Characteristics of and trends in subgroups of prisoner suicides in England and Wales

2011 ◽  
Vol 41 (11) ◽  
pp. 2275-2285 ◽  
Author(s):  
N. Humber ◽  
M. Piper ◽  
L. Appleby ◽  
J. Shaw
Keyword(s):  
Mental Health ◽  
Suicide Prevention ◽  
Drug Dependence ◽  
Policy Development ◽  
Case Series ◽  
Mental Healthcare ◽  
Service Level ◽  
Treatment Needs ◽  
England And Wales ◽  
History Of

BackgroundThe suicide rate is higher in prisoners compared with the general population. The aim was to describe the characteristics of and longitudinal trends in prisoner suicides in England and Wales.MethodA case series was ascertained from the Safer Custody and Offender Policy Group at the Ministry of Justice and included a 9-year (1999–2007) national census of prisoner suicides. Questionnaires were completed by prison staff on sociodemographic, custodial, clinical and service-level characteristics of the suicides.ResultsThere was a fall in the number of prison suicides and a decline in the proportion of young prisoner (18–20 years) suicides over time. Females were over-represented. Upward trends were found in prisoners with a history of violence and with previous mental health service contact. A downward trend was found in those with a primary psychiatric diagnosis of drug dependence. Drug dependence was found to be significant in explaining suicides within the first week of custody.ConclusionsThe findings provide an important insight to aid a target set in the National Suicide Prevention Strategy in England to reduce suicides in the prisoner population by 20% and highlight an important area for policy development in mental health services. Examining trends identified subgroups that may require improved mental healthcare and recognized those that appeared to be having their treatment needs more adequately met. Evidence suggests that targeted suicide prevention strategies for subgroups of prisoners are required.

scholarly journals Changes in daily mental health service use and mortality at the commencement and lifting of COVID-19 ‘lockdown’ policy in 10 UK sites: a regression discontinuity in time design

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e049721
Author(s):  
Ioannis Bakolis ◽  
Robert Stewart ◽  
David Baldwin ◽  
Jane Beenstock ◽  
Paul Bibby ◽  
...  
Keyword(s):  
Mental Health ◽  
Inpatient Care ◽  
Service Use ◽  
Regression Discontinuity ◽  
Mental Healthcare ◽  
Service Level ◽  
Community Services ◽  
Mental Health Service Use ◽  
Healthcare Data ◽  
Early Intervention In Psychosis

ObjectivesTo investigate changes in daily mental health (MH) service use and mortality in response to the introduction and the lifting of the COVID-19 ‘lockdown’ policy in Spring 2020.DesignA regression discontinuity in time (RDiT) analysis of daily service-level activity.Setting and participantsMental healthcare data were extracted from 10 UK providers.Outcome measuresDaily (weekly for one site) deaths from all causes, referrals and discharges, inpatient care (admissions, discharges, caseloads) and community services (face-to-face (f2f)/non-f2f contacts, caseloads): Adult, older adult and child/adolescent mental health; early intervention in psychosis; home treatment teams and liaison/Accident and Emergency (A&E). Data were extracted from 1 Jan 2019 to 31 May 2020 for all sites, supplemented to 31 July 2020 for four sites. Changes around the commencement and lifting of COVID-19 ‘lockdown’ policy (23 March and 10 May, respectively) were estimated using a RDiT design with a difference-in-difference approach generating incidence rate ratios (IRRs), meta-analysed across sites.ResultsPooled estimates for the lockdown transition showed increased daily deaths (IRR 2.31, 95% CI 1.86 to 2.87), reduced referrals (IRR 0.62, 95% CI 0.55 to 0.70) and reduced inpatient admissions (IRR 0.75, 95% CI 0.67 to 0.83) and caseloads (IRR 0.85, 95% CI 0.79 to 0.91) compared with the pre lockdown period. All community services saw shifts from f2f to non-f2f contacts, but varied in caseload changes. Lift of lockdown was associated with reduced deaths (IRR 0.42, 95% CI 0.27 to 0.66), increased referrals (IRR 1.36, 95% CI 1.15 to 1.60) and increased inpatient admissions (IRR 1.21, 95% CI 1.04 to 1.42) and caseloads (IRR 1.06, 95% CI 1.00 to 1.12) compared with the lockdown period. Site-wide activity, inpatient care and community services did not return to pre lockdown levels after lift of lockdown, while number of deaths did. Between-site heterogeneity most often indicated variation in size rather than direction of effect.ConclusionsMH service delivery underwent sizeable changes during the first national lockdown, with as-yet unknown and unevaluated consequences.

