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FORENSIC MENTAL HEALTH SERVICES MANAGED CARE NETWORK Current Awareness bulletin: Forensic mental health services Issue 7 February 2009 Citations for the following articles can be found on the forensic network’s website, and full text for many of the following articles are available online via the NHS Scotland e-Library. Please use the links where available and your ATHENS username and password. If you require an ATHENS account, or require a copy of any of the articles, please contact your local librarian. Please note that the articles you are accessing may be protected by copyright legislation; please contact your librarian for a copyright declaration form if you are in any doubt. If you have any questions regarding this or any other library services please contact your own librarian in the first instance, otherwise contact the librarian at The State Hospital – contact details below. Contents: Anger Management CBT Criminal Justice Critical Incidents Detention Disability Rights Funding Learning Disabilities Legislation Mental Health Nurses Mental Health Policy Mindfulness Offenders Patient Focus Public Involvement Personality Disorders Personality Profile Physical Activity Physical Health Prisons Professional Issues Psychosis 3 3 3 5 5 7 7 7 8 8 9 10 10 11 11 12 12 13 13 14 14 PTSD Quality of Life Recovery Rehabilitation Risk Schizophrenia Security Self-Esteem Sexual Offenders Smoke Free Suicide Intervention Telepsychiatry Tribunals 2 15 16 16 18 18 19 19 20 20 23 24 24 25 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Anger Management Arsuffi, Lara (2008) The Triple C programme: A qualitative evaluation of a new anger management protocol piloted in a British medium secure unit Forensic Update Volume 95, Pages 2935 CBT Kobori, Osamu et al (2008) Cognitive Behavioural Therapy for Obsessive Compulsive Symptoms Affected by Past Psychotic Experience of Schizophrenia: A Case Report Behavioural and Cognitive Psychotherapy Volume 36, Issue 3, Pages 365-369 Obsessive-compulsive symptoms (OCS) have been observed in a substantial proportion of patients with schizophrenia. Although several studies have investigated the comorbidity associated with OCS in schizophrenia, few case studies are available regarding cognitive behavioural therapy (CBT) for the treatment of OCS of patients within this group. This paper describes a case report in which OCS emerged gradually after the remission of positive symptoms of schizophrenia. The SBT involved psycho education and case formulation, cognitive restructuring, exposure and response prevention (EPR), and behavioural experiments. Improvement in the compulsive behaviours led to a greater insight regarding the relationship between OCS and past experience of positive symptoms (eg. hallucinations). The cognitive characteristics of the patient were discussed in light of current cognitive models of OCD. Steel, Craig (2008) Cognitive Behaviour Therapy for Psychosis: Current Evidence and Future Directions Behavioural and Cognitive Psychotherapy Volume 36, Issue 6, Pages 705-712 The past decade has seen considerable growth in the evidence based of cognitive behavioural therapy for psychosis. Consistent reports of moderate effect sizes have led to such interventions being recommended as part of routine clinical practice. Most of this evidence is based on a generic form of CBT for psychosis applied to a heterogeneous group. An increase in the effectiveness of cognitive behavioural interventions may require new protocols. Such therapeutic developments should be based on the theoretical understanding of the psychological processes associated with specific forms of psychotic presentation. The current evidence base of CBT for psychosis is reviewed, and barriers that have held back the development of this research are discussed. Criminal Justice Scottish Government (2008) Homicide in Scotland, 2007-08 Statistics on crimes of homicide recorded by the police in 2007-08. http://www.scotland.gov.uk/Resource/Doc/254935/0075510.pdf 3 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Scottish Government (2008) Revitalising Justice: Proposals to Modernise and Improve the Criminal Justice System A document that summarises the proposals that will be included in the Criminal Justice and Licensing Bill (to be introduced into the Scottish Parliament in early 2009). http://www.scotland.gov.uk/Resource/Doc/239241/0065910.pdf Scottish Government (2008) Statistical Bulletin Crime and Justice Series Reconvictions of Offenders Discharged from Custody or Given Non-Custodial Sentences in 2004-05 and 2005-06, Scotland http://www.scotland.gov.uk/Resource/Doc/229014/0062005.pdf Scottish Prisons Commission (2008) Scotland’s Choice: Report of the Scottish Prisons Commission July 2008 http://www.scotland.gov.uk/Resource/Doc/230180/0062359.pdf Tata, Cyrus et al (2008) Assisting and Advising The Sentencing Decision Process; The Pursuit of “Quality” in Pre-Sentence Reports The British Journal of Criminology Volume 48, Number 6, Pages 835-855 Pre-sentence reports are an increasingly prevalent feature of the sentencing process. Yet, although judges have been surveyed about their general views, we know relatively little about how such reports are read and interpreted by judges considering sentence in specific cases, and, in particular, how these judicial interpretations compare with the intentions of the writers of those same reports. This article summarizes some of the main findings of a four-year qualitative study in Scotland examining: how reports are constructed by report writers; what the writers aim to convey to the sentencing judge; and how those same reports are then interpreted and used in deciding sentence. Policy development has been predicated on the view that higher-quality reports will help to 'sell' community penalties to the principal consumers of such reports (judges). This research suggests that, in the daily use and interpretation of reports, this quality-led policy agenda is defeated by a discourse of judicial 'ownership' of sentencing. http://proquest.umi.com/pqdweb?did=1581596851&sid=2&Fmt=2&clientI d=57473&RQT=309&VName=PQD Ventress, Michael A et al (2008) Keeping PACE: fitness to be interviewed by the police Advances in Psychiatric Treatment Volume 14, Issue 5, Pages 369-381 The second half of the 20th century witnessed a number of serious miscarriages of justice that resulted from improper police interviewing of suspects and unreliable and false confessions. To prevent miscarriages of justice involving people with mental disorder or particular mental vulnerabilities, psychiatrists have a role in determining the fitness to be interviewed of persons suspected of criminal offences. In this article, the role of the psychiatrist in assessing fitness to be interviewed is set against the background of the latest revisions of the Codes of Practice of the Police and Criminal Evidence Act 1984 and relevant case law in England and Wales. http://intl-apt.rcpsych.org/cgi/content/abstract/14/5/369 4 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Critical Incidents Clarke, Ian (2008) Learning from critical incidents Advances in Psychiatric Treatment Volume 14, Issue 6, Pages 460-468 Critical incident reviews are an integral part of modern psychiatric practice. The issue is central to the clinical governance agenda in the UK, yet there is widespread debate about their usefulness. There is a lack of systematic