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February Forensic Network by MikeJenny



              Current Awareness bulletin:
            Forensic mental health services
                       Issue 7
                    February 2009
Citations for the following articles can be found on the forensic network’s
website, and full text for many of the following articles are available online via
the NHS Scotland e-Library. Please use the links where available and your
ATHENS username and password. If you require an ATHENS account, or
require a copy of any of the articles, please contact your local librarian.

Please note that the articles you are accessing may be protected by copyright
legislation; please contact your librarian for a copyright declaration form if you
are in any doubt.

If you have any questions regarding this or any other library services please
contact your own librarian in the first instance, otherwise contact the librarian
at The State Hospital – contact details below.

Anger Management                               3
CBT                                            3
Criminal Justice                               3
Critical Incidents                             5
Detention                                      5
Disability Rights                              7
Funding                                        7
Learning Disabilities                          7
Legislation                                    8
Mental Health Nurses                           8
Mental Health Policy                           9
Mindfulness                                    10
Offenders                                      10
Patient Focus Public Involvement               11
Personality Disorders                          11
Personality Profile                            12
Physical Activity                              12
Physical Health                                13
Prisons                                        13
Professional Issues                            14
Psychosis                                      14
PTSD                                         15
Quality of Life                              16
Recovery                                     16
Rehabilitation                               18
Risk                                         18
Schizophrenia                                19
Security                                     19
Self-Esteem                                  20
Sexual Offenders                             20
Smoke Free                                   23
Suicide Intervention                         24
Telepsychiatry                               24
Tribunals                                    25

2                      Compiled by Rebecca N. Hart, Librarian, The State Hospital
                               110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
                       Anger Management
Arsuffi, Lara (2008) The Triple C programme: A qualitative
evaluation of a new anger management protocol piloted in a
British medium secure unit Forensic Update Volume 95, Pages 29-

Kobori, Osamu et al (2008) Cognitive Behavioural Therapy for
Obsessive Compulsive Symptoms Affected by Past Psychotic
Experience of Schizophrenia: A Case Report Behavioural and
Cognitive Psychotherapy Volume 36, Issue 3, Pages 365-369
Obsessive-compulsive symptoms (OCS) have been observed in a
substantial proportion of patients with schizophrenia. Although several
studies have investigated the comorbidity associated with OCS in
schizophrenia, few case studies are available regarding cognitive
behavioural therapy (CBT) for the treatment of OCS of patients within this
group. This paper describes a case report in which OCS emerged
gradually after the remission of positive symptoms of schizophrenia. The
SBT involved psycho education and case formulation, cognitive
restructuring, exposure and response prevention (EPR), and behavioural
experiments. Improvement in the compulsive behaviours led to a greater
insight regarding the relationship between OCS and past experience of
positive symptoms (eg. hallucinations). The cognitive characteristics of
the patient were discussed in light of current cognitive models of OCD.

Steel, Craig (2008) Cognitive Behaviour Therapy for Psychosis:
Current Evidence and Future Directions Behavioural and Cognitive
Psychotherapy Volume 36, Issue 6, Pages 705-712
The past decade has seen considerable growth in the evidence based of
cognitive behavioural therapy for psychosis. Consistent reports of
moderate effect sizes have led to such interventions being recommended
as part of routine clinical practice. Most of this evidence is based on a
generic form of CBT for psychosis applied to a heterogeneous group. An
increase in the effectiveness of cognitive behavioural interventions may
require new protocols. Such therapeutic developments should be based
on the theoretical understanding of the psychological processes associated
with specific forms of psychotic presentation. The current evidence base
of CBT for psychosis is reviewed, and barriers that have held back the
development of this research are discussed.

                          Criminal Justice
Scottish Government (2008) Homicide in Scotland, 2007-08
Statistics on crimes of homicide recorded by the police in 2007-08.

3                         Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
Scottish Government (2008) Revitalising Justice: Proposals to
Modernise and Improve the Criminal Justice System
A document that summarises the proposals that will be included in the
Criminal Justice and Licensing Bill (to be introduced into the Scottish
Parliament in early 2009).

Scottish Government (2008) Statistical Bulletin Crime and Justice
Series Reconvictions of Offenders Discharged from Custody or
Given Non-Custodial Sentences in 2004-05 and 2005-06, Scotland

Scottish Prisons Commission (2008) Scotland’s Choice: Report of
the Scottish Prisons Commission July 2008

Tata, Cyrus et al (2008) Assisting and Advising The Sentencing
Decision Process; The Pursuit of “Quality” in Pre-Sentence Reports
The British Journal of Criminology Volume 48, Number 6, Pages
Pre-sentence reports are an increasingly prevalent feature of the
sentencing process. Yet, although judges have been surveyed about their
general views, we know relatively little about how such reports are read
and interpreted by judges considering sentence in specific cases, and, in
particular, how these judicial interpretations compare with the intentions
of the writers of those same reports. This article summarizes some of the
main findings of a four-year qualitative study in Scotland examining: how
reports are constructed by report writers; what the writers aim to convey
to the sentencing judge; and how those same reports are then interpreted
and used in deciding sentence. Policy development has been predicated
on the view that higher-quality reports will help to 'sell' community
penalties to the principal consumers of such reports (judges). This
research suggests that, in the daily use and interpretation of reports, this
quality-led policy agenda is defeated by a discourse of judicial 'ownership'
of sentencing.

