Search

Background: We examined whether a series of variables were related to the number of psychiatric inpatients using publicly available data about English psychiatric bed utilisation and NHS workforce. Method: Using linear regression, with auto-regressive errors, we examined relationships between variables over time using data from December 2013 to March 2021. Results: Over time, the number of inpatients reduced by either 6.58 or 8.07 per month depending upon the dataset utilised, and the number of community nurses and community nursing support staff reduced by 7.43 and 2.14 nurses per month, respectively. Increasing numbers of consultant psychiatrists were associated with fewer inpatients over time. More care and treatment reviews (CTRs) were associated with more admissions over time, while more post-admission CTRs were associated with increased discharges over time. Conclusions: Future studies should examine whether psychiatric bed utilisation elsewhere within the NHS by people with intellectual disabilities has increased.

Background: Treatment for adults who set fires relies upon valid and reliable assessment. Research is needed to ensure self-report measures are available for adults with neurodevelopmental disabilities and that they are robust. Method: Qualitative and quantitative data from three rounds of a Delphi exercise with practitioners and a focus group discussion with adults with neurodevelopmental disabilities were used to generate consensus about the accessibility of item adaptations made to the Fire Interest Rating Scale, Fire Attitudes Scale, and the Identification with Fire Questionnaire. Results: Findings suggested the accessibility of current measures could be improved to better meet the needs of adults with neurodevelopmental disabilities and adaptations to all questionnaire items were needed. Conclusion: Following feedback, revisions to current measures were implemented leading to the development of the Adapted Firesetting Assessment Scale with improved accessibility for adults with neurodevelopmental disabilities.

Autistic adults who have a history of committing crimes present a major problem for providers of services in terms of legal disposal options and possible interventions, and greater understanding of this group and their associated needs is required. For this reason, we aimed to investigate the face validity of a proposed sub-typology of autistic adults detained in secure psychiatric hospitals in the United Kingdom. Initially, a focus group was completed with psychiatrists, clinical psychologists, healthcare workers, family members and autistic adults who had been detained in hospital, leading to revisions of the sub-typology. Following this, a consensus rating exercise of 10 clinical vignettes based on this sub-typology with three rounds was completed with 15 psychiatrists and clinical psychologists; revisions to the vignettes to improve clarity were made following each round. The findings indicated that these subtypes possess face validity and raters were able to classify all 10 clinical case vignettes into the sub-typology, and percentage of agreement ranged from 96% to 100% for overall subtype classification. This study suggests that the further validity of the sub-typology should be investigated within a larger study, as these subtypes have the potential to directly inform the hospital care pathway such that length of stay can be minimised.

Background: People with intellectual disabilities have a shorter life expectancy, but healthcare improvements mean that they are beginning to live longer, with associated health difficulties. This means that there is an urgent need to focus research on ageing as well as end-of-life care. This study aimed to explore a specialist intellectual disability service for older people who are dying and how it related to their quality of life and to costs associated with care provided. Method: Data were collected for nine residents and 15 staff members of the specialist service. A single case study design with mixed methods including observations, interviews, standardized questionnaires and costs analysis was utilized. Results: We found positive results regarding overall quality of life, although individuals had limited social networks. Placement fees paid by local health trusts and social services departments were slightly higher than the estimated cost of care reflecting good financial management by a small voluntary sector organization. Conclusion: Whilst the philosophical arguments around "specialist" care persist, this service fills a gap in intellectual disability care provision.