research into their impact on clinical outcomes, with most authors commenting on their form, their political implications, and whether they should exist at all. This article explores the historical basis to incident investigation, outlines an “ideal” method of review and discusses the concepts of the learning organisation and root cause analysis. Further discussion focuses on what the objectives of critical incident review might be and whether organisations as a whole can learn from them. http://intl-apt.rcpsych.org/cgi/content/abstract/14/6/460 Detention A series of articles on detention in Advances in Psychiatric Treatment Volume 14, Issue 3 Roberts, Glenn et al (2008) Detained – what’s my choice? Part 1: Discussion Advances in Psychiatric Treatment Volume 14, Issue 3, Pages 172-180 Choice, responsibility, recovery and social inclusion are concepts guiding the “modernisation” and redesign of psychiatric services. Each has its advocates and detractors, and at the deep end of mental health/psychiatric practice they all interact. In the context of severe mental health problems choice and social inclusion are often deeply compromised; they are additionally difficult to access when someone is detained and significant aspects of personal responsibility have been temporarily taken over by others. One view is that you cannot recover while others are in control. We disagree and believe that it is possible to work in a recovery-oriented way in all service settings. This series of articles represents a collaborative dialogue between providers and consumers of compulsory psychiatric services and expert commentators. We worked together, reflecting on the literature and our own professional and personal experience to better understand how choice can be worked with as a support for personal recovery even in circumstances of psychiatric detention. We were particularly interested to consider whether and how detention and compulsion could be routes to personal recovery. We offer both the process of our co-working and out specific findings as part of a continuing dialogue on these difficult issues. http://intl-apt.rcpsych.org/cgi/content/abstract/14/3/172 5 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Copeland, Mary Ellen; Mead, Shery (2008) Continuing the dialogue: Invited Commentary on…Detained – what’s my choice? Part 1 Advances in Psychiatric Treatment Volume 14, Issue 3, Pages 181-182 We consider the value of dialogue between healthcare professionals and mental health service users with severe mental illnesses. Discussion with the service user before, during and after a psychiatric crisis should help services to offer choice even to individuals under compulsory detention. http://intl-apt.rcpsych.org/cgi/content/abstract/14/3/181 Fulford, K.W.M.; King, Malcolm (2008) A values-based perspective on good practice in compulsion: Invited Commentary on…Detained – what’s my choice? Part 1 Advances in Psychiatric Treatment Volume 14, Issue 3, Pages 183-184 We outline how the values-based approach adopted in training materials supported the Mental Health Act 2007 for England and Wales will complement recovery-based practice in compulsory psychiatric detention. http://intl-apt.rcpsych.org/cgi/content/abstract/14/3/183 Dorkins, Eluned et al (2008) Detained – what’s my choice? Part 2: Conclusions and recommendations Advances in Psychiatric Treatment Volume 14, Issue 3, Pages 184-186 We have developed this succession of articles as a series of iterative steps, each seeking to uphold the recovery values of co-working and collaboration, looking for agreement and commonality but valuing equally diverse viewpoints and difference. Our conclusion is that this is the beginning of a creative dialogue on choice as a route to recovery for people who are psychiatrically detained. We commend our method of engaging with the inevitable tensions and dilemmas by: clarifying the story behind difficult interactions, identifying the relevant guiding principles and jointly working to explore from different viewpoints what can be done to promote recovery. http://intl-apt.rcpsych.org/cgi/content/abstract/14/3/184 6 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Disability Rights Sayce, Liz; Boardman, Jed (2008) Disability rights and mental health in the UK: recent developments of the Disability Discrimination Act Advances in Psychiatric Treatment Volume 15, Issue 4, Pages 265-275 The Disability Discrimination Act, passed by Parliament in 1995 and amended in 2001 and 2005, covers people in Britain with physical or mental impairments that have a substantial and long-term adverse effect on their ability to carry out normal day-to-day activities. The Act has been important in setting a framework for good practice and it can stimulate more systemic change through formal investigations of organisations or whole sectors, and through the Disability Equality Duty, in force since December 2006. The Disability Discrimination Act has implications for people working in mental health services when they are considering employment and educational opportunities for service users, and when they are considering how to redress systemic disadvantage, including inequalities in physical health. http://intl-apt.rcpsych.org/cgi/content/abstract/14/4/265 Funding Hayman-White, Karla; Happell, Brenda (2008) Psychiatric Nursing and Mental Health Funding: The Double Dilemma The International Journal of Psychiatric Nursing Research Volume 12, Issue 3, Pages 1488-1496 The impact of mental illness on disease and disability burden is receiving more recognition that has previously been the case. It is now commonly understood that approximately 20% of the Australian population will experience a mental illness at some stage during their lives. Unfortunately this recognition is not reflected in the funding of mental health services, or in strategies to identify and rectify shortfalls in the nursing workforce. This paper provides as exploration of two areas. Firstly an overview of the current funding devoted to mental health and secondly an examination of workforce data with a view to recognising likely future trends for psychiatric nursing. The data demonstrates the existence of a double dilemma, firstly that the need for psychiatric nurses is likely to increase, and secondly that the looming workforce crisis may be more severe than has been anticipated. Learning Disabilities Slevin, E. (2008) People with learning disabilities admitted to an assessment and treatment unit: impact on challenging behaviours and mental health problems Journal of Psychiatric and Mental Health Nursing Volume 15, Issue 7, Pages 537-546 This study describes the evaluation of an assessment and treatment unit for people with learning disabilities. Results showed the main reasons for admission for the 48 people admitted to the unit were because of challenging behaviours and mental health problems. Valid and reliable scales were used to measure the behaviours and mental health problems 7 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] of those admitted across three-time periods: pre-admission, during admission and post-admission. The analysis found significant reductions in challenging behaviours and mental health problems following admission to the unit. The unit was staffed by a multidisciplinary team with nurses making up the largest group of staff. A number of issues of concern are discussed including access to mental health services for people with learning