Ventress, Michael A et al (2008) Keeping PACE: fitness to be
interviewed by the police Advances in Psychiatric Treatment
Volume 14, Issue 5, Pages 369-381
The second half of the 20th century witnessed a number of serious
miscarriages of justice that resulted from improper police interviewing of
suspects and unreliable and false confessions. To prevent miscarriages of
justice involving people with mental disorder or particular mental
vulnerabilities, psychiatrists have a role in determining the fitness to be
interviewed of persons suspected of criminal offences. In this article, the
role of the psychiatrist in assessing fitness to be interviewed is set against
the background of the latest revisions of the Codes of Practice of the
Police and Criminal Evidence Act 1984 and relevant case law in England
and Wales.
4                          Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                   110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
                         Critical Incidents
Clarke, Ian (2008) Learning from critical incidents Advances in
Psychiatric Treatment Volume 14, Issue 6, Pages 460-468
Critical incident reviews are an integral part of modern psychiatric
practice. The issue is central to the clinical governance agenda in the UK,
yet there is widespread debate about their usefulness. There is a lack of
systematic research into their impact on clinical outcomes, with most
authors commenting on their form, their political implications, and
whether they should exist at all. This article explores the historical basis
to incident investigation, outlines an “ideal” method of review and
discusses the concepts of the learning organisation and root cause
analysis. Further discussion focuses on what the objectives of critical
incident review might be and whether organisations as a whole can learn
from them.

A series of articles on detention in Advances in Psychiatric
Treatment Volume 14, Issue 3

Roberts, Glenn et al (2008) Detained – what’s my choice? Part 1:
Discussion Advances in Psychiatric Treatment Volume 14, Issue 3,
Pages 172-180
Choice, responsibility, recovery and social inclusion are concepts guiding
the “modernisation” and redesign of psychiatric services. Each has its
advocates and detractors, and at the deep end of mental
health/psychiatric practice they all interact. In the context of severe
mental health problems choice and social inclusion are often deeply
compromised; they are additionally difficult to access when someone is
detained and significant aspects of personal responsibility have been
temporarily taken over by others. One view is that you cannot recover
while others are in control. We disagree and believe that it is possible to
work in a recovery-oriented way in all service settings. This series of
articles represents a collaborative dialogue between providers and
consumers of compulsory psychiatric services and expert commentators.
We worked together, reflecting on the literature and our own professional
and personal experience to better understand how choice can be worked
with as a support for personal recovery even in circumstances of
psychiatric detention. We were particularly interested to consider whether
and how detention and compulsion could be routes to personal recovery.
We offer both the process of our co-working and out specific findings as
part of a continuing dialogue on these difficult issues.

5                          Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                   110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
Copeland, Mary Ellen; Mead, Shery (2008) Continuing the
dialogue: Invited Commentary on…Detained – what’s my choice?
Part 1 Advances in Psychiatric Treatment Volume 14, Issue 3,
Pages 181-182
We consider the value of dialogue between healthcare professionals and
mental health service users with severe mental illnesses. Discussion with
the service user before, during and after a psychiatric crisis should help
services to offer choice even to individuals under compulsory detention.

Fulford, K.W.M.; King, Malcolm (2008) A values-based perspective
on good practice in compulsion: Invited Commentary on…Detained
– what’s my choice? Part 1 Advances in Psychiatric Treatment
Volume 14, Issue 3, Pages 183-184
We outline how the values-based approach adopted in training materials
supported the Mental Health Act 2007 for England and Wales will
complement recovery-based practice in compulsory psychiatric detention.

Dorkins, Eluned et al (2008) Detained – what’s my choice? Part 2:
Conclusions and recommendations Advances in Psychiatric
Treatment Volume 14, Issue 3, Pages 184-186
We have developed this succession of articles as a series of iterative
steps, each seeking to uphold the recovery values of co-working and
collaboration, looking for agreement and commonality but valuing equally
diverse viewpoints and difference. Our conclusion is that this is the
beginning of a creative dialogue on choice as a route to recovery for
people who are psychiatrically detained. We commend our method of
engaging with the inevitable tensions and dilemmas by: clarifying the
story behind difficult interactions, identifying the relevant guiding
principles and jointly working to explore from different viewpoints what
can be done to promote recovery.

6                         Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
                         Disability Rights
Sayce, Liz; Boardman, Jed (2008) Disability rights and mental
health in the UK: recent developments of the Disability
Discrimination Act Advances in Psychiatric Treatment Volume 15,
Issue 4, Pages 265-275
The Disability Discrimination Act, passed by Parliament in 1995 and
amended in 2001 and 2005, covers people in Britain with physical or
mental impairments that have a substantial and long-term adverse effect
on their ability to carry out normal day-to-day activities. The Act has
been important in setting a framework for good practice and it can
stimulate more systemic change through formal investigations of
organisations or whole sectors, and through the Disability Equality Duty,
in force since December 2006. The Disability Discrimination Act has
implications for people working in mental health services when they are
considering employment and educational opportunities for service users,
and when they are considering how to redress systemic disadvantage,
including inequalities in physical health.

Hayman-White, Karla; Happell, Brenda (2008) Psychiatric Nursing
and Mental Health Funding: The Double Dilemma The International
Journal of Psychiatric Nursing Research Volume 12, Issue 3, Pages
The impact of mental illness on disease and disability burden is receiving
more recognition that has previously been the case. It is now commonly
understood that approximately 20% of the Australian population will
experience a mental illness at some stage during their lives.
Unfortunately this recognition is not reflected in the funding of mental
health services, or in strategies to identify and rectify shortfalls in the
nursing workforce. This paper provides as exploration of two areas.
Firstly an overview of the current funding devoted to mental health and
secondly an examination of workforce data with a view to recognising
likely future trends for psychiatric nursing. The data demonstrates the
existence of a double dilemma, firstly that the need for psychiatric nurses
is likely to increase, and secondly that the looming workforce crisis may
be more severe than has been anticipated.