Purpose The number of measures available to practitioners to assess fire interest and other fire-related attitudes is limited. To help establish the utility of such measures, this study explored whether three fire measures contained multiple factors and whether such factors related to firesetting behaviour. Method The Fire Interest Rating Scale, the Fire Attitude Scale, and the Identification with Fire Questionnaire were administered to 234 male prisoners (117 firesetters, 117 non-firesetters) and results were factor analyzed. To determine the relationship of the resulting factors with firesetting behaviour, their ability to discriminate firesetters from controls was examined and compared to the original scales. Results Responses were best represented by five factors, four of which discriminated firesetters from non-firesetters. One factor demonstrated significant accuracy in discriminating single offence firesetters from repeat firesetters. Taken together the factors offered more clarity than using the original scale outcomes and showed equivalent predictive accuracy. Conclusions The five factors identified may aid practitioners in helping to formulate the specific treatment needs of identified firesetters. [ABSTRACT FROM AUTHOR]

Revenge has frequently been acknowledged to account for a relatively large proportion of motives in deliberate firesetting. However, very little is actually known about the aetiology of revenge firesetting. Theoretical approaches to revenge-seeking behaviour are discussed. A brief review of how revenge is accounted for in existing theoretical explanations of deliberate firesetting and the known characteristics of revenge firesetters are provided. On this basis, the authors suggest, as a motive, revenge firesetting has to date been mis-conceptualised. A new conceptual framework is thus proposed, paying particular attention to the contextual, affective, cognitive, volitional and behavioural factors which may influence and generate a single episode of revenge firesetting. Treatment implications and suggestions for future research are also provided. [ABSTRACT FROM PUBLISHER]

This research examined whether a government-initiated pilot project of mandatory polygraph testing would increase the disclosures made by community-supervised sexual offenders in the United Kingdom. The Offender Managers of 332 pilot polygraph sexual offenders and 303 sexual offenders who were receiving usual community supervision were telephoned quarterly, over a 21-month period, to collect information about numbers of clinically relevant disclosures, the seriousness of disclosures made, and actions taken as a result of disclosures. Perceptions of polygraph usefulness were also collected. Offender Managers in the pilot polygraph group—compared to comparison Offender Managers—reported (a) a higher proportion of offenders making at least one disclosure (i.e., 76.5% vs. 51.2% respectively), and (b) that their offenders made more total disclosures overall (Ms = 2.60 vs. 1.25 respectively). The majority of disclosures made by sexual offenders in the polygraph group were associated with the polygraph session itself. Polygraph Offender Managers reported being more likely to take an action that involved increasing supervision, informing a third party, informing Multi-Agency Public Protection Arrangements (MAPPA), changing supervision focus, or issuing a warning to the offender. However, the relative seriousness of disclosures did not appear to differ across groups. In terms of polygraph test results, one third of offenders (most notably those who were higher in risk) failed their first test with “Deception Indicated.” This outcome—received on a first test—was most likely to elicit clinically relevant disclosures. Offender Managers described the polygraph as aiding supervision strategies. This research and its associated caveats are discussed. [ABSTRACT FROM AUTHOR]

This research examined whether a government-initiated pilot project of mandatory polygraph testing would increase the disclosures made by community-supervised sexual offenders in the United Kingdom. The Offender Managers of 332 pilot polygraph sexual offenders and 303 sexual offenders who were receiving usual community supervision were telephoned quarterly, over a 21-month period, to collect information about numbers of clinically relevant disclosures, the seriousness of disclosures made, and actions taken as a result of disclosures. Perceptions of polygraph usefulness were also collected. Offender Managers in the pilot polygraph group-compared to comparison Offender Managers-reported (a) a higher proportion of offenders making at least one disclosure (i.e., 76.5% vs. 51.2% respectively), and (b) that their offenders made more total disclosures overall (Ms = 2.60 vs. 1.25 respectively). The majority of disclosures made by sexual offenders in the polygraph group were associated with the polygraph session itself. Polygraph Offender Managers reported being more likely to take an action that involved increasing supervision, informing a third party, informing Multi-Agency Public Protection Arrangements (MAPPA), changing supervision focus, or issuing a warning to the offender. However, the relative seriousness of disclosures did not appear to differ across groups. In terms of polygraph test results, one third of offenders (most notably those who were higher in risk) failed their first test with "Deception Indicated." This outcome-received on a first test-was most likely to elicit clinically relevant disclosures. Offender Managers described the polygraph as aiding supervision strategies. This research and its associated caveats are discussed.