scholarly journals Brain Injury and Mental Health Among the Victims of Intimate Partner Violence: A Case-Series Exploratory Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Gunnur Karakurt ◽  
Kathleen Whiting ◽  
Stephen E. Jones ◽  
Mark J. Lowe ◽  
Stephen M. Rao
Keyword(s):  
Mental Health ◽  
Intimate Partner Violence ◽  
White Matter ◽  
Partner Violence ◽  
Exploratory Study ◽  
Case Series ◽  
Intimate Partner ◽  
Self Report ◽  
Case Series Study ◽  
History Of

Intimate partner violence (IPV) survivors frequently report face, head, and neck as their injury site. Many mild traumatic brain injuries (TBIs) are undiagnosed or underreported among IPV survivors while these injuries may be linked to changes in brain function or pathology. TBI sustained due to IPV often occurs over time and ranges in severity. The aim of this case-series study was to explore risk factors, symptoms, and brain changes unique to survivors of intimate partner violence with suspicion of TBI. This case-series exploratory study examines the potential relationships among IPV, mental health issues, and TBI. Participants of this study included six women: 3 women with a history of IPV without any experience of concussive blunt force to the head, and 3 women with a history of IPV with concussive head trauma. Participants completed 7T MRI of the brain, self-report psychological questionnaires regarding their mental health, relationships, and IPV, and the Structured Clinical Interview. MRI scans were analyzed for cerebral hemorrhage, white matter disturbance, and cortical thinning. Results indicated significant differences in resting-state connectivity among survivors of partner violence as well as differences in relationship dynamics and mental health symptoms. White matter hyperintensities are also observed among the survivors. Developing guidelines and recommendations for TBI-risk screening, referrals, and appropriate service provision is crucial for the effective treatment of TBI-associated IPV. Early and accurate characterization of TBI in survivors of IPV may relieve certain neuropsychological consequences.

scholarly journals Samhällsvårdens Svarte Petter

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Ulrika Levander ◽  
Lina Sturfelt
Keyword(s):  
Mental Health ◽  
Residential Care ◽  
Mental Healthcare ◽  
Preventive Actions ◽  
Child Psychiatric ◽  
History Of ◽  
Mental Health Interventions ◽  
Public Responsibility ◽  
Open Question ◽  
Children In Care

Drawing the short straw. Contemporary and historical categorizations of children in foster and residential care with mental health disordersAbout 67 per cent of children placed in residential care in Sweden suffer from mental health disorders. Although the problem has been recognized for decades, the group’s access to sufficient mental healthcare is still lagging. In this article we examine contemporary and historical categorizations of mental health issues among children in foster and residential care. The study examines Swedish commission reports, government bills, and Children’s Acts published between 1902 and 2016 where the issue is discussed. Hereby, ”the history of the present”, and its implications for the targeted group, is analysed and problematized. Our findings show that continuous talk of preventive actions in the name of the all-embracing welfare state repeatedly has downplayed the group’s access to mental health interventions. Ever since the establishment of the child psychiatric field in the 1940s, a discursive battle about the public responsibility for the group is also raging. In the 1970s, coordination is articulated as the grand solution, but the problem still persists. Neither the contemporary child rights perspective nor the latest law regulations of forced coordination for children in care have changed the group’s underprivileged position. Whether the legal turn will finally lead to recognition of the group’s right to adequate mental health care remains an open question.

