Pub Date : 1999-04-01DOI: 10.1080/09585189908402144
J. Atkinson, H. Gilmour, J. Dyer, Fiona Hutcheson, L. Patterson
Abstract Extended leave of absence (ELOA) is defined as leave of absence over 6 months and could be unlimited in Scotland until 1996. Patients have previously been detained under s.18 of the Mental Health (Scotland) Act 1984. A retrospective evaluation of use of ELOA was carried out using data held by the Mental Welfare Commission for Scotland. Records were used to describe reasons for using ELOA, support and service use. Over the period 1988–94 there were 534 people who had at least one episode of ELOA over 6 months and, of these, 250 had at least one episode of ELOA over 12 months. A diagnosis of schizophrenia occurs in 73% of patients. Lack of insight and threat of stopping medication are the most common reasons for using ELOA. Although threat to others is recorded more often than threat to self, self-neglect is recorded more often than either. The outcome of ELOA by year results in 30% of patients being discharged and 23% recalled to hospital. Of the total, 75% receive good support from at least one r...
{"title":"Retrospective evaluation of extended leave of absence in Scotland 1988-94.","authors":"J. Atkinson, H. Gilmour, J. Dyer, Fiona Hutcheson, L. Patterson","doi":"10.1080/09585189908402144","DOIUrl":"https://doi.org/10.1080/09585189908402144","url":null,"abstract":"Abstract Extended leave of absence (ELOA) is defined as leave of absence over 6 months and could be unlimited in Scotland until 1996. Patients have previously been detained under s.18 of the Mental Health (Scotland) Act 1984. A retrospective evaluation of use of ELOA was carried out using data held by the Mental Welfare Commission for Scotland. Records were used to describe reasons for using ELOA, support and service use. Over the period 1988–94 there were 534 people who had at least one episode of ELOA over 6 months and, of these, 250 had at least one episode of ELOA over 12 months. A diagnosis of schizophrenia occurs in 73% of patients. Lack of insight and threat of stopping medication are the most common reasons for using ELOA. Although threat to others is recorded more often than threat to self, self-neglect is recorded more often than either. The outcome of ELOA by year results in 30% of patients being discharged and 23% recalled to hospital. Of the total, 75% receive good support from at least one r...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"359 1","pages":"131-147"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80207432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402135
P. Power
{"title":"Community treatment orders: The Australian experience","authors":"P. Power","doi":"10.1080/09585189908402135","DOIUrl":"https://doi.org/10.1080/09585189908402135","url":null,"abstract":"","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"41 1","pages":"9-15"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76926190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402134
P. Mullen
{"title":"The abuse of children in care: The Grundy reports from Queensland","authors":"P. Mullen","doi":"10.1080/09585189908402134","DOIUrl":"https://doi.org/10.1080/09585189908402134","url":null,"abstract":"","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"12 1","pages":"5-8"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82659378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402149
K. Rix, M. Agarwal
Abstract A 21-year-old man attacked a fellow patient in a hospital ward and was convicted of inflicting grievous bodily harm. Before sentencing, oral evidence was given by a consultant psychiatrist to the effect that the risk of his causing serious harm to the public was low. Nevertheless a restriction order was imposed. He appealed successfully against this imposition. The appeal was upheld on the basis that there was insufficient evidence that he would cause serious harm to the public and that the trial judge, in construing s.41 of the Mental Health Act 1983, had fallen into the trap of applying the adjective ‘serious’ to the noun ‘risk’ rather than to ‘harm’. This case is considered against the background of the Butler Committee recommendations, which led to the wording of s.41, and in the light of the leading case of Birch, which drew attention to this particular trap.
{"title":"Risk of serious harm or a serious risk of harm? A trap for judges","authors":"K. Rix, M. Agarwal","doi":"10.1080/09585189908402149","DOIUrl":"https://doi.org/10.1080/09585189908402149","url":null,"abstract":"Abstract A 21-year-old man attacked a fellow patient in a hospital ward and was convicted of inflicting grievous bodily harm. Before sentencing, oral evidence was given by a consultant psychiatrist to the effect that the risk of his causing serious harm to the public was low. Nevertheless a restriction order was imposed. He appealed successfully against this imposition. The appeal was upheld on the basis that there was insufficient evidence that he would cause serious harm to the public and that the trial judge, in construing s.41 of the Mental Health Act 1983, had fallen into the trap of applying the adjective ‘serious’ to the noun ‘risk’ rather than to ‘harm’. This case is considered against the background of the Butler Committee recommendations, which led to the wording of s.41, and in the light of the leading case of Birch, which drew attention to this particular trap.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"27 1","pages":"187-196"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80222043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402137
J. Bland, G. Mezey, B. Dolan
All 87 women patients who were detained in Broadmoor Hospital during the first 6 months of 1994 are described in terms of their demographic and offence characteristics, their behaviours prior to and during admission, their diagnostic categories and treatment needs. Histories of sexual victimization and physical abuse were present in a substantial number of the population. Acts of self-harm represented a more significant management problem (present in 94% of women) than aggression towards others. The most common behaviours leading to admission were assault (71.3%) and arson (47.1%), although 23% of the women had not been convicted of any offence. The findings are discussed with reference to the need to develop within secure settings psychotherapeutic approaches that reflect the complexity of these women's lives as well as the multiple levels of trauma most have experienced.
