Childhood neurodisability occurs when there is a compromise of the central or peripheral nervous system due to genetic, pre-birth or birth trauma, and/or injury or illness in childhood. This incorporates a wide range of specific neurodevelopmental disorders or conditions. This report presents a review of published evidence in relation to the following research questions: what is the prevalence of various neurodevelopmental disorders amongst young people within the youth justice system secure estate; and what are the key issues for policy and practice associated with these levels of prevalence? The review found that many young people currently in secure settings in England have undiagnosed neurodevelopmental conditions which have directly contributed to their offending behaviour. The report has several key audiences, from national government departments and bodies, to local strategic partnerships and agency leads, to practitioners working with young people with potential neurodevelopmental difficulties.
Childhood neurodisability occurs when there is a compromise of the central or peripheral nervous system due to genetic, pre-birth or birth trauma, and/or injury or illness in childhood. This incorporates a wide range of specific neurodevelopmental disorders or conditions. This report presents a review of published evidence in relation to the following research questions: what is the prevalence of various neurodevelopmental disorders amongst young people within the youth justice system secure estate; and what are the key issues for policy and practice associated with these levels of prevalence? The review found that many young people currently in secure settings in England have undiagnosed neurodevelopmental conditions which have directly contributed to their offending behaviour. The report has several key audiences, from national government departments and bodies, to local strategic partnerships and agency leads, to practitioners working with young people with potential neurodevelopmental difficulties.
Subject terms:
learning disabilities, mentally disordered offenders, young offenders, youth justice;
The story of offenders with mental illness is not confined to prisons. There are a number of other places where offenders with mental illnesses come into contact with the criminal justice system, including police custody, the courts and probation. This report focuses on contacts at these 'non-prison' locations, outlining their limitations in dealing with the mentally disordered, and using examples of good practice from the UK and abroad to suggest improvements.
The story of offenders with mental illness is not confined to prisons. There are a number of other places where offenders with mental illnesses come into contact with the criminal justice system, including police custody, the courts and probation. This report focuses on contacts at these 'non-prison' locations, outlining their limitations in dealing with the mentally disordered, and using examples of good practice from the UK and abroad to suggest improvements.
Subject terms:
mentally disordered offenders, prisons, community mental health services, good practice;
British Journal of Psychiatry, 192(8), August 2008, pp.130-133.
Publisher:
Cambridge University Press
The rate of total homicide and the rate of homicide due to mental disorder rose steadily until the mid-1970s. From then there was a reversal in the rate of homicides attributed to mental disorder, which declined to historically low levels, while other homicides continued to rise. The reasons for the rise and fall in homicides attributed to mental disorder are not clear. The earlier increase in such homicides may have been due to the same sociological factors that caused the increase in other homicides over that time. The subsequent decline may have been due to improvements in psychiatric treatments and service organisation. Another possibility is that there has been an informal change to the legal tests for the finding of homicide due to mental disorder.
The rate of total homicide and the rate of homicide due to mental disorder rose steadily until the mid-1970s. From then there was a reversal in the rate of homicides attributed to mental disorder, which declined to historically low levels, while other homicides continued to rise. The reasons for the rise and fall in homicides attributed to mental disorder are not clear. The earlier increase in such homicides may have been due to the same sociological factors that caused the increase in other homicides over that time. The subsequent decline may have been due to improvements in psychiatric treatments and service organisation. Another possibility is that there has been an informal change to the legal tests for the finding of homicide due to mental disorder.
This report presents information on the mental health of young offenders from a survey of psychiatric morbidity among prisoners aged 16-64 in England an Wales. The survey was carried out between September and December 1997. It was commissioned by the Department of Health. The report brings together the data on prevalence of mental disorders among young offenders from the main report of the survey together with the results of additional analysis of service use, risk factors and social functioning which were previously only available for the prison population as a whole.
