildings, including hospitals (Department for Communities and Local Government, 2011). While serious fires in psychiatric hospitals are reasonably rare, incidents in UK secure mental health units in recent years, at Stockton Hall in North Yorkshire in 2010 (BBC News, 2010) and Camlet Lodge in London in 2008 (James, 2008), have demonstrated that fire can seriously disrupt service provision and endanger life. Additionally, the total number of incidents in psychiatric hospitals attended by the fire and rescue service is disproportionately greater per bed than in general medical hospitals (Grice, 2012). Around 10% of people admitted to forensic psychiatric services have committed arson (Coid et al, 2001) and many more may have a history of problematic firesetting behaviour (Geller et al, 1992). It is important therefore that staff who work in these services hold sufficient practical and theoretical knowledge to contribute to the prevention of firesetting and to the assessment, treatment and management of firesetters in secure care.