scholarly journals Mental health law in Colombia

2015 ◽  
Vol 12 (4) ◽  
pp. 92-94 ◽  
Author(s):  
Roberto Chaskel ◽  
James M. Shultz ◽  
Silvia L. Gaviria ◽  
Eliana Taborda ◽  
Roland Vanegas ◽  
...  
Keyword(s):  
Mental Health ◽  
Policy Development ◽  
Mental Healthcare ◽  
Epidemiological Data ◽  
Health Law ◽  
Mental Health Law ◽  
The Past ◽  
Law And Policy ◽  
Laws And Policies ◽  
Health Laws

Mental health law in Colombia has evolved over the past 50 years, in concert with worldwide recognition and prioritisation of mental healthcare. Laws and policies have become increasingly sophisticated to accommodate the ongoing transformations throughout Colombia's healthcare system and improvements in mental health screening, treatment and supportive care. Mental health law and policy development have been informed by epidemiological data on patterns of mental disorders in Colombia. Colombia is distinguished by the fact that its mental health laws and policies have been formulated during a 60-year period of continuous armed conflict. The mental health of Colombian citizens has been affected by population-wide exposure to violence and, accordingly, the mental health laws that have been enacted reflect this feature of the Colombian experience.

Advocacy, Ethics, and Values in Mental Health

2014 ◽  
Author(s):  
Jakki Cowley
Keyword(s):  
Mental Health ◽  
Conflicts Of Interest ◽  
Information Support ◽  
England And Wales ◽  
Professional Obligations ◽  
Mental Capacity Act 2005 ◽  
Recent Developments ◽  
History Of ◽  
Mental Capacity Act ◽  
The Uk

This chapter discusses mental health advocacy in the UK and how the history of mental health care has influenced current practice, as well as how the advocacy sector in general has shaped government policy and legislation. The emphasis is on England and Wales, although advocacy delivery in Scotland and Northern Ireland is also considered. The chapter first defines advocacy and outlines its history in the UK before analyzing recent developments in the country. It then examines the principles of advocacy (independence; empowerment; representation, information, support; accountability; confidentiality), together with different forms of advocacy in the UK and key legislation, including the Mental Capacity Act 2005 and the Mental Health Act 1983 in England and Wales. Finally, it looks at issues and challenges faced by mental health advocates with regard to ethics and values, such as conflicts of interest and duty, the nature of professional obligations and neutrality, and social justice.

scholarly journals Mental Healthcare in Rural Latin America

2017 ◽  
Author(s):  
Jody Epstein
Keyword(s):  
Mental Health ◽  
Latin America ◽  
Latin American ◽  
Mental Healthcare ◽  
Health Service Delivery ◽  
Healthcare Systems ◽  
Mental Health Disorders ◽  
Mental Health Service Delivery ◽  
History Of ◽  
Health Disorders

<p class="normal">The goal of this article is to provide an overview of epidemiology of mental health disorders in Latin America, discuss unique issues in mental health faced by rural Latin American communities, summarize the history of Latin American healthcare systems, and describe current strategies to improve and innovate mental health service delivery in Latin America.  </p>

scholarly journals Coping with a coroner's inquest: a psychiatrist's guide

2009 ◽  
Vol 15 (1) ◽  
pp. 7-16 ◽  
Author(s):  
Paul St John-Smith ◽  
Albert Michael ◽  
Teifion Davies
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Suicide Prevention ◽  
Suicide Rate ◽  
England And Wales ◽  
Community Psychiatrist

SummaryDuring the period 2000–2004 the average annual suicide rate in England and Wales was 10.2 deaths per 100 000 population over 10 years of age. About a quarter of those who take their own lives are in contact with mental health services in the year before their death. This means that an average in-patient, sector or community psychiatrist is likely to experience the death of at least one patient by suicide in most years. Suicides by patients cause considerable distress for the psychiatrist that is unlikely to resolve until after the coroner's hearing. This article discusses suicide prevention and provides guidance for psychiatrists on preparing for a coroner's inquest following a patient's death that may have been by suicide.