                       Learning Disabilities
Slevin, E. (2008) People with learning disabilities admitted to an
assessment and treatment unit: impact on challenging behaviours
and mental health problems Journal of Psychiatric and Mental
Health Nursing Volume 15, Issue 7, Pages 537-546
This study describes the evaluation of an assessment and treatment unit
for people with learning disabilities. Results showed the main reasons for
admission for the 48 people admitted to the unit were because of
challenging behaviours and mental health problems. Valid and reliable
scales were used to measure the behaviours and mental health problems

7                         Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
of those admitted across three-time periods: pre-admission, during
admission and post-admission. The analysis found significant reductions in
challenging behaviours and mental health problems following admission to
the unit. The unit was staffed by a multidisciplinary team with nurses
making up the largest group of staff. A number of issues of concern are
discussed including access to mental health services for people with
learning disabilities, the need for robust community services and areas
that require further research. In conclusion, the study found evidence
supporting the value of the unit and how it may lessen distress in learning
disabled people who are behaviourally disturbed. It is suggested that
nurses played a key role in the unit but they need to make the support
and caring they provide more visible. Nurses need to harness and make
explicit the caring they provide for people with learning disabilities.

McGloine, Annemarie (2008) The role of the named person
Newsletter for mental health officers in Scotland Issue 17, Pages

                      Mental Health Nurses
Snowden, A. (2008) Quantitative analysis of mental health nurse
prescribers in Scotland Journal of Psychiatric and Mental Health
Nursing Volume 15, Issue 6, Pages 471-478
The UK parliament approved legislation expanding prescribing rights for all
registered nurses in 2006. Mental health nurses do not appear to be
embracing prescribing to the same degree as their colleagues. For
example, mental health nurses represent 14% of the UK nursing
population, but only 3% nurse prescribing population. In order to explore
this disparity, the paper discusses quantitative analysis of the following
objectives: (1) describe the impact of nurse prescribing on nurse
prescribers in NHS Greater Glasgow and Clyde; and (2) identify
differences between mental health nurse prescribers and other nurse
prescribers in NHS Greater Glasgow and Clyde. Following online pilot
study, a 26-item questionnaire was posted to 668 nurse prescribers in
NHS Greater Glasgow and Clyde. A total of 365 questionnaires were
returned (55.4%). Significant differences were found between mental
health nurse prescribers and others in terms of age, gender, prescribing
practice, academic achievement, method of prescribing, workplace,
experience and attitude to prescribing. Possible reasons for these
differences are suggested and form the basis of further planned research.

8                         Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
                      Mental Health Policy

Altenberger, Iris; Mackay, Rob (2008) What Matters with Personal
Narratives?: An exploration as to how personal narratives are
used in the promotion of recovery and social inclusion by mental
health service users in Scotland.
A short summary of research into Personal Narratives conducted as part of
the Small Research Projects Initiative of the National Programme for
Improving Mental Health and Well-being.

Griesbach, Dawn (2008) An analysis of the responses to the
national consultation on “Towards a Mentally Flourishing
“Towards a Mentally Flourishing Scotland” discussion document was put
forward as a consultation to determine the future direction of mental
health improvement for 2008-11, focusing on what Local Authorities, NHS
Boards and other key stakeholders can do to support the agenda. This
report is an analysis of all the responses received to the consultation

HM Chief Inspector of Prisons for Scotland (2008) Out of Sight:
Severe and Enduring Mental Health Problems in Scotland’s Prisons
Summary findings from Thematic Report on Severe and Enduring Mental
Health Problems in Scotland's Prisons.

The Mental Health Tribunal for Scotland (Practice and Procedure)
(No. 2) Amendment Rules 2008

Scottish Government (2008) Adults with Incapacity (Scotland) Act
2000: Part 5 Code of Practice
This letter provides the revised Code of Practice for Part 5 of the Act,
which deals with medical treatment and research. The Code takes into
account changes made to the Act by the Smoking, Health and Community
Care Act.

Scottish Government (2008 version) The New Mental Health Act: A
guide to emergency and short-term powers
Information for Service Users and their Carers, 2008 version

9                        Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                 110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
Singh, Nirbhay N. et al (2008) Clinical and Benefit-Cost Outcomes
of Teaching a Mindfulness-Based Procedure to Adult Offenders
With Intellectual Disabilities Behavior Modification Volume 32,
Issue 5, Pages 622-637
The effects of a mindfulness-based procedure, called Meditation on the
Soles of the Feet, were evaluated as a cognitive-behavioral intervention
for physical aggression in 6 offenders with mild intellectual disabilities.
They were taught a simple technique that required them to shift their
attention and awareness from the precursors of aggression to the soles of
their feet, a neutral point on their body. Results showed that physical and
verbal aggression decreased substantially, no Stat medication or physical
restraint was required, and there were no staff or peer injuries. Benefit-
cost analysis of lost days of work and cost of medical and rehabilitation
because of injury caused by these individuals in both the 12 months prior
to and following mindfulness-based training showed a 95.7% reduction in
costs. This study suggests that this procedure may be a clinically
effective and cost-effective method of enabling adults offenders with
intellectual disabilities to control their aggression.

Ferguson, A. Murray; Ogloff, James, R.P.; Thomson, Lindsay
(2009) Predicting Recidivism by Mentally Disordered Offenders
Using the LSI-R:SV Criminal Justice and Behavior Volume 36,
Issue 1, Pages 5-20
The Level of Service Inventory-Revised: Screening Version (LSI-R:SV) has
proven to validly predict reoffending in general offender populations but
has not previously been studied specifically with offenders who have a
major mental illness, including those with a dual diagnosis. This research
project measures the validity of the LSI-R:SV for use with 208 mentally ill
offenders who were released from a secure forensic hospital in Melbourne,
Australia. Results indicate that the LSI-R:SV is a good predictor of
recidivism among mentally disordered offenders. However, the LSI-R:SV
does not reliably predict recidivism in individuals who attracted a dual
diagnosis. Further research needs to reevaluate risk factors associated
with recidivism in offenders with a dual diagnosis.

10                        Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
             Patient Focus Public Involvement
Healthcare Policy and Strategy Directorate, Scottish Government
(2008) Patients’ Rights: A Public Consultation on a Patients’
Rights Bill for users of the NHS in Scotland
Patients’ Rights Consultation document

Scottish Government Social Research (2008) Better Together:
Scotland’s Patient Experience Programme Building on The
Experiences of NHS Boards
This research documents Scottish Health Boards’ current patient
experience activities and Boards representatives’ experiences of and
attitudes towards patient experience. The research also examined
expectations of the Scottish Patient Experience Programme and beliefs
about patients’ priorities.

