Staff Attitudes to Self‐harm and its Management in a Forensic Psychiatric Service

2000 ◽  
Vol 2 (4) ◽  
pp. 22-28 ◽  
Author(s):  
Karen Gough ◽  
Andrew Hawkins
2012 ◽  
Vol 20 (5) ◽  
pp. 506-515 ◽  
Author(s):  
Sarah E. Knowles ◽  
Ellen Townsend ◽  
Martin P. Anderson

2017 ◽  
Vol 62 (12) ◽  
pp. 3815-3833 ◽  
Author(s):  
Sandy Krammer ◽  
Hedwig Eisenbarth ◽  
Carole Fallegger ◽  
Michael Liebrenz ◽  
Dorothee Klecha

The present study describes a much understudied group—namely, female prisoners under forensic-psychiatric care in the German-speaking part of Switzerland—to improve understanding of their risks and their needs. Data were derived from internal databases of a Forensic-Psychiatric Service. Data were collected in the form of their sociodemographic characteristics, prevalence of aversive and traumatic events, type of offence committed, and mental health conditions. Based on a full-sample approach, a total of 1,571 files were analysed. Results reveal that two thirds of the participants were not in a stable relationship, more than half did not complete a school degree, and three quarters were without stable employment prior to their incarceration. Two thirds were mothers and about one third did not grow up with their parents. Almost half grew up with an alcohol abusing parent, about half experienced violence and/or neglect in childhood, and about a quarter of the cases sexual abuse. About 95% had a mental health diagnosis according to International Classification of Diseases–Version 10 (ICD-10), and the most prevalent mental and behavioural disorder was due to psychoactive substance abuse. The most frequent offence type was drug-related crimes. Women convicted for drug-related crimes were more likely to have an ICD-10 F1 disorder compared with those convicted for other crimes. Conversely, women with violent offences were less likely to suffer from ICD-10 F1 disorder than those who had committed nonviolent offences. Findings have implications for practitioners and policy makers, and contribute to the cycle of violence theory discussion. In conclusion, future research areas are suggested.


2010 ◽  
Vol 44 (8) ◽  
pp. 713-720 ◽  
Author(s):  
Sheree J. Gibb ◽  
Annette L. Beautrais ◽  
Lois J. Surgenor

1974 ◽  
Vol 124 (582) ◽  
pp. 494-495 ◽  
Author(s):  
Michael J. Craft

The results of treating psychopaths and other mentally abnormal offenders at Balderton Hospital, Nottinghamshire, and in North Wales (Tables I, II and III), have shown that there is a small intractable group who react explosively when in the company of less disturbed patients, and who are best treated in a long-term unit specially designed for their needs. The small group surveyed here are mentally abnormal offenders of dull-normal or average ability whose aggression or inadequacy, sometimes combined with schizophrenia or resulting from brain damage, makes them prone to repeated convictions for violent acts, arson, sexual offences or drunkenness.


2019 ◽  
Vol 28 (22) ◽  
pp. 1468-1476 ◽  
Author(s):  
Sithandazile Masuku

Addressing the rising incidence of self-harm and the demand this places on emergency departments (EDs) are UK Government healthcare priorities. A history of self-harm is linked with suicide risk, so self-harm is a public health issue. The ED is the first point of contact for many people who self-harm so it plays a pivotal role in access to services. Research has highlighted difficulties around triage and assessment in EDs of patients who self-harm, especially frequent attenders. The evidence base on patient experience related to addressing negative staff attitudes is lacking, despite their potent nature and impact on care. Limited knowledge of self-harm aetiology and clinical inexperience have been found to be fundamental to nurses' negative attitudes when dealing with patients who self-harm. This has been linked to negative patient outcomes, including a reluctance to engage with services. This article acknowledges positive changes that have been made and highlights the importance of the triage stage, which is a potential service improvement area, where it would be possible to start and drive positive change in the care of people who self-harm. To address knowledge gaps in education and management, clinical understanding of the aetiology of self-harm should be improved with the aid of education on self-harm cycles. Nurses should also be made aware of common myths surrounding self-harm, as these are barriers to care. Recommendations for practice include partnership working and the urgent need for formal education on this topic for all health professionals working in EDs.