Assessing mental capacity and making decisions

2019 ◽  
Vol 15 (4) ◽  
pp. 187-189 ◽  
Author(s):  
John Finch
Keyword(s):  
Mental Health ◽  
Mental Capacity ◽  
England And Wales ◽  
Mental Health Act ◽  
Mental Capacity Act 2005 ◽  
History Of ◽  
Mental Capacity Act

John Finch, a legal member of the Mental Health Act Commission for England and Wales from its creation by statute in 1983 until 1991, takes a fresh look at the uncomfortable history of the Mental Capacity Act 2005 and asks whether the Act has served any useful purpose.

scholarly journals Examining prisoner experience of an equine assisted psychotherapy

2019 ◽  
Vol 40 (3/4) ◽  
pp. 111-124
Author(s):  
Shona Robinson-Edwards ◽  
Stephanie Kewley ◽  
Laura Riley ◽  
Dawn Fisher
Keyword(s):  
Mental Health ◽  
Interpretative Phenomenological Analysis ◽  
Mental Health Problems ◽  
Therapeutic Interventions ◽  
Team Approach ◽  
Treatment Needs ◽  
England And Wales ◽  
Content Type ◽  
Equine Assisted Psychotherapy ◽  
Equine Assisted

Purpose The purpose of this paper is to examine prisoner experience of an equine assisted psychotherapy (EAP). This paper explores the use of therapeutic interventions; specifically focussing on EAP, within this paper EAP constitutes the use of horses in therapy and involves a team approach from equine and mental health experts. Design/methodology/approach This paper took a qualitative approach; due to the exploratory nature of this study a phenomenological approach was adopted. Interpretative phenomenological analysis was deemed appropriate; the intervention took place in an adult, male, open condition prison in England (Category D) however participants who engaged in the equine intervention were from both the open prison and a nearby closed Category C prison. The equine intervention was delivered by qualified therapists who worked to help improve emotional regulation among participants with a history of drug and alcohol abuse. Findings The findings within this paper identify a strong correlation between EAP and positive experiences expressed by participants. Alternative approaches such as animal assisted therapies are worthy of consideration when attempting to support the rehabilitation and treatment needs of incarcerated clients. Participants achieved a number of goals and their confidence improved as they felt a sense of achievement. Research limitations/implications This paper demonstrates the complexities of therapeutic interventions. Research relating to EAP in the UK is few and far between, consequently understanding is limited. This paper seeks to offer an insight into this topic and build upon this research in the future. Practical implications Access to prison for research purposes is challenging. Due to the nature of this study and the resources required sometimes EAP therapy cannot be implemented in or near many prisons in England and Wales. Therefore gaining access to this prison and exploring the data is the first phase of further research in this area. Social implications Researching the way individuals experience therapeutic interventions is a “growing phenomenon”. This paper aimed to explore EAP interventions, however due to the sample size it was imperative that the role of EAP was not misrepresented. Therefore this papers intention is to raise awareness of EAP interventions and therapeutic interventions in prisons in England and Wales. Originality/value To the authors knowledge no previous study has examined such an intervention using this method and as such the findings of this evaluation are important. Moreover this paper enhances and develops our knowledge about how best to support and treat people with histories of substance use and/or mental health problems and anxiety while in prison, and the vital role such therapies may play.

Digital Heath Interventions in Mental Health

2021 ◽  
pp. 328-340
Author(s):  
Aleksandra Stanimirovic
Keyword(s):  
Mental Health ◽  
Remote Monitoring ◽  
Mental Healthcare ◽  
Therapeutic Interventions ◽  
Passive Monitoring ◽  
Science Regulation ◽  
History Of ◽  
Healthcare Interventions ◽  
Tracking Devices ◽  
Digital Healthcare

Technological renaissance of the last century stimulated the application of digital interventions in the healthcare domain. Digital healthcare interventions (DHIs) could be implemented through smartphone applications (apps), remote monitoring and tracking devices, and wearable computers. Technology is positioned to transform how mental healthcare is delivered and accessed. In fact, remote active and passive monitoring of parameters, such as mood, activity, and sleep, could be integrated with therapeutic interventions. However, the transformation entails combined conscription of science, regulation, and design. Implementation, adoption, and evaluation of DHI present special challenges. This chapter presents brief history of DHIs in mental health and frameworks an evaluation strategy in terms of the appropriate methods required for appraisal of DHIs.

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