{"title":"Special women, special needs: A descriptive study of female special hospital patients","authors":"J. Bland, G. Mezey, B. Dolan","doi":"10.1080/09585189908402137","DOIUrl":"https://doi.org/10.1080/09585189908402137","url":null,"abstract":"All 87 women patients who were detained in Broadmoor Hospital during the first 6 months of 1994 are described in terms of their demographic and offence characteristics, their behaviours prior to and during admission, their diagnostic categories and treatment needs. Histories of sexual victimization and physical abuse were present in a substantial number of the population. Acts of self-harm represented a more significant management problem (present in 94% of women) than aggression towards others. The most common behaviours leading to admission were assault (71.3%) and arson (47.1%), although 23% of the women had not been convicted of any offence. The findings are discussed with reference to the need to develop within secure settings psychotherapeutic approaches that reflect the complexity of these women's lives as well as the multiple levels of trauma most have experienced.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"8 1","pages":"34-45"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76557555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402143
J. Coid, J. Wilkins, B. Coid
Abstract A co-morbid history of fire-setting and self-mutilation in a sample of female remanded prisoners identified a subgroup with severe personality disorder, early onset of behavioural disorder, and extensive criminality. The relationship between fire-setting and self-mutilation in these subjects was mediated through antisocial personality disorder and an underlying mood disorder. The phenomenology of fire-setting and self-mutilating behaviour was identical in women with pyromania.
{"title":"Fire-setting, pyromania and self-mutilation in female remanded prisoners","authors":"J. Coid, J. Wilkins, B. Coid","doi":"10.1080/09585189908402143","DOIUrl":"https://doi.org/10.1080/09585189908402143","url":null,"abstract":"Abstract A co-morbid history of fire-setting and self-mutilation in a sample of female remanded prisoners identified a subgroup with severe personality disorder, early onset of behavioural disorder, and extensive criminality. The relationship between fire-setting and self-mutilation in these subjects was mediated through antisocial personality disorder and an underlying mood disorder. The phenomenology of fire-setting and self-mutilating behaviour was identical in women with pyromania.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"64 1","pages":"119-130"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72729307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402138
R. Brook, M. Dolan, P. Coorey
Abstract Absconding by Special Hospital patients frequently precipitates alarmist media reporting or internal inquiries, yet available studies indicate that absconding is rare and the risk to the public is minimal. The present study set out to examine the significance of previously identified clinical factors and specific absconder profiles in risk assessment, by comparing the frequency of key variables in a group of Special Hospital absconders and non-absconders. The results confirmed that absconding was rare with minimal risk to the public. The majority of absconding incidents occurred from trips outside the hospital. Factors predictive of a high risk of absconding were a previous history of absconding, acting-out behaviour and a previous history of assault. Clinical teams correctly identified 61% of cases as high risk prior to the absconding episode, but the false positive rate was 20%. More detailed databases with larger sample sizes and systematic data collection should assist in the development of a...
{"title":"Absconding of patients detained in an english special hospital","authors":"R. Brook, M. Dolan, P. Coorey","doi":"10.1080/09585189908402138","DOIUrl":"https://doi.org/10.1080/09585189908402138","url":null,"abstract":"Abstract Absconding by Special Hospital patients frequently precipitates alarmist media reporting or internal inquiries, yet available studies indicate that absconding is rare and the risk to the public is minimal. The present study set out to examine the significance of previously identified clinical factors and specific absconder profiles in risk assessment, by comparing the frequency of key variables in a group of Special Hospital absconders and non-absconders. The results confirmed that absconding was rare with minimal risk to the public. The majority of absconding incidents occurred from trips outside the hospital. Factors predictive of a high risk of absconding were a previous history of absconding, acting-out behaviour and a previous history of assault. Clinical teams correctly identified 61% of cases as high risk prior to the absconding episode, but the false positive rate was 20%. More detailed databases with larger sample sizes and systematic data collection should assist in the development of a...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"178 1","pages":"46-58"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86810712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402148
H. Gordon, N. Hindley, A. Marsden, M. Shivayogi
The use of mechanical restraint in British psychiatry is seen as unethical. A different view, however, is held in the United States. The article reviews the literature on the use of mechanical restraint and describes the case-history of a patient in a Special Hospital who poses exceptional difficulties in management and for whom mechanical restraint may prove helpful.