2007 ◽  
Vol 9 (4) ◽  
pp. 28-34 ◽  
Author(s):  
Karen Gough ◽  
Samantha Churchward ◽  
Eluned Dorkins ◽  
Jason Fee ◽  
Susan Oxborrow ◽  
...  

1974 ◽  
Vol 14 (4) ◽  
pp. 268-272 ◽  
Author(s):  
M.J. Craft

This essay describes an area of clinical interest explored by a consultant psychiatrist who was appointed for one purpose and developed another. It describes a new community forensic psychiatric service for an area which was Welsh speaking and had no penal units. As a result of the discharge of 500 in-patients from 8 psychiatric hospitals in 1961–63 a ‘spare' hospital became available as the centre piece of a service which is now described.


Crisis ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 123-131 ◽  
Author(s):  
Rahel Eynan ◽  
Yvonne Bergmans ◽  
Jesmin Antony ◽  
John R. Cutcliffe ◽  
Henry G. Harder ◽  
...  

Background: Participants’ safety is the primary concern when conducting research with suicidal or potentially suicidal participants. The presence of suicide risk is often an exclusion criterion for research participants. Subsequently, few studies have examined the effects of research assessments on study participants’ suicidality. Aims: The purpose of this research was to examine the patterns of postassessment changes in self-harm and suicide urges of study participants who were recently discharged from an inpatient psychiatric service. Method: Study participants (N = 120) were recruited from patients with a lifetime history of suicidal behavior admitted with current suicidal ideation or suicide attempt to an inpatient psychiatric service and/or a crisis stabilization unit. Participants were assessed for suicidal ideation with the Suicide Ideation Scale at 1, 3, and 6 months following their discharge from hospital. The risk assessment protocol was administered at the start and at the end of each of the study follow-up assessments. Results: Changes in self-harm and suicide urges following study assessments were small, infrequent, and were most likely to reflect a decrease in suicidality. Similarly, participants rarely reported worsening self-control over suicidal urges, and when they did, the effect was minimal. By the end of the 6-month follow-up period, increases in self-harm and suicidal urges postassessment were not seen. Conclusion: The inclusion of suicidal participants in research interviews rarely increased suicide risk. Research involving suicidal individuals is possible when study protocols are well planned and executed by trained assessors and clinicians who are able to identify participants at risk and provide intervention if necessary. The few participants that required intervention had high levels of suicide ideation and behavior at baseline and almost all reported symptoms of posttraumatic stress disorder. Further study is needed to better characterize this subgroup of participants.


2016 ◽  
Vol 22 (1) ◽  
pp. 5 ◽  
Author(s):  
Kiran Sukeri ◽  
Orlando A. Betancourt ◽  
Robin Emsley ◽  
Mohammed Nagdee ◽  
Helmut Erlacher

<strong>Objectives:</strong> No research data exists on forensic psychiatric service provision in the Eastern Cape, Republic of South Africa. The objective of this research was to assess current forensic psychiatric service provision and utilisation rates at Fort England Hospital. This is important in improving and strengthening the service. A related objective was to develop a model for a provincial prison mental health service. <strong></strong><p><strong>Methodology:</strong> This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service was developed utilising prevalence rates of mental illness among prisoners to calculate bed and staff requirements for an ambulatory and in-patient service. <strong></strong></p><p><strong>Results:</strong> During the study period a total of 403 remand detainees were admitted to the forensic psychiatry division of Fort England Hospital. The average length of stay was 494 days and the bed utilisation rate was determined at 203.54%. We estimate that to provide a provincial prison mental health service to treat psychotic illnesses and major depression the province requires a 52 bedded facility and a total staff complement of approximately 31. <strong></strong></p><p><strong>Conclusions:</strong> Forensic psychiatric services include the assessment, management and treatment of mentally disordered persons in conflict with the law and prisoners requiring psychiatric assessments. The Eastern Cape Province does not have plans or policies to assess and manage mentally ill offenders, resulting in an increased load on available services. We recommend that an inter-departmental task team, which includes Health, Justice and Constitutional Development and Correctional Services, should be established in the province, to develop a strategy to assist in the development of an effective and efficient forensic psychiatric service. This should be driven by the provincial Department of Health.</p>


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