                      Personality Disorders
Gudjonsson, Gisli H.; Main, Nicole (2008) How are personality
disorders related to compliance? Journal of Forensic Psychiatry
and Psychology Volume 19, Issue 2, Pages 180-190
The aim of this study was to investigate the relationship between
personality disorders, as measured by the Millon Clinical Multiaxial
Inventory - III, and compliance, as measured by the Gudjonsson
Compliance Scale. A voluntary sample of 58 mentally disordered offenders
residing in medium secure units completed both tests. Of these, 54 (93%)
met a diagnosis threshold for either a trait or a disorder (50% met the full
diagnosis for at least one personality disorder). The most common
personality traits/disorders were avoidant, passive-aggressive, dependent,
depressive, and paranoid. The presence or prominence of clinical
syndrome/severe clinical syndrome was evident in 42 (72%) of the
patients. As far as clinical syndromes are concerned, the most common
diagnoses were anxiety, followed by drug dependence and alcohol
dependence. Compliance correlated most significantly with dependent,
avoidant, passive-aggressive, and masochistic personality disorder scores
(Axis II), and with dysthymia, anxiety, and delusional disorders (Axis I).
These findings support the hypothesis that compliance is more strongly
associated with some personality disorders than others, particularly those
in Cluster C, and that the primary link with compliance is through anxiety
and low self-esteem.

11                        Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
                        Personality Profile
Stupperich, Alexandra et al (2009) Violence and Personality in
Forensic Patients: Is There a Forensic Patient-Specific Personality
Profile? Journal of Interpersonal Violence Volume 24, Issue 1,
Pages 209-225
Concerning the discussion about the connection of personality traits,
personality disorders, and mental illness, this study focused on the
personality profiles of male forensic patients, prison inmates, and young
men without criminal reports. The main topic centred on group-specific
personality profiles and identifying personality facets corresponding with
mental illness. The authors therefore used the Rasch model-based Trier
Integrated Personality Inventory. They individually tested 141 German
forensic patients with different crime backgrounds, 122 prison inmates,
and 111 soldiers of the German army. Within group differences they
found that the individuals with mental retardation differ from patients with
a personality disorder or psychosis. Patients with mental retardation
displayed higher neurotic and/or paranoid personality accents and tended
to be low organised and self-confident.

                          Physical Activity
Acil, A.A. et al (2008) The effects of physical exercises to mental
state and quality of life in patients with schizophrenia Journal of
Psychiatric and Mental Health Nursing Volume 15, Issue 10, Pages
The purpose of this study was to examine the effects of 10 weeks of
physical exercises programme on mental states and quality of life (QOL)
of individuals with schizophrenia. The study involved 30 inpatients or
outpatients with schizophrenia who were assigned randomly into aerobic
exercise (n = 15) group and control (n = 15) group, participated to the
study voluntarily. There were no personal differences such as age, gender,
disorder duration, medication use between the both groups. An aerobic
exercise programme was applied to the subject group, the periods of 10
weeks as 3 days in a week. Data were collected by using the Brief
Symptom Inventory, the Scale for the Assessment of Positive Symptoms,
the Scale for the Assessment of Negative Symptoms and to the both
group before and after the exercise programme. After the 10-week
aerobic exercise programmes the subjects in the exercise programme
showed significantly decreases in the Scale for the Assessment of Positive
Symptoms, the Scale for the Assessment of Negative Symptoms and the
Brief Symptom Inventory points and their World Health Organization
Quality of Life Scale-Turkish Version points were increased than controls.
These results suggest that mild to moderate aerobic exercise is an
effective programme for decreasing psychiatric symptoms and for
increasing QOL in patients with schizophrenia.

12                        Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
Jones, Lisa (2008) Promoting Physical Activity in Acute Mental
Health British Journal of Occupational Therapy Volume 71, Issue
11, Pages 499-502
Government initiatives, such as mental health promotion and social
inclusion, have influenced the provision of physical activity to clients on an
inpatient acute mental health unit in north Manchester. The use of
physical activity as an intervention fits well with the Model of Human
Occupation and is particularly relevant to the concepts of volition and
personal causation. This practice analysis discusses the current
interventions taking place in north Manchester and expands on some of
the theory and policy initiatives that influence practice. Suggestions for
improvements in the service are then made based on a critical reflection
of existing practice.

                           Physical Health
Scottish Government (2008) Mental Health in Scotland: Improving
the Physical Health and Well Being of those experiencing Mental

Cooke, David J. et al (2008) Casting Light on Prison Violence in
Scotland: Evaluating the Impact of Situational Risk Factors
Criminal Justice and Behavior Volume 35, Issue 8, Pages 1065-
Violence among prisons and that between prisoners and staff is a
perennial concern for all prison systems. That violent prisoners are only
violent in certain circumstances suggests a need to develop ways to
understand not only the origins of violence in prison but also the
situational contexts in which violence occurs. The technology of risk
assessment has evolved dramatically in the last decade; however, the
focus on individual risk factors has been at the expense of a de-
emphasizing of the role of situational factors. In this article, evidence for
the importance of situational factors in relation to prison violence is
considered. The authors describe the development of a new risk
assessment procedure – promoting risk intervention by situational
management (PRISM). Within the context of the Scottish Prison Service,
they conclude that systematic attention to situational risk factors can help
reduce prison violence.