This report presents information on the mental health of young offenders from a survey of psychiatric morbidity among prisoners aged 16-64 in England an Wales. The survey was carried out between September and December 1997. It was commissioned by the Department of Health. The report brings together the data on prevalence of mental disorders among young offenders from the main report of the survey together with the results of additional analysis of service use, risk factors and social functioning which were previously only available for the prison population as a whole.
Subject terms:
mental health problems, mentally disordered offenders, prisoners, young offenders;
British Journal of Psychiatry, 189(2), August 2006, pp.168-172.
Publisher:
Cambridge University Press
Previous research has shown that there are gender differences in reoffending after discharge from medium-secure units, but these have not been adequately explained. The aim was to investigate gender differences in reoffending after discharge from medium-secure psychiatric units. All people discharged from medium-secure units in England and Wales between April 1997 and March 1998 were followed up for 1 year (n=959; 12% women). Reoffending was estimated by collecting reconviction data from the Home Office's Offenders' Index or from files at the mental health unit up to 2 years after discharge. Women were less likely than men to be reconvicted within 2 years of discharge (9% v. 16%, OR=0.49, 95% CI 0.25-0.98). Adjustments for history of self-harm, drug or alcohol problems and previous offending substantially reduced the gender difference. In the full model the OR was 0.97 (95% CI 0.45-2.12). Some or all of the gender differences in reoffending between men and women are explained by self-harm, alcohol and drug problems and previous criminal history.
Previous research has shown that there are gender differences in reoffending after discharge from medium-secure units, but these have not been adequately explained. The aim was to investigate gender differences in reoffending after discharge from medium-secure psychiatric units. All people discharged from medium-secure units in England and Wales between April 1997 and March 1998 were followed up for 1 year (n=959; 12% women). Reoffending was estimated by collecting reconviction data from the Home Office's Offenders' Index or from files at the mental health unit up to 2 years after discharge. Women were less likely than men to be reconvicted within 2 years of discharge (9% v. 16%, OR=0.49, 95% CI 0.25-0.98). Adjustments for history of self-harm, drug or alcohol problems and previous offending substantially reduced the gender difference. In the full model the OR was 0.97 (95% CI 0.45-2.12). Some or all of the gender differences in reoffending between men and women are explained by self-harm, alcohol and drug problems and previous criminal history.
Subject terms:
medium secure units, mentally disordered offenders, recidivists, gender;
The police are very often the agency that has initial contact with mentally disordered offenders when they respond to an incident. This may be as a result of a call from neighbours, family, friends, carers, and members of the public or from staff from other agencies and in a variety of settings. It may also be as a result of their own observation of an incident or a person’s behaviour. This point of intervention is sometimes referred to as the ‘Point of Arrest’. However, this is something of a misnomer as the option for the police to effect an arrest is just one of a number of possible outcomes which are outlined.
The police are very often the agency that has initial contact with mentally disordered offenders when they respond to an incident. This may be as a result of a call from neighbours, family, friends, carers, and members of the public or from staff from other agencies and in a variety of settings. It may also be as a result of their own observation of an incident or a person’s behaviour. This point of intervention is sometimes referred to as the ‘Point of Arrest’. However, this is something of a misnomer as the option for the police to effect an arrest is just one of a number of possible outcomes which are outlined.
University of Leicester. Nuffield Community Care Studies Unit
Publication year:
1995
Pagination:
57p
Place of publication:
Leicester
The Health of the Nation document (1992) identified services for mentally disordered offenders (MDOs) as a priority problem. It is against this background that Leicestershire Health has asked for a literature review of services for this client category in order to inform the commissioning process. This review is chiefly concerned with the overall pattern of services which should be available for MDOs and does not include material specific to the technical skills of the various professionals who provide help for MDOs. For example, there is no discussion of the sorts of therapies which can be used for different sorts of offenders. It is assumed that such information will form part of individual professionals' own skills. Information is not given on specific client categories, such as women, ethnic minorities and people with learning disabilities, or on consumer views.