disabilities, the need for robust community services and areas that require further research. In conclusion, the study found evidence supporting the value of the unit and how it may lessen distress in learning disabled people who are behaviourally disturbed. It is suggested that nurses played a key role in the unit but they need to make the support and caring they provide more visible. Nurses need to harness and make explicit the caring they provide for people with learning disabilities. http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltex t&AN=00042157-200809000-00002&LSLINK=80&D=ovft Legislation McGloine, Annemarie (2008) The role of the named person Newsletter for mental health officers in Scotland Issue 17, Pages 4-5 http://www.strath.ac.uk/media/departments/glasgowschoolofsocialwork/c cw/media_136460_en.pdf Mental Health Nurses Snowden, A. (2008) Quantitative analysis of mental health nurse prescribers in Scotland Journal of Psychiatric and Mental Health Nursing Volume 15, Issue 6, Pages 471-478 The UK parliament approved legislation expanding prescribing rights for all registered nurses in 2006. Mental health nurses do not appear to be embracing prescribing to the same degree as their colleagues. For example, mental health nurses represent 14% of the UK nursing population, but only 3% nurse prescribing population. In order to explore this disparity, the paper discusses quantitative analysis of the following objectives: (1) describe the impact of nurse prescribing on nurse prescribers in NHS Greater Glasgow and Clyde; and (2) identify differences between mental health nurse prescribers and other nurse prescribers in NHS Greater Glasgow and Clyde. Following online pilot study, a 26-item questionnaire was posted to 668 nurse prescribers in NHS Greater Glasgow and Clyde. A total of 365 questionnaires were returned (55.4%). Significant differences were found between mental health nurse prescribers and others in terms of age, gender, prescribing practice, academic achievement, method of prescribing, workplace, experience and attitude to prescribing. Possible reasons for these differences are suggested and form the basis of further planned research. http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltex t&AN=00042157-200808000-00005&LSLINK=80&D=ovft 8 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Mental Health Policy Altenberger, Iris; Mackay, Rob (2008) What Matters with Personal Narratives?: An exploration as to how personal narratives are used in the promotion of recovery and social inclusion by mental health service users in Scotland. A short summary of research into Personal Narratives conducted as part of the Small Research Projects Initiative of the National Programme for Improving Mental Health and Well-being. http://www.scotland.gov.uk/Resource/Doc/254267/0075279.pdf Griesbach, Dawn (2008) An analysis of the responses to the national consultation on “Towards a Mentally Flourishing Scotland” “Towards a Mentally Flourishing Scotland” discussion document was put forward as a consultation to determine the future direction of mental health improvement for 2008-11, focusing on what Local Authorities, NHS Boards and other key stakeholders can do to support the agenda. This report is an analysis of all the responses received to the consultation document. http://www.scotland.gov.uk/Resource/Doc/224023/0060499.pdf HM Chief Inspector of Prisons for Scotland (2008) Out of Sight: Severe and Enduring Mental Health Problems in Scotland’s Prisons Summary findings from Thematic Report on Severe and Enduring Mental Health Problems in Scotland's Prisons. http://www.scotland.gov.uk/Resource/Doc/244128/0068210.pdf The Mental Health Tribunal for Scotland (Practice and Procedure) (No. 2) Amendment Rules 2008 http://www.statutelaw.gov.uk/legResults.aspx?LegType=All+Legislation& PageNumber=2&NavFrom=3&activeTextDocId=3534592 Scottish Government (2008) Adults with Incapacity (Scotland) Act 2000: Part 5 Code of Practice This letter provides the revised Code of Practice for Part 5 of the Act, which deals with medical treatment and research. The Code takes into account changes made to the Act by the Smoking, Health and Community Care Act. http://www.scotland.gov.uk/Resource/Doc/227589/0061536.pdf Scottish Government (2008 version) The New Mental Health Act: A guide to emergency and short-term powers Information for Service Users and their Carers, 2008 version http://www.scotland.gov.uk/Resource/Doc/236140/0064723.pdf 9 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Mindfulness Singh, Nirbhay N. et al (2008) Clinical and Benefit-Cost Outcomes of Teaching a Mindfulness-Based Procedure to Adult Offenders With Intellectual Disabilities Behavior Modification Volume 32, Issue 5, Pages 622-637 The effects of a mindfulness-based procedure, called Meditation on the Soles of the Feet, were evaluated as a cognitive-behavioral intervention for physical aggression in 6 offenders with mild intellectual disabilities. They were taught a simple technique that required them to shift their attention and awareness from the precursors of aggression to the soles of their feet, a neutral point on their body. Results showed that physical and verbal aggression decreased substantially, no Stat medication or physical restraint was required, and there were no staff or peer injuries. Benefitcost analysis of lost days of work and cost of medical and rehabilitation because of injury caused by these individuals in both the 12 months prior to and following mindfulness-based training showed a 95.7% reduction in costs. This study suggests that this procedure may be a clinically effective and cost-effective method of enabling adults offenders with intellectual disabilities to control their aggression. Offenders Ferguson, A. Murray; Ogloff, James, R.P.; Thomson, Lindsay (2009) Predicting Recidivism by Mentally Disordered Offenders Using the LSI-R:SV Criminal Justice and Behavior Volume 36, Issue 1, Pages 5-20 The Level of Service Inventory-Revised: Screening Version (LSI-R:SV) has proven to validly predict reoffending in general offender populations but has not previously been studied specifically with offenders who have a major mental illness, including those with a dual diagnosis. This research project measures the validity of the LSI-R:SV for use with 208 mentally ill offenders who were released from a secure forensic hospital in Melbourne, Australia. Results indicate that the LSI-R:SV is a good predictor of recidivism among mentally disordered offenders. However, the LSI-R:SV does not reliably predict recidivism in individuals who attracted a dual diagnosis. Further research needs to reevaluate risk factors associated with recidivism in offenders with a dual diagnosis. 