{"title":"The use of mechanical restraint in the management of psychiatric patients: Is it ever appropriate?","authors":"H. Gordon, N. Hindley, A. Marsden, M. Shivayogi","doi":"10.1080/09585189908402148","DOIUrl":"https://doi.org/10.1080/09585189908402148","url":null,"abstract":"The use of mechanical restraint in British psychiatry is seen as unethical. A different view, however, is held in the United States. The article reviews the literature on the use of mechanical restraint and describes the case-history of a patient in a Special Hospital who poses exceptional difficulties in management and for whom mechanical restraint may prove helpful.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"53 1","pages":"173-186"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85815488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402140
R. Baxter, S. Rabe-Hesketh, J. Parrott
Abstract A cohort of 63 patients with schizophrenia formerly treated in medium security and discharged were followed up with case-notes and interview, up to 10 years later. Outcome variables studied included reconviction, reoffending behaviour, contact with psychiatric services, mortality, health and social needs, and patient satisfaction. Previously, the group had high levels of inpatient psychiatric care (86%), violent offending (68%), substance abuse (71%), alcohol abuse (29%), history of conduct disorder (48%) and periods in care (22%). At follow-up, 2 were dead (by suicide); of the remainder, 92% had retained links with psychiatric services, 30% had been reconvicted of at least one violent offence, and more than this proportion, again, had reoffended violently. Episodes of violent reoffending outnumbered violent reconviction by nearly 4:1. Most violence was ‘non-serious’. In terms of violence, comorbidity with conduct disorder or problem alcohol use doubled reoffending rates compared with schizophren...
{"title":"Characteristics, needs and reoffending in a group of patients with schizophrenia formerly treated in medium security","authors":"R. Baxter, S. Rabe-Hesketh, J. Parrott","doi":"10.1080/09585189908402140","DOIUrl":"https://doi.org/10.1080/09585189908402140","url":null,"abstract":"Abstract A cohort of 63 patients with schizophrenia formerly treated in medium security and discharged were followed up with case-notes and interview, up to 10 years later. Outcome variables studied included reconviction, reoffending behaviour, contact with psychiatric services, mortality, health and social needs, and patient satisfaction. Previously, the group had high levels of inpatient psychiatric care (86%), violent offending (68%), substance abuse (71%), alcohol abuse (29%), history of conduct disorder (48%) and periods in care (22%). At follow-up, 2 were dead (by suicide); of the remainder, 92% had retained links with psychiatric services, 30% had been reconvicted of at least one violent offence, and more than this proportion, again, had reoffended violently. Episodes of violent reoffending outnumbered violent reconviction by nearly 4:1. Most violence was ‘non-serious’. In terms of violence, comorbidity with conduct disorder or problem alcohol use doubled reoffending rates compared with schizophren...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"434 1","pages":"69-83"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78781167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-04-01DOI: 10.1080/09585189908402146
E. Miller
This review paper considers the hypothesis that head injury may be a factor that predisposes to offending. Three major types of evidence are reviewed. The psychological changes that commonly follow significant head injury, such as irritability and impulsivity, could put the head injury victim at increased risk of committing criminal acts. Furthermore, and although methodologically flawed, follow-up studies of head injury victims and investigations of convicted violent offenders both give evidence consistent with the notion that head injury helps to precipitate crime. Some methodological and other points are also discussed.
{"title":"Head injury and offending","authors":"E. Miller","doi":"10.1080/09585189908402146","DOIUrl":"https://doi.org/10.1080/09585189908402146","url":null,"abstract":"This review paper considers the hypothesis that head injury may be a factor that predisposes to offending. Three major types of evidence are reviewed. The psychological changes that commonly follow significant head injury, such as irritability and impulsivity, could put the head injury victim at increased risk of committing criminal acts. Furthermore, and although methodologically flawed, follow-up studies of head injury victims and investigations of convicted violent offenders both give evidence consistent with the notion that head injury helps to precipitate crime. Some methodological and other points are also discussed.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"1 1","pages":"157-166"},"PeriodicalIF":1.4,"publicationDate":"1999-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77232980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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