The Health of the Nation document (1992) identified services for mentally disordered offenders (MDOs) as a priority problem. It is against this background that Leicestershire Health has asked for a literature review of services for this client category in order to inform the commissioning process. This review is chiefly concerned with the overall pattern of services which should be available for MDOs and does not include material specific to the technical skills of the various professionals who provide help for MDOs. For example, there is no discussion of the sorts of therapies which can be used for different sorts of offenders. It is assumed that such information will form part of individual professionals' own skills. Information is not given on specific client categories, such as women, ethnic minorities and people with learning disabilities, or on consumer views.
Extended abstract:
Author:DREWETT Alison Title: A literature review of services for mentally disordered offenders Publisher: University of Leicester. Nuffield Community Care Studies Unit, 1995
Summary
This review is chiefly concerned with the overall pattern of services which should be available for mentally disordered offenders (MDOs), and does not include material specific to the technical skills of the various professionals who provide help for MDOs. For example, there is no discussion of the sorts of therapies which can be used for different sorts of offenders. It is assumed that such information will form part of individual professionals' own skills. Information is not given on specific client categories, such as women, ethnic minorities and people with learning disabilities, or on consumer views.
Context
The Health of the Nation document (1992) identified services for mentally disordered offenders (MDOs) as a priority problem. It is against this background that Leicestershire Health asked for a literature review of services for this client category in order to inform the commissioning process.
Contents
The introduction gives the background and explains how the review was carried out, concentrating chiefly on collecting unpublished and less readily available information (‘grey literature') from the varied agencies which purchase and provide services for this client category. Section 2 discusses numbers of mentally disordered offenders and the psychiatric needs of prisoners, those in contact with the probation service, those taken to police stations, and all offenders. Section 3 is about multi-agency working, discussing the problems and concluding that many agencies are now engaging in a multi-disciplinary approach and authorities are beginning to try to identify what works. The following chapters examine some of the services being put in place. Section 4 is on diverting MDOs, asking why this is done, describing where diversion takes place and the numbers identified and diversion schemes, and discussing effectiveness. Secure accommodation for mentally disordered offenders is discussed in Section 5: prisons, special hospitals, regional secure units, and psychiatric wards, ending with service developments in providing a coherent secure service and assessing risk. Section 6 covers community care for MDOs, with sections on training and service problems. The publication concludes that although the principle of providing health care instead of punishment for MDOs is not new, coherent health and social care is not available for all in the UK , and the level depends very much on where they live. Agencies must work together. The comparatively few offenders presenting serious danger tend to distort responses, with the risk of resources being concentrated on them at the expense of the far more numerous others. Some psychopaths may not receive any health care because they are considered untreatable. All parts are interdependent and repercussions of neglect will be felt elsewhere. While, in theory, there is a push towards helping all types of clients have access to generic services, there is nevertheless some call for specific services staffed by for generic professionals.those trained to help MDOs – as if, in practice, generic services were not answering. Given the scale of need, services are unlikely to be able to given all the help all MDOs need, so there must be a balance between providing highly specialised services on the one hand and, on the other, educating staff in generic services so that they are able to respond to the needs of MDOs. Specialist staff should be available in an advisory capacity
64 references
Subject terms:
learning disabilities, literature reviews, mental health services, mentally disordered offenders;
Scotland. Scottish Executive Central Research Unit
Publication year:
2001
Pagination:
6p.
Place of publication:
Edinburgh
Study on the operation and impact of the Hospital Direction, a new disposal within the Crime and Punishment (Scotland) Act 1997. The Hospital Direction was introduced to allow the court to simultaneously detain in hospital and impose a prison sentence to be completed on discharge on offenders who are suffering from a treatable mental disorder and deemed in need of psychiatric care but who are fit enough to stand trial.
Study on the operation and impact of the Hospital Direction, a new disposal within the Crime and Punishment (Scotland) Act 1997. The Hospital Direction was introduced to allow the court to simultaneously detain in hospital and impose a prison sentence to be completed on discharge on offenders who are suffering from a treatable mental disorder and deemed in need of psychiatric care but who are fit enough to stand trial.