10 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Patient Focus Public Involvement Healthcare Policy and Strategy Directorate, Scottish Government (2008) Patients’ Rights: A Public Consultation on a Patients’ Rights Bill for users of the NHS in Scotland Patients’ Rights Consultation document http://www.scotland.gov.uk/Resource/Doc/238978/0065812.pdf Scottish Government Social Research (2008) Better Together: Scotland’s Patient Experience Programme Building on The Experiences of NHS Boards This research documents Scottish Health Boards’ current patient experience activities and Boards representatives’ experiences of and attitudes towards patient experience. The research also examined expectations of the Scottish Patient Experience Programme and beliefs about patients’ priorities. http://www.scotland.gov.uk/Resource/Doc/247026/0069783.pdf Personality Disorders Gudjonsson, Gisli H.; Main, Nicole (2008) How are personality disorders related to compliance? Journal of Forensic Psychiatry and Psychology Volume 19, Issue 2, Pages 180-190 The aim of this study was to investigate the relationship between personality disorders, as measured by the Millon Clinical Multiaxial Inventory - III, and compliance, as measured by the Gudjonsson Compliance Scale. A voluntary sample of 58 mentally disordered offenders residing in medium secure units completed both tests. Of these, 54 (93%) met a diagnosis threshold for either a trait or a disorder (50% met the full diagnosis for at least one personality disorder). The most common personality traits/disorders were avoidant, passive-aggressive, dependent, depressive, and paranoid. The presence or prominence of clinical syndrome/severe clinical syndrome was evident in 42 (72%) of the patients. As far as clinical syndromes are concerned, the most common diagnoses were anxiety, followed by drug dependence and alcohol dependence. Compliance correlated most significantly with dependent, avoidant, passive-aggressive, and masochistic personality disorder scores (Axis II), and with dysthymia, anxiety, and delusional disorders (Axis I). These findings support the hypothesis that compliance is more strongly associated with some personality disorders than others, particularly those in Cluster C, and that the primary link with compliance is through anxiety and low self-esteem. http://search.ebscohost.com/login.aspx?direct=true&db=pbh&AN=31747 774&site=ehost-live 11 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Personality Profile Stupperich, Alexandra et al (2009) Violence and Personality in Forensic Patients: Is There a Forensic Patient-Specific Personality Profile? Journal of Interpersonal Violence Volume 24, Issue 1, Pages 209-225 Concerning the discussion about the connection of personality traits, personality disorders, and mental illness, this study focused on the personality profiles of male forensic patients, prison inmates, and young men without criminal reports. The main topic centred on group-specific personality profiles and identifying personality facets corresponding with mental illness. The authors therefore used the Rasch model-based Trier Integrated Personality Inventory. They individually tested 141 German forensic patients with different crime backgrounds, 122 prison inmates, and 111 soldiers of the German army. Within group differences they found that the individuals with mental retardation differ from patients with a personality disorder or psychosis. Patients with mental retardation displayed higher neurotic and/or paranoid personality accents and tended to be low organised and self-confident. Physical Activity Acil, A.A. et al (2008) The effects of physical exercises to mental state and quality of life in patients with schizophrenia Journal of Psychiatric and Mental Health Nursing Volume 15, Issue 10, Pages 808-815 The purpose of this study was to examine the effects of 10 weeks of physical exercises programme on mental states and quality of life (QOL) of individuals with schizophrenia. The study involved 30 inpatients or outpatients with schizophrenia who were assigned randomly into aerobic exercise (n = 15) group and control (n = 15) group, participated to the study voluntarily. There were no personal differences such as age, gender, disorder duration, medication use between the both groups. An aerobic exercise programme was applied to the subject group, the periods of 10 weeks as 3 days in a week. Data were collected by using the Brief Symptom Inventory, the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms and to the both group before and after the exercise programme. After the 10-week aerobic exercise programmes the subjects in the exercise programme showed significantly decreases in the Scale for the Assessment of Positive Symptoms, the Scale for the Assessment of Negative Symptoms and the Brief Symptom Inventory points and their World Health Organization Quality of Life Scale-Turkish Version points were increased than controls. These results suggest that mild to moderate aerobic exercise is an effective programme for decreasing psychiatric symptoms and for increasing QOL in patients with schizophrenia. http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltex t&AN=00042157-200812000-00004&LSLINK=80&D=ovft 12 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Jones, Lisa (2008) Promoting Physical Activity in Acute Mental Health British Journal of Occupational Therapy Volume 71, Issue 11, Pages 499-502 Government initiatives, such as mental health promotion and social inclusion, have influenced the provision of physical activity to clients on an inpatient acute mental health unit in north Manchester. The use of physical activity as an intervention fits well with the Model of Human Occupation and is particularly relevant to the concepts of volition and personal causation. This practice analysis discusses the current interventions taking place in north Manchester and expands on some of the theory and policy initiatives that influence practice. Suggestions for improvements in the service are then made based on a critical reflection of existing practice. Physical Health Scottish Government (2008) Mental Health in Scotland: Improving the Physical Health and Well Being of those experiencing Mental Illness http://www.scotland.gov.uk/Resource/Doc/251663/0073699.pdf Prisons Cooke, David J. et al (2008) Casting Light on Prison Violence in Scotland: Evaluating the Impact of Situational Risk Factors Criminal Justice and Behavior Volume 35, Issue 8, Pages 10651078 Violence among prisons and that between prisoners and staff is a perennial concern for all prison systems. That violent prisoners are only violent in certain circumstances suggests a need to develop ways to understand not only the origins of violence in prison but also the situational contexts in which violence occurs. The technology of risk assessment has evolved dramatically in the last decade; however, the focus on individual risk factors has been at the expense of a deemphasizing of the role of situational factors. In this article, evidence for the importance of situational factors in relation to prison violence is considered. The authors describe the development of a new risk assessment procedure – promoting risk intervention by situational management (PRISM). Within the context of the Scottish Prison Service, they conclude that systematic attention to situational risk factors can help reduce prison violence. 