Advancing research in adult secure mental health services in England

2021 ◽  
pp. 002580242110669
Author(s):  
Howard Ryland ◽  
Louise Davies ◽  
Jeremy Kenney-Herbert ◽  
Michael Kingham ◽  
Mayura Deshpande

Forensic mental health services in high income countries are typically high cost and low volume, providing care to people with mental illness, personality disorders, learning disability and autism deemed to pose a risk to others. Research into how forensic mental health services work as a whole system is limited. Such research is urgently needed to guide policy makers and ensure that services operate effectively.

2020 ◽  
pp. 136346152095262
Author(s):  
Abner Weng Cheong Poon ◽  
Maria Cassaniti ◽  
Michele Sapucci ◽  
Rosaleen Ow

Many studies show that carers of people with mental illness experience a negative impact on their wellbeing. Given the growing number of people relocating to Australia every year, there are limited studies examining the experience of carers of people with mental illness from culturally and linguistically diverse communities in Australia. Using cultural safety as a conceptual framework, this exploratory study recruited 14 carers of Chinese and Vietnamese heritage who were attending culturally and linguistically oriented support groups in Sydney, Australia. Standardised, validated scales were administered to measure carers’ wellbeing and knowledge of recovery. Structured interviews were conducted to understand carers’ perceived needs. Descriptive statistical and qualitative thematic analysis were used. Findings show that carers experienced social isolation and psychological distress, had multiple diverse needs and had a reasonably good understanding of recovery. Six themes were identified: i) obtaining information in own language; ii) attaining emotional support from support groups; iii) needing respite services to cope with caregiving responsibilities; iv) involvement in planning of treatment and care; v) migration process influencing caregiving, and; vi) cultural and transcultural factors influencing caregiving experience. Findings indicate that some carers might be experiencing some level of culturally unsafe practices in mainstream mental health services. Implications for support groups and mental health services are discussed.


BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Hannah Kate Williams ◽  
Madhri Senanayke ◽  
Callum C. Ross ◽  
Rob Bates ◽  
Mary Davoren

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.


2004 ◽  
Vol 28 (3) ◽  
pp. 292 ◽  
Author(s):  
Terry Buchan ◽  
Duncan P Boldy

The change in the focus of care for people with mental illness from hospital to community has been far from uniformly successful for a variety of reasons. A review of the development of mental health services suggests that the views of doctors and the responses of administrative systems are significant forces in shaping the development of services. This study explored the attitudes of general practitioners, psychiatrists and administrators, with a view to establishing areas of congruence in order to move towards an improved model of service delivery. Recommendations are made in the areas of primary care psychiatry, access, communication and education.


2021 ◽  

In this thoughtful article, a young person, Anna, reflects on her experience of risk being conflated with mental illness in child and adolescent mental health services (CAMHS), highlighting crucial lessons for clinicians, commissioners, and policy makers.


BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Vishal Bhavsar ◽  
Jyoti Sanyal ◽  
Rashmi Patel ◽  
Hitesh Shetty ◽  
Sumithra Velupillai ◽  
...  

Background How neighbourhood characteristics affect the physical safety of people with mental illness is unclear. Aims To examine neighbourhood effects on physical victimisation towards people using mental health services. Method We developed and evaluated a machine-learning-derived free-text-based natural language processing (NLP) algorithm to ascertain clinical text referring to physical victimisation. This was applied to records on all patients attending National Health Service mental health services in Southeast London. Sociodemographic and clinical data, and diagnostic information on use of acute hospital care (from Hospital Episode Statistics, linked to Clinical Record Interactive Search), were collected in this group, defined as ‘cases’ and concurrently sampled controls. Multilevel logistic regression models estimated associations (odds ratios, ORs) between neighbourhood-level fragmentation, crime, income deprivation, and population density and physical victimisation. Results Based on a human-rated gold standard, the NLP algorithm had a positive predictive value of 0.92 and sensitivity of 0.98 for (clinically recorded) physical victimisation. A 1 s.d. increase in neighbourhood crime was accompanied by a 7% increase in odds of physical victimisation in women and an 13% increase in men (adjusted OR (aOR) for women: 1.07, 95% CI 1.01–1.14, aOR for men: 1.13, 95% CI 1.06–1.21, P for gender interaction, 0.218). Although small, adjusted associations for neighbourhood fragmentation appeared greater in magnitude for women (aOR = 1.05, 95% CI 1.01–1.11) than men, where this association was not statistically significant (aOR = 1.00, 95% CI 0.95–1.04, P for gender interaction, 0.096). Neighbourhood income deprivation was associated with victimisation in men and women with similar magnitudes of association. Conclusions Neighbourhood factors influencing safety, as well as individual characteristics including gender, may be relevant to understanding pathways to physical victimisation towards people with mental illness.


2017 ◽  
Vol 14 (4) ◽  
pp. 96-97 ◽  
Author(s):  
David M. Ndetei ◽  
Job Muthike ◽  
Erick S. Nandoya

Kenya's Mental Health Act 1989 is now outdated. It is a signatory to international rights conventions that provide for state protection of the rights of people with mental illness, their property and their treatment. There is, however, a glaring failure to implement the existing legal provisions. A new Mental Health Bill that aims to respond comprehensively to the challenges affecting mental health services in Kenya is awaiting enactment.


2000 ◽  
Vol 6 (2) ◽  
pp. 38 ◽  
Author(s):  
Cynthia Fan ◽  
Wally Karnilowicz

The study aimed to examine the attitudes toward mental illness and knowledge of mental health services among Anglo-Australian and Chinese-Australian adults. Participants included 105 Anglo-Australians and 129 Chinese-Australians. Participants were requested to complete a questionnaire on attitudes toward mental illness and knowledge of mental health service available in the community. The results indicated that there was a significant ethnic difference in attitudes towards mental illness. Chinese-Australians endorsed authoritarian, restrictive attitudes towards people with mental illness and interpersonal etiology more than Anglo-Australians. There was also a significant difference in attitudes towards mental illness due to the amount of contact with people with mental illness. The more contact the participants had with people with mental illness, the less they endorsed authoritarian, and restrictive attitudes toward people with mental illness. Though there was a non-significant difference in knowledge of mental health services due to ethnic origin or amount of contact with people with mental illness, there were ethnic differences in the type of mental health services preferred. Among Chinese-Australians, age was positively related to knowledge of services for acute and chronic cases of mental illness. Implications for community mental health education programs are discussed.


2003 ◽  
Vol 29 (2-3) ◽  
pp. 185-201
Author(s):  
John V. Jacobi

Mental illness affects the health status of about one in five Americans each year. More than five percent of adult Americans have a “serious” mental illness—an illness that interferes with social functioning. About two and one-half percent have “severe and persistent” mental illness, a categorization for the most disabling forms of mental illness, such as schizophrenia and bipolar disorder. All mental illness interferes to some degree with social activities. Left untreated, serious mental illness can be disabling—disrupting family life, employment status and the ability to maintain housing. Nevertheless, privately insured people in the United States (that is, the majority of insured people in the United States) are not covered for mental health services to the same extent that they are covered for physical health services. Second-class coverage of mental health services reduces access to care for people with mental illness because cost becomes a significant barrier to service. The resulting lack of treatment fuels the disabling potential of mental illness.


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