13                         Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                   110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
                        Professional Issues
Freckelton, Ian (2008) Trends in Regulation of Mental Health
Practitioners Psychiatry, Psychology and Law Volume 15, Issue 3,
Pages 415-434
Regulation of mental health professionals in Australia and New Zealand,
along with the regulation of all health practitioners, is in the process of
substantial transition. With trust as the cornerstone for governance of the
health professionals, the likelihood is a reorientation toward investigations
into “performance” as against “conduct”. However, this poses particular
challenges for assessment of psychiatrists’ and psychologists’
performance. Entitlement to registration is likely to shift conceptually
toward a model involving revalidation and recertification by reference to
ongoing fitness to practise, demonstration of relevant personal attributes,
and maintenance of adequate skills and health. In Australia, national
registration and regulation are on the agenda. Lay participation in
regulation is increasing and community and regulatory tolerance for
exploitative or predatory conduct by mental health professionals is on the
wane. The ambit of regulation is broadening with forensic work by
practitioners already incorporated and signs that the conduct of
unregistered and deregistered practitioners will soon be subject to a formk
of regulatory intervention.

Taylor, Pamela J. et al (2008) Presentations of psychosis with
violence: variations in different jurisdictions. A comparison of
patients with psychosis in the high security hospitals of Scotland
and England Behavioral Sciences and the Law Volume 26, Issue 5,
Pages 585-602
Background International literature is consistent on there being a
significant relationship between psychosis and violence, less so on its
extent and nature, but two main presentational types are increasingly
recognized. In one, people are unremarkable before onset of illness and
psychotic symptoms commonly drive violence; in the other, psychosis is
preceded by childhood conduct problems, associated with personality
disorder, and psychotic symptoms seem less relevant. Aims To explore
the extent to which variations in aspects of social and service context in
different jurisdictions affect presentational type among people admitted to
high security hospitals. Hypotheses There will be differences between
jurisdictions in proportions of patients with pure psychosis or with
psychosis and antecedent personality disorder, but symptom drive to
violence will be more common in the pure psychosis group regardless of
social, legal and service context. Method Independently conducted record
studies were used to compare high security hospital patients with
psychosis in Scotland and England, all resident between 25 August 1992
and 13 August 1993. Results The cohorts were similar in offence histories,
predominance of schizophrenia, age at first hospitalization for psychosis
and first high security hospitalization. More Scottish patients had co-
morbid substance misuse diagnoses and/or personality disorder than
patients in England. Psychotic symptom drive to the index offence was,

14                         Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                   110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
however, four times more likely in the pure psychosis groups, regardless
of sex, ethnic group or country. Scottish patients spent less time in high
security after the index act. Conclusions Our hypotheses were sustained.
Knowledge about lifestyle before onset of psychosis is important for
interpreting literature on how psychotic symptoms relate to violence. This
may also influence longer term outcome, although the shorter length of
secure hospital stay in Scotland was perhaps affected more by greater...

Frueh, B. Christopher et al (2009) Disseminating Evidence-Based
Practices for Adults With PTSD and Severe Mental Illness in
Public-Sector Mental Health Agencies Behavior Modification
Volume 33, Issue 1, Pages 66-81
Posttraumatic stress disorder (PTSD) remains largely untreated among
adults with severe mental illnesses (SMI). The treatment of psychotic
symptoms usually takes precedence in the care of adults with SMI. Such
oversight is problematic in that PTSD in SMI populations is common
(19%-43%), contributes a significant illness burden, and hinders mental
health care. Yet few public-sector mental health agencies routinely
provide specialized services for PTSD. The purpose of the article is to
describe strategies and efforts to disseminate trauma-focused empirically
based practices in a public-sector mental health system. Identified
challenges include limited resources and commitment; knowledge deficits,
attitudes and biases; and limited practice accountability at provider,
facility, and system levels. Proposed strategies for overcoming these
challenges are to set clear goals, nurture broad-based organizational
commitment and key stakeholder involvement, implement speciality
training efforts to provide information and change attitudes, provide
ongoing supervision, conduct fidelity monitoring, and ensure
accountability to the extent possible.

15                        Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
                           Quality of Life
Pitkanen, A. et al (2009) Individual quality of life of people with
severe mental disorders Journal of Psychiatric and Mental Health
Nursing Volume 16, Issue 1, Pages 3-9
People with mental disorders have been found to suffer from impaired
quality of life (QoL). Therefore, the assessment of QoL has become
important in psychiatric research. This explorative study was carried out in
acute psychiatric wards. Thirty-five patients diagnosed with schizophrenia
and related psychosis were interviewed. QoL was rated by the Schedule
for Evaluation of Individual Quality of Life which is a respondent-
generated QoL measure using semi-structured interview technique.
Patients named five areas of life important to them and then rated their
current status and placed relative weight on each QoL area. The data were
analysed with qualitative content analysis and descriptive statistics. The
most frequently named areas for QoL were health, family, leisure
activities, work/study and social relationships, which represented 72% of
all QoL areas named. Patients' average satisfaction with these QoL areas
ranged 49.0–69.1 (scale 0–100). The mean global QoL score was 61.5
(standard deviation 17.4; range 24.6–89.6; scale 0–100). Awareness of
patients' perceptions of their QoL areas can enhance our understanding of
an individual patient's QoL and reveal unsatisfactory areas where QoL
could be improved with individually tailored needs-based interventions.

Laithwaite, Healther; Gumley, Andrew (2007) Sense of Self,
Adaptation and Recovery in Patients with Psychosis in a Forensic
NHS Setting Clinical Psychology and Psychotherapy Volume 14,
Pages 302-316
Qualitative methods have been used to explore users’ recovery from
psychosis. These studies have highlighted the importance of hope and
redefining sense of self as being important aspects of the recovery
process. To date there have been no studies that have collaborated with
users in high-security forensic settings to develop an experiential
perspective of recovery in psychosis. This study used a social
constructionist version of grounded theory to develop an experiential
account of recovery in psychosis. Thirteen individuals who had experience
of psychosis and were residing in a high-security setting were interviewed
in depth about their experiences of recovery. The interviews were
transcribed and analysed using the social constructionist version of
grounded theory. Contrasting accounts of recovery were apparent from
the way in which participants spoke about their experiences. Some
participants gave rich and reflective accounts of their recovery. These
participants spoke about the nature of past experiences and the
importance of those experiences in contextualizing their problems, and
reflected on the implications of this on the tasks of recovery. In contrast,
other participants’ transcripts tended to be short and unelaborated.