13 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Professional Issues Freckelton, Ian (2008) Trends in Regulation of Mental Health Practitioners Psychiatry, Psychology and Law Volume 15, Issue 3, Pages 415-434 Regulation of mental health professionals in Australia and New Zealand, along with the regulation of all health practitioners, is in the process of substantial transition. With trust as the cornerstone for governance of the health professionals, the likelihood is a reorientation toward investigations into “performance” as against “conduct”. However, this poses particular challenges for assessment of psychiatrists’ and psychologists’ performance. Entitlement to registration is likely to shift conceptually toward a model involving revalidation and recertification by reference to ongoing fitness to practise, demonstration of relevant personal attributes, and maintenance of adequate skills and health. In Australia, national registration and regulation are on the agenda. Lay participation in regulation is increasing and community and regulatory tolerance for exploitative or predatory conduct by mental health professionals is on the wane. The ambit of regulation is broadening with forensic work by practitioners already incorporated and signs that the conduct of unregistered and deregistered practitioners will soon be subject to a formk of regulatory intervention. Psychosis Taylor, Pamela J. et al (2008) Presentations of psychosis with violence: variations in different jurisdictions. A comparison of patients with psychosis in the high security hospitals of Scotland and England Behavioral Sciences and the Law Volume 26, Issue 5, Pages 585-602 Background International literature is consistent on there being a significant relationship between psychosis and violence, less so on its extent and nature, but two main presentational types are increasingly recognized. In one, people are unremarkable before onset of illness and psychotic symptoms commonly drive violence; in the other, psychosis is preceded by childhood conduct problems, associated with personality disorder, and psychotic symptoms seem less relevant. Aims To explore the extent to which variations in aspects of social and service context in different jurisdictions affect presentational type among people admitted to high security hospitals. Hypotheses There will be differences between jurisdictions in proportions of patients with pure psychosis or with psychosis and antecedent personality disorder, but symptom drive to violence will be more common in the pure psychosis group regardless of social, legal and service context. Method Independently conducted record studies were used to compare high security hospital patients with psychosis in Scotland and England, all resident between 25 August 1992 and 13 August 1993. Results The cohorts were similar in offence histories, predominance of schizophrenia, age at first hospitalization for psychosis and first high security hospitalization. More Scottish patients had comorbid substance misuse diagnoses and/or personality disorder than patients in England. Psychotic symptom drive to the index offence was, 14 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] however, four times more likely in the pure psychosis groups, regardless of sex, ethnic group or country. Scottish patients spent less time in high security after the index act. Conclusions Our hypotheses were sustained. Knowledge about lifestyle before onset of psychosis is important for interpreting literature on how psychotic symptoms relate to violence. This may also influence longer term outcome, although the shorter length of secure hospital stay in Scotland was perhaps affected more by greater... [ABSTRACT FROM AUTHOR] http://search.ebscohost.com/login.aspx?direct=true&db=pbh&AN=34380 422&site=ehost-live PTSD Frueh, B. Christopher et al (2009) Disseminating Evidence-Based Practices for Adults With PTSD and Severe Mental Illness in Public-Sector Mental Health Agencies Behavior Modification Volume 33, Issue 1, Pages 66-81 Posttraumatic stress disorder (PTSD) remains largely untreated among adults with severe mental illnesses (SMI). The treatment of psychotic symptoms usually takes precedence in the care of adults with SMI. Such oversight is problematic in that PTSD in SMI populations is common (19%-43%), contributes a significant illness burden, and hinders mental health care. Yet few public-sector mental health agencies routinely provide specialized services for PTSD. The purpose of the article is to describe strategies and efforts to disseminate trauma-focused empirically based practices in a public-sector mental health system. Identified challenges include limited resources and commitment; knowledge deficits, attitudes and biases; and limited practice accountability at provider, facility, and system levels. Proposed strategies for overcoming these challenges are to set clear goals, nurture broad-based organizational commitment and key stakeholder involvement, implement speciality training efforts to provide information and change attitudes, provide ongoing supervision, conduct fidelity monitoring, and ensure accountability to the extent possible. 15 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Quality of Life Pitkanen, A. et al (2009) Individual quality of life of people with severe mental disorders Journal of Psychiatric and Mental Health Nursing Volume 16, Issue 1, Pages 3-9 People with mental disorders have been found to suffer from impaired quality of life (QoL). Therefore, the assessment of QoL has become important in psychiatric research. This explorative study was carried out in acute psychiatric wards. Thirty-five patients diagnosed with schizophrenia and related psychosis were interviewed. QoL was rated by the Schedule for Evaluation of Individual Quality of Life which is a respondentgenerated QoL measure using semi-structured interview technique. Patients named five areas of life important to them and then rated their current status and placed relative weight on each QoL area. The data were analysed with qualitative content analysis and descriptive statistics. The most frequently named areas for QoL were health, family, leisure activities, work/study and social relationships, which represented 72% of all QoL areas named. Patients' average satisfaction with these QoL areas ranged 49.0–69.1 (scale 0–100). The mean global QoL score was 61.5 (standard deviation 17.4; range 24.6–89.6; scale 0–100). Awareness of patients' perceptions of their QoL areas can enhance our understanding of an individual patient's QoL and reveal unsatisfactory areas where QoL could be improved with individually tailored needs-based interventions. http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&NEWS=N&PAGE=toc&S EARCH=00042157-20090200000000.kc&LINKTYPE=asBody&LINKPOS=1&D=ovft Recovery Laithwaite, Healther; Gumley, Andrew (2007) Sense of Self, Adaptation and Recovery in Patients with Psychosis in a Forensic NHS Setting Clinical Psychology and Psychotherapy Volume 14, Pages 302-316 Qualitative methods have been used to explore users’ recovery from psychosis. These studies have highlighted the importance of hope and redefining sense of self as being important aspects of the recovery process. To date there have been no studies that have collaborated with users in high-security forensic settings to develop an experiential perspective of recovery in psychosis. This study used a social constructionist version of grounded theory to develop an experiential account of recovery in psychosis. Thirteen individuals who had experience of psychosis and were residing in a high-security setting were interviewed in depth about their experiences of recovery. The interviews were transcribed and analysed using the social constructionist version of grounded theory. Contrasting accounts of recovery were apparent from the way in which participants spoke about their experiences. Some participants gave rich and reflective accounts of their recovery. These participants spoke about the nature of past experiences and the importance of those experiences in contextualizing their problems, and reflected on the implications of this on the tasks of recovery. In contrast, other participants’ transcripts tended to be short and unelaborated. 