No. Segregated facilities do exist, even if it is more common to have separate institutions entirely that each have a fixed treatment level. And even the equivalent of Ward A institutions have isolation rooms for acute cases.
Yes, that was my experience in forensic psych. Most places were organised in 3 wards - acute, mixed and chronic; acute for currently violent patients, mixed is an in-between ward, settled patients, waiting to go onto chronic ward, and chronic - stable, no recent history of violent behaviour. Obviously, these are the tiniest percentage of psych patients, like 0.0001% or less. Interestingly, in forensic psych institutions, women tend to be only in mixed and chronic wards, never in the acute, due to difficulties with keeping them safe amongst violent male patients. Regular psych wards are usually divided into adult acute, chronic and psychogeriatrics (all co-ed). Adult acute (usually 2-3 wards per hospital) will accept all acute patients, voluntary and non-voluntary, between the ages of 16 - 60. They will have (actually all psych wards except for chronic have this) both an enclosed area for 1:1 obs as well as separate room for sedated patients. Chronic ward is usually away from the acute, in a nice setting, like a psych nursing home with various types accommodation (fully nurse-supported or independent). Psychogeriatric wards are usually in the same premises as adult acute, usually comprise of two wards - organic (severe dementia patients, admitted with view to placement in a nursing home once they are stable) and old age psych (chronic elderly psych patients). I haven't worked in child and adolescent or learning disabilities psych so I only have a general idea how that works, bt three-tier system is usually employed.
Nothing like that exists around my neck of the woods. We have a locked area in our vets' hospital where some dangerous patients are maintained. I know, I volunteer there. It's more to keep general traffic out that to lock people in. I often ferried vets out to go to the inhouse clothing store/PX. We did not need passes or armed guards. But I worked at the UW Hospital, and I've been treated at St Mary's--no prisoners. Mendota State Hospital did house some pretty tough guys, including Ed Gein, the guy that "The Silence of the Lambs" was patterned after. That was a long time ago. They have now lost their funding. But for 99% of the patients here, including kids, you go to out-patient services.
Here, convicted criminals who are severely mentally ill are housed in a separate secure prison/hospital, as are those who committed violent crimes but are too mentally ill to stand trial. The psychiatric hospitals take both voluntary and involuntary clients, and are divided into only two sections - unstable/incoming, and stable. There is also a separate section for youth and another for the elderly, but they are also run as separate entities. The youth area was very small, as communities usually try to keep kids with families, or at least in the same community.
I have worked in the equivalent of a Ward A institution, and I have seen others. My mother was a psychiatric social worker before she retired. And my ex-wife -- best not go into that.
