Aims and method Two police liaison and section 136 schemes were developed alongside police services at different sites within the same NHS trust. In one, a mental health nurse worked with frontline police attending incidents related to mental health. The other involved nurses providing advice from the police control room. Section 136 detentions were measured over two 6-month periods (6 months apart) before and after practice change. Data analysed included total numbers of section 136 assessments, outcomes following subsequent assessment, and relevant diagnostic and demographic factors. Association of any change in section 136 total numbers and proportion subsequently admitted was investigated in both sites.Results The model involving a nurse alongside frontline police showed significant reduction in section 136 numbers (38%, P < 0.01) as well as greater admission rates (P = 0.01). The scheme involving support within the police control room did not show any change in section 136 detention but showed a non-significant (P = 0.16) decrease in subsequent admission.Clinical implications Mental health nurses working alongside frontline police officers can help improve section 136 numbers and outcomes.
Abnormal patterns of left STG function cannot be regarded as a trait marker for schizophrenia. Functional abnormalities may reflect aspects of mental state.
Aims: To assess the impact of a changed ward environment upon levels of inpatient arousal and aggression on a National Health Service psychiatric intensive care unit.Method: A retrospective service evaluation comparing seclusion episodes, duration of close observation, recorded aggressive incidents and data from the Nursing Observed Illness Intensity Scale (NOIIS) on a psychiatric intensive care unit for two three-month periods either side of a move from an old, temporary building to a new, purpose-built ward. The ward environments were also objectively assessed and compared using the Environment Assessment Inventory (EAI).Results: A statistically significant reduction in episodes of seclusion, total seclusion hours and aggressive incidents, as well as a reduction in levels of agitation from the NOIIS data on the new ward compared to the old ward. The EAI scores showed important qualitative improvements on the new ward.Conclusions: This study supports the hypothesis that the physical environment of a psychiatric intensive care unit has a significant impact on levels of arousal and aggression. Established measures of ward environment should be applied to the development and improvement of psychiatric wards.
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