16 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Recovery tasks seemed to be segregated from previous experiences and their reflection on their experience of psychosis seemed minimized. However, all participants spoke about the importance of developing relationships with staff and family. The development of relationships influenced how participants redefined themselves. Implications for clinical practice and further research are reviewed. Lloyd, Chris et al (2008) Conceptualising Recovery in Mental Health Rehabilitation The British Journal of Occupational Therapy Volume 71, Issue 8, Pages 321-328 Recovery as a concept has gained increased attention in the field of mental health. There is an expectation that service providers use a recovery framework in their work. This raises the question of what recovery means, and how it is conceptualised and operationalised. It is proposed that service providers approach the application of recovery principles by considering systematically individual recovery goals in multiple domains, encompassing clinical recovery, personal recovery, social recovery and functional recovery. This approach enables practitioners to focus on service users’ personal recovery goals while considering parallel goals in the clinical, social and role-functioning domains. Practitioners can reconceptualise recovery as involving more than symptom remission, and interventions can be tailored to aspects of recovery of importance to service users. In order to accomplish this shift, practitioners will require effective assessments, access to optimal treatment and care, and the capacity to conduct recovery planning in collaboration with service users and their families and carers. Mental health managers can help by fostering an organisational culture of service provision that supports a broader focus than that on clinical recovery alone, extending to client-centred recovery planning in multiple recovery domains. Mancini, Anthony D (2008) Self-determination theory: a framework for the recovery paradigm Advances in Psychiatric Treatment Volume 14, Issue 5, Pages 358-365 Recovery is an increasingly important concept in mental health services research and policy-making. However, despite burgeoning interest in the concept, no overarching theoretical or empirical framework has been offered to support its key ideas. Further, it is often unclear how recovery ideas translate into routine practices of mental health programmes and practitioners. In this article, a theoretical framework for recovery ideas is derives from self-determination theory, a widely researched and empirically validated theory of human need fulfilment. I discuss the conceptual overlap of self-determination theory and recovery ideas, and, using key motivational concepts, develop a typology of recovery-oriented practices for three hypothetical programme types (controlling, traditional/paternalistic and recovery oriented). I describe existing measure of recovery-oriented practice and consider the implications of self-determination theory for measurement of and research on recoveryoriented practice. http://intl-apt.rcpsych.org/cgi/content/abstract/14/5/358 17 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Tilley, Stephen (2008) National Programme for Improving Mental Health and Well-Being: Small Research Projects Initiative 20052006: Plotting the Story of Recovery in Edinburgh and Scotland The study sought to contribute to the development of recovery in Scotland by plotting, through critical inquiry, the story of recovery in both Edinburgh and Scotland. http://www.scotland.gov.uk/Resource/Doc/224307/0060556.pdf Rehabilitation Dunn, Christopher; Seymour, Alison (2008) Forensic Psychiatry and Vocational Rehabilitation: Where are We at? The British Journal of Occupational Therapy Volume 71, Issue 10, Pages 448450 Having a productive occupation is seen as fundamental to an individual’s health and wellbeing. Employment provides structure, self-identity, a means to provide for oneself and social inclusion. The Government has made a commitment to invest in supporting people back into the workplace following illness. This opinion piece reflects the authors’ interest in how this applies to service users with a forensic history, who face additional barriers to employment. It calls on occupational therapists to share research and practice accounts of vocational rehabilitation within forensic settings in order to contribute to the evidence base for this area of occupational therapy practice. Risk Woods, Phil; Lasiuk, Gerri C. (2008) Risk prediction: a review of the literature Journal of Forensic Nursing Volume 4, Issue 1, Pages 1-10 This review of risk assessment and prediction literature briefly describes the historical and philosophical influences on the construct of dangerousness; chronicles the advances in research associated with the reconceptualization of dangerousness as risk; and describes current practice and research related to risk assessment, with particular attention to commonly used risk assessment tools and to existing issues and controversies. This cannot be considered a systematic review of the literature but a reflection of some of the key issues found in the literature. http://proquest.umi.com/pqdlink?did=1584101101&sid=3&Fmt=3&clientI d=57473&RQT=309&VName=PQD 18 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Schizophrenia Swanson, Jeffrey W. et al (2008) Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia The British Journal of Psychiatry Volume 193, Issue 1, Pages 37-43 Background: Violence is an uncommon but significant problem associated with schizophrenia. Aims: To compare antipsychotic medications in reducing violence among patients with schizophrenia over 6 months, identify prospective predictors of violence and examine the impact of medication adherence on reduced violence. Method: Participants (n=1445) were randomly assigned to double-blinded treatment with one of five antipsychotic medications. Analyses are presented for the intention-to-treat sample and for patients completing 6 months on assigned medication. Results: Violence declined from 16% to 9% in the retained sample and from 19% to 14% in the intention-to-treat sample. No difference by medication group was found, except that perphenazine showed greater violence reduction than quetiapine in the retained sample. Medication adherence reduced violence, but not in patients with a history of childhood antisocial conduct. Prospective predictors of violence included childhood conduct problems, substance use, victimisation, economic deprivation and living situation. Negative psychotic symptoms predicted lower violence. Conclusions: Newer antipsychotics did not reduce violence more than perphenazine. Effective antipsychotics are needed, but may not reduce violence unrelated to acute psychopathology. http://ovidsp.ovid.com/athens/ovidweb.cgi?T=JS&NEWS=N&PAGE=fulltex t&AN=00002405-200807000-00009&LSLINK=80&D=ovft Security Brown, Christine S.H.; Lloyd, Keith (2008) OPRISK: A structured checklist assessing security needs for mentally disordered offenders referred to high security psychiatric hospital Criminal Behaviour and Mental Health Volume 18, Issue 3, Pages 190-202 More mentally disordered offenders (MDOs) are referred to secure psychiatric care settings than are accepted for admission. Psychiatrists working in different care settings may disagree on the appropriate level of security