NATIONAL CONFIDENTIAL INQUIRY INTO SUICIDE AND HOMICIDE BY PEOPLE WITH MENTAL ILLNESS
Publisher:
University of Manchester
Publication year:
2015
Pagination:
95
Place of publication:
Manchester
Presents data and analysis on suicides and homicides in the UK between 2003 and 2013, focusing on mental health. Suicide figures show different patterns across the UK countries, with higher rates in Scotland and Northern Ireland and a recent rise in England and Wales. Key messages include: the rise in suicide among male mental health patients appears to be greater than in the general population - suicide prevention in middle aged males should be seen as a suicide prevention priority; it is in the safety of crisis resolution/home treatment that current bed pressures are being felt – the safe use of these services should be monitored and providers and commissioners (England) should review their acute care services; opiates are now the most common substance used in overdose – clinicians should be aware of the potential risks from opiate-containing painkillers and patients’ access to these drugs; families and carers are a vital but under-used resource in mental health care – with the agreement of service users, closer working with families would have safety benefits; good physical health care may help reduce risk in mental health patients – patients’ physical and mental health care needs should be addressed by mental health teams together with patients’ GPs; sudden death among younger in-patients continues to occur, with no fall – these deaths should always be investigated and physical health should be assessed on admission and polypharmacy avoided.
(Edited publisher abstract)
Presents data and analysis on suicides and homicides in the UK between 2003 and 2013, focusing on mental health. Suicide figures show different patterns across the UK countries, with higher rates in Scotland and Northern Ireland and a recent rise in England and Wales. Key messages include: the rise in suicide among male mental health patients appears to be greater than in the general population - suicide prevention in middle aged males should be seen as a suicide prevention priority; it is in the safety of crisis resolution/home treatment that current bed pressures are being felt – the safe use of these services should be monitored and providers and commissioners (England) should review their acute care services; opiates are now the most common substance used in overdose – clinicians should be aware of the potential risks from opiate-containing painkillers and patients’ access to these drugs; families and carers are a vital but under-used resource in mental health care – with the agreement of service users, closer working with families would have safety benefits; good physical health care may help reduce risk in mental health patients – patients’ physical and mental health care needs should be addressed by mental health teams together with patients’ GPs; sudden death among younger in-patients continues to occur, with no fall – these deaths should always be investigated and physical health should be assessed on admission and polypharmacy avoided.
(Edited publisher abstract)
Subject terms:
mental health problems, suicide, homicide, mentally disordered offenders, mental health services;
The Joint Commissioning Panel for Mental Health (JCP-MH) is a new collaboration co-chaired by the Royal College of General Practitioners and the Royal College of Psychiatrists, which brings together leading organisations and individuals with an interest in commissioning for mental health and learning disabilities. This guide is about the commissioning of high, medium, and low secure forensic mental health services for working-age adults. Forensic mental health services are provided for individuals with a mental disorder (including neurodevelopmental disorders) who pose, or have posed, risks to others, and where that risk is usually related to their mental disorder. These services will be commissioned by NHS England, with commissioning decisions being based upon a set of service specifications developed by an appointed Clinical Reference Group. The guide has been written by a group of forensic mental health service experts, in consultation with patients and carers.
(Edited publisher abstract)
The Joint Commissioning Panel for Mental Health (JCP-MH) is a new collaboration co-chaired by the Royal College of General Practitioners and the Royal College of Psychiatrists, which brings together leading organisations and individuals with an interest in commissioning for mental health and learning disabilities. This guide is about the commissioning of high, medium, and low secure forensic mental health services for working-age adults. Forensic mental health services are provided for individuals with a mental disorder (including neurodevelopmental disorders) who pose, or have posed, risks to others, and where that risk is usually related to their mental disorder. These services will be commissioned by NHS England, with commissioning decisions being based upon a set of service specifications developed by an appointed Clinical Reference Group. The guide has been written by a group of forensic mental health service experts, in consultation with patients and carers.
(Edited publisher abstract)
Subject terms:
forensic psychiatry, commissioning, managers, mentally disordered offenders, mental health services;