Suicide rates by ethnic group among patients in contact with mental health services: an observational cohort study in England and Wales

Background Security needs among patients referred to forensic mental health services have rarely been systematically studied. Aims To ascertain security needs among patients referred to a high secure hospital, Broadmoor High Secure Hospital, England. We also aimed to compare the security needs for those referred to mental illness services with those referred to personality disorder services in the hospital. Method A retrospective complete cohort study of all referrals to Broadmoor Hospital over a 2-year period was conducted. All referred patients (n = 204) were assessed for need for high secure care by two Broadmoor clinicians. The final decision on need for admission was taken by a multidisciplinary admission panel. Independent of the panel, researchers rated need for security using the DUNDRUM-1 triage security scale. Results Those admitted to Broadmoor Hospital had higher triage security scores than those declined (F = 4.209, d.f. = 1, P = 0.042). Referrals to the personality disorder pathway had higher security needs than those referred to the mental illness pathway high secure service (F = 6.9835, d.f. = 1, P = 0.0089). Overall security needs among referrals to Broadmoor were extremely high, both by comparison with previous needs identified in UK medium secure services and international medium and high secure services. Conclusions High secure patient cohorts represent a uniquely vulnerable group within mental health services, with extremely high security needs identified in this study. This has significant implications for services given the high levels of resources needed to provide therapeutically safe and secure care and treatment to this group.

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Rising Indigenous suicide rates in Kimberley and implications for suicide prevention

Australasian Psychiatry ◽

10.1177/1039856216665281 ◽

2016 ◽

Vol 24 (6) ◽

pp. 561-564 ◽

Cited By ~ 9

Author(s):

Anita Campbell ◽

Murray Chapman ◽

Cate McHugh ◽

Adelln Sng ◽

Sivasankaran Balaratnasingam

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Suicide Prevention ◽

Indigenous Australians ◽

Indigenous Youth ◽

Suicide Rates ◽

Culturally Informed ◽

Retrospective Audit ◽

Prevention Interventions

Objectives: This audit examined the demographics of Indigenous Australians dying by suicide in the Kimberley region of Western Australia during the period 2005–2014. Methods: This is a de-identified retrospective audit of reported suicide deaths provided to Kimberley Mental Health and Drug Service during the period 2005–2014. Variables such as age, sex, method of suicide, previous engagement with mental health services, locality and ethnicity were assessed. Results: Indigenous suicide rates in the Kimberley region have dramatically increased in the last decade. There is also an overall trend upwards in Indigenous youth suicide and Indigenous female suicides. Conclusions: These findings highlight the need for culturally informed, and youth focussed, suicide prevention interventions within the Kimberley region.

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Mentally disordered young offenders in transition from child and adolescent to adult mental health services across England and Wales

Journal of Forensic Practice ◽

10.1108/jfp-01-2017-0002 ◽

2017 ◽

Vol 19 (4) ◽

pp. 301-308 ◽

Cited By ~ 2

Author(s):

Maria I. Livanou ◽

Vivek Furtado ◽

Swaran P. Singh

Keyword(s):

Mental Health ◽

Mental Health Services ◽

Health Services ◽

Adolescent Mental Health ◽

Child And Adolescent ◽

Young Offenders ◽

England And Wales ◽

Content Type ◽

Health And Wellbeing ◽

The Impact

Purpose This paper provides an overview of transitions across forensic child and adolescent mental health services in England and Wales. The purpose of this paper is to delineate the national secure services system for young people in contact with the youth justice system. Design/methodology/approach This paper reviews findings from the existing literature of transitions across forensic child and adolescent mental health services, drawing attention to present facilitators and barriers to optimal transition. The authors examine the infrastructure of current services and highlight gaps between child and adult service continuity and evaluate the impact of poor transitions on young offenders’ mental health and wellbeing. Findings Young offenders experience a broad range of difficulties, from the multiple interfaces with the legal system, untreated mental health problems, and poor transition to adult services. Barriers such as long waiting lists, lack of coordination between services and lack of transition preparation impede significantly smooth transitions. Research limitations/implications The authors need to develop, test and evaluate models of transitional care that improve mental health and wellbeing of this group. Practical implications Mapping young offenders’ care pathway will help to understand their needs and also to impact current policy and practice. Key workers in forensic services should facilitate the transition process by developing sustainable relationships with the young person and creating a safe clinical environment. Originality/value Transition of care from forensic child and adolescent mental health services is a neglected area. This paper attempts to highlight the nature and magnitude of the problems at the transition interface in a forensic context.

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