for MDOs, resulting in treatment delay. A pre-admission structured assessment of security needs for MDOs may facilitate agreement and access to care. http://web.ebscohost.com/ehost/pdf?vid=3&hid=102&sid=94e7bcf7-38fa4832-b17c-a82489ae5216%40sessionmgr107 19 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Self-Esteem Laithwaite, Heather et al (2007) Self-Esteem and Psychosis: A Pilot Study investigating the Effectiveness of a Self-Esteem Programme on the Self-Esteem and Positive Symptomatology of Mentally Disordered Offenders Behavioural and Cognitive Psychotherapy Volume 35, Pages 569-577 The importance of self-esteem in the development and maintenance of psychotic experiences has been shown in previous research. However, there has been little research into the role this plays in individuals with psychosis and forensic histories. The current study investigated the effectiveness of a standardized group programme for improving selfesteem in individuals with psychosis living in high security settings. Fifteen participants were included in the group programme and measures were taken to record changes in self-esteem and symptomatology. The results demonstrated significant improvements in self-esteem over the course of the group intervention, with some effects maintained at 3month follow-up. Improvements in depressed mood were also found. The results demonstrated the effectiveness of a group intervention for self-esteem in individuals with psychosis. The findings of this study, alongside implications for further research, are discussed. Sexual Offenders Beggs, Sarah M.; Grace, Randolph C. (2008) Psychopathy, Intelligence, and Recidivism in Child Molesters: Evidence of an Interaction Effect Criminal Justice and Behavior Volume 35, Issue 6, Pages 683-695 The authors studied the relationships between psychopathy, intelligence and offending in a sample of treated child molesters (N=216). Regression analyses showed that psychopathy (as measured by the Psychopathy Checklist-Revised) was strongly related to both offense history and recidivism during follow-up. Intelligence (assessed using four-subtest short forms of the Wechsler Adult Intelligence Scale-Revised and Third Versions) was not related to offending. However, there was a significant interaction between intelligence and psychopathy on recidivism: Offenders with relatively low intelligence and high psychopathy scores were more than 4 times as likely to have received a sexual reconviction as other offenders. Results are discussed in terms of implications for risk assessment. Craissati, Jackie et al (2008) The Relationship Between Developmental Variables, Personality Disorder, and Risk in Sex Offenders Sexual Abuse: A Journal of Research and Treatment Volume 20, Issue 2, Pages 119-138 Previous research on the evaluation of the Challenge Project, a community treatment program for sex offenders in southeast London, identified the potential role of key developmental variables as enhancing actuarial risk measures to identify individuals at highest risk for community failure. The aim of the current study was to assess the relationship between developmental variable and later personality dysfunction in adulthood, 20 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] and the contribution of these factors to assessing risk for sexual recidivism, in a wider group of sex offenders managed in the community by the probation service. Over an 8-month period, 241 participants were assessed, including 162 child molesters and 79 rapists. A wide range of background data were collected, including the administration of several psychometric measures. A strong relationship was found between key developmental variables and adult mental health and personality difficulties, as well as a range of risk measures. The implications of the findings for further research are discussed. Freeman, Naomi J.; Sandler, Jeffrey C. (2008) Female and Male Sex Offenders: A Comparison of Recidivism Patters and Risk Factors Journal of Interpersonal Violence Volume 23, Issue 10, Pages 1394-1413 Few studies have empirically validated the assertion that female and male sex offenders are vastly different. Therefore, utilising a matched sample of 780 female and male sex offenders in New York State, the current study explored differences and similarities of recidivism patters and risk factors for the two offender groups. Results suggested that male sex offenders were significantly more likely than female sex offenders to be rearrested for both sexual and nonsexual offences. However, limited differences in terms of risk factors between female and male sex offenders were found. Grubin, Don (2008) The Use of Medication in the Treatment of Sex Offenders Prison Service Journal, Issue 178 Treatment for sex offenders typically takes the form of psychological interventions such as the cognitive-behavioural type approaches used by the sex offender treatment programmes delivered in British prisons. Its focus is on assisting offenders to recognise the attitudes and behaviours that increase their risk of reoffending, as well as helping them to develop strategies to reduce their risk. However, it should not be forgotten, although it often is, that sex is also inherent to sex offending - while emotional and psychological factors contribute to sex offending behaviour, at its root lies the pressure exerted by sexual drive. http://www.hmprisonservice.gov.uk/assets/documents/10003BCDthe_use _of_medication_in_treatment.pdf 21 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Ireland, Carol A. (2008) Cognitive impairment and sex offending: management during therapy and factors in offending The British Journal of Forensic Practice Volume 10, Issue 2, Pages 18-25 This paper will discuss the potential impact of a range of cognitive impairments when working with sex offenders who present with them. It will begin by outlining the nature of cognitive impairment and the research examining the extent of such difficulties in sex offenders. It will then explore the impact of such impairments when engaging a sex offender in treatment, including the role that cognitive impairment might play in the function of their offence. Finally, some methods by which to manage and compensate for cognitive impairments will be presented. While the focus of this paper is on sex offenders, the issues presented in this paper are not exclusive to this group and may be applied to offenders in general. http://proquest.umi.com/pqdweb?did=1533048951&sid=1&Fmt=3&clientI d=57473&RQT=309&VName=PQD Kirkwood, Steve; Richley, Tim (2008) Circles of Support and Accountability: the case for their use in Scotland to assist in the community reintegration and risk management of Sexual Offenders 2008 SCOLAG 236-239 This study was undertaken on behalf of the Scottish Government by the Scottish Centre for Crime and Justice Research (SCCJR), to investigate the use of Circles, which use volunteers to support high risk, high needs sex offenders. http://www.scolag.org/journal/articles/2008_SCOLAG_236-239.pdf Lindsay, William R. et al (2008) The Ward and Hudson Pathways Model of the Sexual Offense Process Applied to Offenders With Intellectual Disability Sexual Abuse: A Journal of Research and Treatment Volume 20, Issue 4, Pages 379-392 The offense pathways model of Ward and Hudson has had a significant impact on work with sex offenders. Researchers have hypothesised that offenders with intellectual disability (ID) will show a predominantly