16                        Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
Recovery tasks seemed to be segregated from previous experiences and
their reflection on their experience of psychosis seemed minimized.
However, all participants spoke about the importance of developing
relationships with staff and family. The development of relationships
influenced how participants redefined themselves. Implications for clinical
practice and further research are reviewed.

Lloyd, Chris et al (2008) Conceptualising Recovery in Mental
Health Rehabilitation The British Journal of Occupational Therapy
Volume 71, Issue 8, Pages 321-328
Recovery as a concept has gained increased attention in the field of
mental health. There is an expectation that service providers use a
recovery framework in their work. This raises the question of what
recovery means, and how it is conceptualised and operationalised. It is
proposed that service providers approach the application of recovery
principles by considering systematically individual recovery goals in
multiple domains, encompassing clinical recovery, personal recovery,
social recovery and functional recovery. This approach enables
practitioners to focus on service users’ personal recovery goals while
considering parallel goals in the clinical, social and role-functioning
domains. Practitioners can reconceptualise recovery as involving more
than symptom remission, and interventions can be tailored to aspects of
recovery of importance to service users. In order to accomplish this shift,
practitioners will require effective assessments, access to optimal
treatment and care, and the capacity to conduct recovery planning in
collaboration with service users and their families and carers. Mental
health managers can help by fostering an organisational culture of service
provision that supports a broader focus than that on clinical recovery
alone, extending to client-centred recovery planning in multiple recovery

Mancini, Anthony D (2008) Self-determination theory: a
framework for the recovery paradigm Advances in Psychiatric
Treatment Volume 14, Issue 5, Pages 358-365
Recovery is an increasingly important concept in mental health services
research and policy-making. However, despite burgeoning interest in the
concept, no overarching theoretical or empirical framework has been
offered to support its key ideas. Further, it is often unclear how recovery
ideas translate into routine practices of mental health programmes and
practitioners. In this article, a theoretical framework for recovery ideas is
derives from self-determination theory, a widely researched and
empirically validated theory of human need fulfilment. I discuss the
conceptual overlap of self-determination theory and recovery ideas, and,
using key motivational concepts, develop a typology of recovery-oriented
practices for three hypothetical programme types (controlling,
traditional/paternalistic and recovery oriented). I describe existing
measure of recovery-oriented practice and consider the implications of
self-determination theory for measurement of and research on recovery-
oriented practice.

17                         Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                   110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
Tilley, Stephen (2008) National Programme for Improving Mental
Health and Well-Being: Small Research Projects Initiative 2005-
2006: Plotting the Story of Recovery in Edinburgh and Scotland
The study sought to contribute to the development of recovery in Scotland
by plotting, through critical inquiry, the story of recovery in both
Edinburgh and Scotland.

Dunn, Christopher; Seymour, Alison (2008) Forensic Psychiatry
and Vocational Rehabilitation: Where are We at? The British
Journal of Occupational Therapy Volume 71, Issue 10, Pages 448-
Having a productive occupation is seen as fundamental to an individual’s
health and wellbeing. Employment provides structure, self-identity, a
means to provide for oneself and social inclusion. The Government has
made a commitment to invest in supporting people back into the
workplace following illness. This opinion piece reflects the authors’
interest in how this applies to service users with a forensic history, who
face additional barriers to employment. It calls on occupational therapists
to share research and practice accounts of vocational rehabilitation within
forensic settings in order to contribute to the evidence base for this area
of occupational therapy practice.

Woods, Phil; Lasiuk, Gerri C. (2008) Risk prediction: a review of
the literature Journal of Forensic Nursing Volume 4, Issue 1,
Pages 1-10
This review of risk assessment and prediction literature briefly describes
the historical and philosophical influences on the construct of
dangerousness; chronicles the advances in research associated with the
reconceptualization of dangerousness as risk; and describes current
practice and research related to risk assessment, with particular attention
to commonly used risk assessment tools and to existing issues and
controversies. This cannot be considered a systematic review of the
literature but a reflection of some of the key issues found in the literature.

18                         Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                   110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
Swanson, Jeffrey W. et al (2008) Comparison of antipsychotic
medication effects on reducing violence in people with
schizophrenia The British Journal of Psychiatry Volume 193, Issue
1, Pages 37-43
Background: Violence is an uncommon but significant problem associated
with schizophrenia. Aims: To compare antipsychotic medications in
reducing violence among patients with schizophrenia over 6 months,
identify prospective predictors of violence and examine the impact of
medication adherence on reduced violence. Method: Participants
(n=1445) were randomly assigned to double-blinded treatment with one
of five antipsychotic medications. Analyses are presented for the
intention-to-treat sample and for patients completing 6 months on
assigned medication. Results: Violence declined from 16% to 9% in the
retained sample and from 19% to 14% in the intention-to-treat sample.
No difference by medication group was found, except that perphenazine
showed greater violence reduction than quetiapine in the retained sample.
Medication adherence reduced violence, but not in patients with a history
of childhood antisocial conduct. Prospective predictors of violence included
childhood conduct problems, substance use, victimisation, economic
deprivation and living situation. Negative psychotic symptoms predicted
lower violence. Conclusions: Newer antipsychotics did not reduce violence
more than perphenazine. Effective antipsychotics are needed, but may not
reduce violence unrelated to acute psychopathology.

Brown, Christine S.H.; Lloyd, Keith (2008) OPRISK: A structured
checklist assessing security needs for mentally disordered
offenders referred to high security psychiatric hospital Criminal
Behaviour and Mental Health Volume 18, Issue 3, Pages 190-202
More mentally disordered offenders (MDOs) are referred to secure
psychiatric care settings than are accepted for admission. Psychiatrists
working in different care settings may disagree on the appropriate level of
security for MDOs, resulting in treatment delay. A pre-admission
structured assessment of security needs for MDOs may facilitate
agreement and access to care.

