scholarly journals Mental disorder in people convicted of homicide: long-term national trends in rates and court outcome

2020 ◽  
pp. 1-7
Author(s):  
Sandra Flynn ◽  
Saied Ibrahim ◽  
Nav Kapur ◽  
Louis Appleby ◽  
Jenny Shaw
Keyword(s):  
Mental Illness ◽  
Health Services ◽  
Mental Disorder ◽  
Serious Mental Illness ◽  
Substance Misuse ◽  
Case Series ◽  
Limited Information ◽  
Home Office ◽  
England And Wales ◽  
Complex Needs

Background Homicide rates have fallen markedly in the UK over the past decade. There has been little research on whether homicides by people with mental disorder have contributed to this downward trend. Furthermore, there is limited information on trends in court outcomes for people with mental disorder who commit homicide. Aims To examine trends in general population homicide and homicide by people with mental disorder, and to explore court outcome. Method We conducted a national, consecutive case series of homicide in England and Wales (1997–2015). Data were received from the Home Office Statistics Unit of Home Office Science. Clinical information was obtained from psychiatric reports and mental health services. Results There has been a fall in the homicide rate in England and Wales since 2008. Despite this, the relative contribution of mental disorder as a proportion of all homicide has increased. Our findings also showed the inappropriate management of people with serious mental illness convicted of homicide. Of those who committed homicide and were diagnosed with schizophrenia, a third were imprisoned, and there was a marked fall in hospital order referrals. We found this to be linked to substance misuse comorbidity. Conclusions The proportional increase in homicide by people with schizophrenia suggests more complex factors may be driving rates, such as substance misuse. Addressing substance misuse comorbidity and maintaining engagement with services may help prevent patient homicide. Despite their complex needs, people with serious mental illness continue to be imprisoned. Improvements in assessment and the timely transfer of prisoners to health services are required.

scholarly journals Trends in rates of mental illness in homicide perpetrators

2011 ◽  
Vol 198 (6) ◽  
pp. 485-489 ◽  
Author(s):  
Nicola Swinson ◽  
Sandra M. Flynn ◽  
David While ◽  
Alison Roscoe ◽  
Navneet Kapur ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Disorder ◽  
Serious Mental Illness ◽  
Case Series ◽  
Drug Misuse ◽  
Psychotic Symptoms ◽  
Diminished Responsibility

BackgroundThe rise in homicides by those with serious mental illness is of concern, although this increase may not be continuing.AimsTo examine rates of mental illness among homicide perpetrators.MethodA national consecutive case series of homicide perpetrators in England and Wales from 1997 to 2006. Rates of mental disorder were based on data from psychiatric reports, contact with psychiatric services, diminished responsibility verdict and hospital disposal.ResultsOf the 5884 homicides notified to the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness between 1997 and 2006, the number of homicide perpetrators with schizophrenia increased at a rate of 4% per year, those with psychotic symptoms at the time of the offence increased by 6% per year. The number of verdicts of diminished responsibility decreased but no change was found in the number of perpetrators receiving a hospital order disposal. The likeliest explanation for the rise in homicide by people with psychosis is the misuse of drugs and/or alcohol, which our data show increased at a similar magnitude to homicides by those with psychotic symptoms. However, we are unable to demonstrate a causal association. Although the Poisson regression provides evidence of an upward trend in homicide by people with serious mental illness between 1997 and 2006, the number of homicides fell in the final 2 years of data collection, so these findings should be treated with caution.ConclusionsThere appears to be a concomitant increase in drug misuse over the period, which may account for this rise in homicide. However, an increase in the number of people in contact with mental health services may suggest that access to mental health services is improving. Previous studies have used court verdicts such as diminished responsibility as a proxy measure of mental disorder. Our data indicate that this does not reflect accurately the prevalence of mental disorder in this population.

scholarly journals What happens to frequent attenders when they attend psychiatric liaison services? a clinical and demographic profile

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S252-S253
Author(s):  
Frederick Grose ◽  
Tennyson Lee ◽  
Richelle Canlas ◽  
William Phung ◽  
Rikke Albert ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Health Services ◽  
Substance Misuse ◽  
Psychiatric Service ◽  
Case Series ◽  
Pathways To Care ◽  
Emotional Trauma ◽  
Complex Needs ◽  
Frequent Attenders ◽  
Other Information

