How secure are the secure psychiatric units in New South Wales?

To evaluate the therapeutic security characteristics of the secure forensic mental health inpatient units in New South Wales, Australia. This study evaluated all eight secure inpatient units in New South Wales using a validated tool, the Security Needs Assessment Profile. A pattern of decreasing therapeutic security across the secure units was found, consistent with their intended security levels, from high security through to open security. However, important inconsistencies across and between levels of security were highlighted. This study clarifies the therapeutic security structure of the New South Wales forensic mental health service, which is an essential first step in service development and reform.