19                        Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
Laithwaite, Heather et al (2007) Self-Esteem and Psychosis: A
Pilot Study investigating the Effectiveness of a Self-Esteem
Programme on the Self-Esteem and Positive Symptomatology of
Mentally Disordered Offenders Behavioural and Cognitive
Psychotherapy Volume 35, Pages 569-577
The importance of self-esteem in the development and maintenance of
psychotic experiences has been shown in previous research. However,
there has been little research into the role this plays in individuals with
psychosis and forensic histories. The current study investigated the
effectiveness of a standardized group programme for improving self-
esteem in individuals with psychosis living in high security settings.
Fifteen participants were included in the group programme and measures
were taken to record changes in self-esteem and symptomatology. The
results demonstrated significant improvements in self-esteem over the
course of the group intervention, with some effects maintained at 3-
month follow-up. Improvements in depressed mood were also found.
The results demonstrated the effectiveness of a group intervention for
self-esteem in individuals with psychosis. The findings of this study,
alongside implications for further research, are discussed.

                         Sexual Offenders
Beggs, Sarah M.; Grace, Randolph C. (2008) Psychopathy,
Intelligence, and Recidivism in Child Molesters: Evidence of an
Interaction Effect Criminal Justice and Behavior Volume 35, Issue
6, Pages 683-695
The authors studied the relationships between psychopathy, intelligence
and offending in a sample of treated child molesters (N=216). Regression
analyses showed that psychopathy (as measured by the Psychopathy
Checklist-Revised) was strongly related to both offense history and
recidivism during follow-up. Intelligence (assessed using four-subtest
short forms of the Wechsler Adult Intelligence Scale-Revised and Third
Versions) was not related to offending. However, there was a significant
interaction between intelligence and psychopathy on recidivism: Offenders
with relatively low intelligence and high psychopathy scores were more
than 4 times as likely to have received a sexual reconviction as other
offenders. Results are discussed in terms of implications for risk

Craissati, Jackie et al (2008) The Relationship Between
Developmental Variables, Personality Disorder, and Risk in Sex
Offenders Sexual Abuse: A Journal of Research and Treatment
Volume 20, Issue 2, Pages 119-138
Previous research on the evaluation of the Challenge Project, a community
treatment program for sex offenders in southeast London, identified the
potential role of key developmental variables as enhancing actuarial risk
measures to identify individuals at highest risk for community failure. The
aim of the current study was to assess the relationship between
developmental variable and later personality dysfunction in adulthood,

20                        Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
and the contribution of these factors to assessing risk for sexual
recidivism, in a wider group of sex offenders managed in the community
by the probation service. Over an 8-month period, 241 participants were
assessed, including 162 child molesters and 79 rapists. A wide range of
background data were collected, including the administration of several
psychometric measures. A strong relationship was found between key
developmental variables and adult mental health and personality
difficulties, as well as a range of risk measures. The implications of the
findings for further research are discussed.

Freeman, Naomi J.; Sandler, Jeffrey C. (2008) Female and Male
Sex Offenders: A Comparison of Recidivism Patters and Risk
Factors Journal of Interpersonal Violence Volume 23, Issue 10,
Pages 1394-1413
Few studies have empirically validated the assertion that female and male
sex offenders are vastly different. Therefore, utilising a matched sample
of 780 female and male sex offenders in New York State, the current
study explored differences and similarities of recidivism patters and risk
factors for the two offender groups. Results suggested that male sex
offenders were significantly more likely than female sex offenders to be
rearrested for both sexual and nonsexual offences. However, limited
differences in terms of risk factors between female and male sex offenders
were found.

Grubin, Don (2008) The Use of Medication in the Treatment of Sex
Offenders Prison Service Journal, Issue 178
Treatment for sex offenders typically takes the form of psychological
interventions such as the cognitive-behavioural type approaches used by
the sex offender treatment programmes delivered in British prisons. Its
focus is on assisting offenders to recognise the attitudes and behaviours
that increase their risk of reoffending, as well as helping them to develop
strategies to reduce their risk. However, it should not be forgotten,
although it often is, that sex is also inherent to sex offending - while
emotional and psychological factors contribute to sex offending behaviour,
at its root lies the pressure exerted by sexual drive.

21                        Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
Ireland, Carol A. (2008) Cognitive impairment and sex offending:
management during therapy and factors in offending The British
Journal of Forensic Practice Volume 10, Issue 2, Pages 18-25
This paper will discuss the potential impact of a range of cognitive
impairments when working with sex offenders who present with them. It
will begin by outlining the nature of cognitive impairment and the
research examining the extent of such difficulties in sex offenders. It will
then explore the impact of such impairments when engaging a sex
offender in treatment, including the role that cognitive impairment might
play in the function of their offence. Finally, some methods by which to
manage and compensate for cognitive impairments will be presented.
While the focus of this paper is on sex offenders, the issues presented in
this paper are not exclusive to this group and may be applied to offenders
in general.

Kirkwood, Steve; Richley, Tim (2008) Circles of Support and
Accountability: the case for their use in Scotland to assist in the
community reintegration and risk management of Sexual
Offenders 2008 SCOLAG 236-239
This study was undertaken on behalf of the Scottish Government by the
Scottish Centre for Crime and Justice Research (SCCJR), to investigate the
use of Circles, which use volunteers to support high risk, high needs sex

Lindsay, William R. et al (2008) The Ward and Hudson Pathways
Model of the Sexual Offense Process Applied to Offenders With
Intellectual Disability Sexual Abuse: A Journal of Research and
Treatment Volume 20, Issue 4, Pages 379-392
The offense pathways model of Ward and Hudson has had a significant
impact on work with sex offenders. Researchers have hypothesised that
offenders with intellectual disability (ID) will show a predominantly
avoidance and passive pathway. The present study classified 62 sex
offenders with ID according to the four self-regulation pathways.
Allocation to pathways is highly reliable and, against prediction, most
participants are allocated to approach pathways. Explicit/active offenders
have a higher rate of contact offenses and a lower rate of reoffending.
Automatic/passive offenders have a lower average IQ. There are no
significant differences between groups on victim choice, previous offenses,
or assessment of cognitive distortions. The results suggest that treatment
may improve understanding of society’s laws, promote self-regulation,
and reduce recidivism for explicit/active offenders.