avoidance and passive pathway. The present study classified 62 sex offenders with ID according to the four self-regulation pathways. Allocation to pathways is highly reliable and, against prediction, most participants are allocated to approach pathways. Explicit/active offenders have a higher rate of contact offenses and a lower rate of reoffending. Automatic/passive offenders have a lower average IQ. There are no significant differences between groups on victim choice, previous offenses, or assessment of cognitive distortions. The results suggest that treatment may improve understanding of society’s laws, promote self-regulation, and reduce recidivism for explicit/active offenders. Murphy, William D (2008) Best Practices in Sex Offender Treatment Prison Service Journal, Issue 178 During the last 30 years, there have been significant advances in our knowledge about the characteristics of sex offenders, methods for assessing their risk and treatment needs, and elements of effective programmes for this population. The purpose of this article is to identify 22 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] current best practices in sex offender treatment and to highlight how these practices have been implemented in England and Wales. http://www.hmprisonservice.gov.uk/assets/documents/10003BCBbest_pr actices_in_sex_offender.pdf Pardue, Angela; Arrigo, Bruce A. (2008) Power, Anger and Sadistic Rapists: Toward a Differentiated Model of Offender Personality International Journal of Offender Therapy and Comparative Criminology Volume 52, Issue 4, Pages 378-400 The extant research on rapists repeatedly indicates that particular offender types can be specified. These include the power, anger, and sadistic assailants. Despite such classifications, limited empirical or anecdotal efforts have undertaken the task of exploring the personality features of each rapist type. This article endeavours to fill this gap in the literature. Using the heuristic analytical lens and the case study method, the high-profile crimes of Gilbert Escobedo (power type), Paul Bernardo (anger type), and Jeffrey Dahmer (sadistic type) are reviewed. As the article discloses, unique personality features were exhibited. Moreover, each rapist type displayed a number of convergent as well as divergent character traits. Given these findings, the article concludes with a series of summary observations relevant for future research on rape and personality as well as prospects for clinical diagnosis, treatment, and prevention. Smoke Free Pritchard, Catherine; McNeill, Ann (2008) Are Smoke-free Buildings and Grounds in Mental Health Units a Realistic Aspiration? Mental Health Review Journal Volume 13, Issue 4, Pages 27-32 The study elevated the impact on staff and patient advocates of the implementation of a smoke-free policy covering buildings and grounds within a mental health trust. Findings show that early consultation is central to the ownership of smoke-free policies. The degree of success of the implementation of the policy was variable and depended on the availability of tobacco and the type of mental health unit, but the smokefree policy provided an opportunity to reduce smoking and hence health inequalities for people with mental health problems. Scottish Government (2009) Achieving Smoke-Free Mental Health Services in Scotland: A Consultation Consultation on achieving smoke-free mental health services in Scotland. http://www.scotland.gov.uk/Resource/Doc/255862/0075839.pdf 23 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Suicide Intervention Griesbach, Dawn et al (2008) The use and impact of Applied Suicide Intervention Skills Training (ASIST) in Scotland: a literature review and evaluation Summary of a report on the evaluation of Applied Suicide Intervention Skills Training (ASIST) given to professionals, community members, volunteers and people affected by suicide, with the aim to help people to become more willing, ready and able to intervene to prevent the immediate risk of suicide. http://www.scotland.gov.uk/Resource/Doc/223478/0060181.pdf Griesbach, Dawn et al (2008) The use and impact of Applied Suicide Intervention Skills Training (ASIST) in Scotland: An evaluation A report on the evaluation of Applied Suicide Intervention Skills Training (ASIST) given to professionals, community members, volunteers and people affected by suicide, with the aim to help people to become more willing, ready and able to intervene to prevent the immediate risk of suicide. http://www.scotland.gov.uk/Resource/Doc/223967/0060485.pdf McLean, Joanne et al (2008) Risk and Protective Factors for Suicide and Suicidal Behaviour: A Literature Review A systematic international literature review of review-level data on suicide risk factors and primary evidence of protective factors against suicide. http://www.scotland.gov.uk/Resource/Doc/251539/0073687.pdf McLean, Joanne et al (2008) Risk and Protective Factors for Suicide and Suicidal Behaviour: A Literature Review Research Findings A summary of systematic international literature review of review-level data on suicide risk factors and primary evidence of protective factors against suicide. http://www.scotland.gov.uk/Resource/Doc/251535/0073686.pdf Telepsychiatry Saleem, Younus et al (2008) Forensic telepsychiatry in the United Kingdom Behavioral Sciences and the Law Volume 26, Issue 3, Pages 333-344 Forensic telepsychiatry remains in its infancy in the United Kingdom. This article sets out to describe how it can be used within a community forensic service, and the future challenges ahead in the United Kingdom. It looks at relevant academic, governmental, and legal resources and is designed as a scholarly reflection by clinicians rather than as a formal literature review. http://search.ebscohost.com/login.aspx?direct=true&db=pbh&AN=32647 756&site=ehost-live 24 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected] Tribunals O’Muirithe, Barry; Shankar, Rohit (2008) An audit of the quality of reports to Mental Health Review Tribunals Medicine, Science and the Law Volume 48, Issue 3, Pages 221-224 The Mental Health Review Tribunal (MHRT) Rules 1983 place a statutory responsibility on the Responsible Authority to provide the tribunal with a formal medical report. Such reports are valuable recovers providing a systemic and evidence-based viewpoint for detaining an individual under the Mental Health Act 1983 (MHA). The reports allow the treating team to present its concerns and subsequent care package to the tribunal, whose members could be from a non-mental health background. There is evidence that the majority of the MHRT reports do not satisfactorily meet the tribunal’s requirements. Recent literature has indicated that the circulation of structured guidelines has resulted in improved quality of the reports. The authors undertook an audit cycle to test the above hypothesis. A preliminary audit ascertained the current practice of MHRT report-making in Cornwall. The reports were objectively assessed against “gold standards” of a comparative framework of eighteen criteria laid out by the Royal College of Psychiatrists. The guidelines were circulated in the form of a template and a re-audit carried out to ascertain any change in practice. The subsequent re-audit demonstrated significant improvements in the quality of reports. 25 Compiled by Rebecca N. Hart, Librarian, The State Hospital 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP Email: [email protected]