AimsWe aimed to describe the demographic and clinical profile, and management of frequent attenders to a psychiatric liaison service.BackgroundFrequent Attenders to emergency departments contribute significantly to the burden on health services and by definition are subjectively highly stressed. It is therefore important that mental health services develop effective responses to this group of patients. A systematic literature search indicated a paucity of information on this group of patients.MethodWe conducted a case series of 49 frequently attending patients to the Psychiatric Liaison service in Tower Hamlets, East London NHS Foundation Trust.We defined frequent attenders as seeing the Psychiatric Liaison Service 5 or more times in 2018. We excluded 4 patients aged <18 years or >65 years.For each patient we collected data regarding their demographics; the details of each attendance to the Psychiatric Liaison Service; and their use of other psychiatric services.We then conducted a multivariate analysis, including stratification of patients based on number of attendances to identify correlation between frequency of attendance and the other information.ResultDemographic: The 45 patients reviewed had a mean age of 37 and a mean of 7 attendances during the study period.Clinical: 89% had a history of emotional trauma, 71% of substance misuse, and 49% of any personality disorder. Only 9% of the patients were under the care of the locality Personality Disorder Service.73% of the patients were under the care of any other psychiatric service. There was no correlation between being under other services and the frequency of attendance.Only 31% had contact with the locality Frequent Attenders Service during the study period, as this was established recently.ConclusionPsychiatric Frequent Attenders have complex needs, which do not fit neatly into existing psychiatric diagnoses and services.The high frequency of emotional trauma, substance misuse and personality disorder indicates a need for training of clinicians in these services to manage these patients, as well as planning for referral pathways for this group of patients who provide services with major challenges in appropriate pathways to care and follow-up

scholarly journals Management challenges in patients with comorbid COVID-19 associated delirium and serious mental illness – A case series

2021 ◽  
pp. 009121742098597
Author(s):  
Saba Syed ◽  
Michael Couse ◽  
Rashi Ojha
Keyword(s):  
Mental Illness ◽  
Serious Mental Illness ◽  
Healthcare Providers ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Active Management ◽  
The Novel ◽  
Psychiatric Facility ◽  
Medical Teams ◽  
Novel Coronavirus

Background There is still a lot unknown about the novel Coronavirus Disease 19 (COVID-19) and its effects in humans. This pandemic has posed several challenging clinical situations to healthcare providers. Objective We hope to highlight the distinctive challenges that COVID-19 presents in patients with serious mental illness and what steps primary medical teams can take to co-manage these patients with the psychiatry consultants. Methods We present a retrospective chart review of four patients who were on psychotropic polypharmacy and admitted to our hospital from the same long-term psychiatric facility with COVID-19 delirium and other associated medical complications. Results We illustrate how the primary medical teams and psychiatrists collaborated in clinical diagnosis, treatment, and management. Conclusions Patients with serious mental illness and COVID-19 infection require active collaboration between primary medical teams and psychiatrists for diagnostic clarification, reduction of psychotropic polypharmacy to avoid adverse effects and drug-drug interactions, prevention of psychiatric decompensation, and active management of agitation while balancing staff and patient safety concerns.

Use of Preventive Health Services in People With Serious Mental Illness

2017 ◽  
Vol 19 (1) ◽  
Author(s):  
Glen L. Xiong ◽  
Ana-Maria Iosif ◽  
Nickolas H. Culpepper ◽  
Robert M. McCarron
Keyword(s):  
Mental Illness ◽  
Health Services ◽  
Serious Mental Illness ◽  
Preventive Health Services ◽  
Preventive Health

Offence Characteristics of Psychotic Men Who Sexually Assault Women

2000 ◽  
Vol 40 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Alan D Smith
Keyword(s):  
Mental Illness ◽  
Social Interaction ◽  
Anal Intercourse ◽  
Vaginal Intercourse ◽  
Home Office ◽  
England And Wales ◽  
Sexual Behaviours ◽  
Sex Offences ◽  
Popular Images

Very little is known about the nature of serious sex offences against women by psychotic men. This study aimed to examine such offences by carrying out a search of Home Office records for all 80 male restricted hospital order in-patients with schizophrenia, resident in any hospital in England and Wales during May 1997, with an index conviction for a contact sex offence against a woman, committed whilst psychotic. Offences peaked in the afternoon, but were proportionally distributed according to day and month. Most (47/59%) offences occurred indoors, with over half of these in the victim's home. Assailants were strangers in 49 (61%) offences. Offences involving strangers were more likely to occur outdoors and without any preceding social interaction compared to those involving assailants known to their victims. Offenders' speech tended to be impersonal, with little attempt at intimacy. Offence sexual behaviours were: breast/genital fondling 63 (79%), vaginal intercourse 42 (52%), fellatio eight (10%), anal intercourse seven (9%), and cunnilingus six (8%). Excessive violence or bizarre behaviour occurred in a minority of offences. The findings are discussed with reference to the literature on sex offences by men without mental illness. The data do not support anecdotal or popular images that most psychotic sex attackers behave in an exceptionally violent or bizarre manner.

Mental health services for single homeless people

2020 ◽  
pp. 1-11
Author(s):  
Philip Timms ◽  
Jenny Drife
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Personality Disorder ◽  
Health Services ◽  
Substance Misuse ◽  
Homeless People ◽  
Psychiatric Services ◽  
Background Information ◽  
The Past ◽  
The Uk

SUMMARY Homelessness has long been associated with high rates of psychosis, alcohol and substance misuse, and personality disorder. However, psychiatric services in the UK have only recently engaged actively with homeless people. This article provides some background information about homelessness and mental illness and describes the elements of inclusion health and some of the models of service for homeless people that have been established over the past 30 years.

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