Murphy, William D (2008) Best Practices in Sex Offender
Treatment Prison Service Journal, Issue 178
During the last 30 years, there have been significant advances in our
knowledge about the characteristics of sex offenders, methods for
assessing their risk and treatment needs, and elements of effective
programmes for this population. The purpose of this article is to identify

22                         Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                   110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
current best practices in sex offender treatment and to highlight how
these practices have been implemented in England and Wales.

Pardue, Angela; Arrigo, Bruce A. (2008) Power, Anger and Sadistic
Rapists: Toward a Differentiated Model of Offender Personality
International Journal of Offender Therapy and Comparative
Criminology Volume 52, Issue 4, Pages 378-400
The extant research on rapists repeatedly indicates that particular
offender types can be specified. These include the power, anger, and
sadistic assailants. Despite such classifications, limited empirical or
anecdotal efforts have undertaken the task of exploring the personality
features of each rapist type. This article endeavours to fill this gap in the
literature. Using the heuristic analytical lens and the case study method,
the high-profile crimes of Gilbert Escobedo (power type), Paul Bernardo
(anger type), and Jeffrey Dahmer (sadistic type) are reviewed. As the
article discloses, unique personality features were exhibited. Moreover,
each rapist type displayed a number of convergent as well as divergent
character traits. Given these findings, the article concludes with a series
of summary observations relevant for future research on rape and
personality as well as prospects for clinical diagnosis, treatment, and

                              Smoke Free
Pritchard, Catherine; McNeill, Ann (2008) Are Smoke-free
Buildings and Grounds in Mental Health Units a Realistic
Aspiration? Mental Health Review Journal Volume 13, Issue 4,
Pages 27-32
The study elevated the impact on staff and patient advocates of the
implementation of a smoke-free policy covering buildings and grounds
within a mental health trust. Findings show that early consultation is
central to the ownership of smoke-free policies. The degree of success of
the implementation of the policy was variable and depended on the
availability of tobacco and the type of mental health unit, but the smoke-
free policy provided an opportunity to reduce smoking and hence health
inequalities for people with mental health problems.

Scottish Government (2009) Achieving Smoke-Free Mental Health
Services in Scotland: A Consultation
Consultation on achieving smoke-free mental health services in Scotland.

23                         Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                   110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
                       Suicide Intervention
Griesbach, Dawn et al (2008) The use and impact of Applied
Suicide Intervention Skills Training (ASIST) in Scotland: a
literature review and evaluation
Summary of a report on the evaluation of Applied Suicide Intervention
Skills Training (ASIST) given to professionals, community members,
volunteers and people affected by suicide, with the aim to help people to
become more willing, ready and able to intervene to prevent the
immediate risk of suicide.

Griesbach, Dawn et al (2008) The use and impact of Applied
Suicide Intervention Skills Training (ASIST) in Scotland: An
A report on the evaluation of Applied Suicide Intervention Skills Training
(ASIST) given to professionals, community members, volunteers and
people affected by suicide, with the aim to help people to become more
willing, ready and able to intervene to prevent the immediate risk of

McLean, Joanne et al (2008) Risk and Protective Factors for
Suicide and Suicidal Behaviour: A Literature Review
A systematic international literature review of review-level data on suicide
risk factors and primary evidence of protective factors against suicide.

McLean, Joanne et al (2008) Risk and Protective Factors for
Suicide and Suicidal Behaviour: A Literature Review Research
A summary of systematic international literature review of review-level
data on suicide risk factors and primary evidence of protective factors
against suicide.

Saleem, Younus et al (2008) Forensic telepsychiatry in the United
Kingdom Behavioral Sciences and the Law Volume 26, Issue 3,
Pages 333-344
Forensic telepsychiatry remains in its infancy in the United Kingdom. This
article sets out to describe how it can be used within a community forensic
service, and the future challenges ahead in the United Kingdom. It looks
at relevant academic, governmental, and legal resources and is designed
as a scholarly reflection by clinicians rather than as a formal literature

24                         Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                   110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP
O’Muirithe, Barry; Shankar, Rohit (2008) An audit of the quality of
reports to Mental Health Review Tribunals Medicine, Science and
the Law Volume 48, Issue 3, Pages 221-224
The Mental Health Review Tribunal (MHRT) Rules 1983 place a statutory
responsibility on the Responsible Authority to provide the tribunal with a
formal medical report. Such reports are valuable recovers providing a
systemic and evidence-based viewpoint for detaining an individual under
the Mental Health Act 1983 (MHA). The reports allow the treating team to
present its concerns and subsequent care package to the tribunal, whose
members could be from a non-mental health background. There is
evidence that the majority of the MHRT reports do not satisfactorily meet
the tribunal’s requirements. Recent literature has indicated that the
circulation of structured guidelines has resulted in improved quality of the
reports. The authors undertook an audit cycle to test the above
hypothesis. A preliminary audit ascertained the current practice of MHRT
report-making in Cornwall. The reports were objectively assessed against
“gold standards” of a comparative framework of eighteen criteria laid out
by the Royal College of Psychiatrists. The guidelines were circulated in
the form of a template and a re-audit carried out to ascertain any change
in practice. The subsequent re-audit demonstrated significant
improvements in the quality of reports.

25                        Compiled by Rebecca N. Hart, Librarian, The State Hospital
                                  110 Lampits Road, CARSTAIRS, Lanark, ML11 8RP

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