National Confidential Inquiry into Suicide and Homicide by People with Mental Illness

Appleby, Louis; Shaw, Jenny; Amos, Tim

doi:10.1192/bjp.170.2.101

Cited by 174 publications

(207 citation statements)

References 3 publications

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“…Those with only historical psychotic symptoms carry a much lower risk of violence. Furthermore, among the population with mental illness as a whole, by far the majority appear to pose little or no risk of violence at all (Appleby et al, 2006). A rational response would therefore involve the distribution of resources on the basis of overall need, rather than on the primary basis of risk (Szmukler, 2001).…”

Section: The Inexorable Rise Of 'Risk'mentioning

confidence: 99%

Forensic psychiatry and general psychiatry: re-examining the relationship

Turner¹,

Salter²

2008

Psychiatr. bull.

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Something is going wrong with forensic psychiatry, as a concept and as a service. Beds in medium secure units are logjammed, and relations with general adult services increasingly fraught with disputes over resources and responsibilities. Despite a remarkable investment in buildings, and the 300% growth of the forensic specialty (Goldberg, 2006), offending behaviour by individuals with mental illness shows no sign of decline, either in terms of prison numbers (at record high levels in the UK) or the countless demands for risk assessment (Duggan, 1997; Moon, 2000).

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Section: The Inexorable Rise Of 'Risk'mentioning

confidence: 99%

Forensic psychiatry and general psychiatry: re-examining the relationship

Turner¹,

Salter²

2008

Psychiatr. bull.

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show abstract

“…4,10 Information on all general population suicides and deaths from undetermined external causes is obtained from the Office for National Statistics. Mental health services identify those people in contact with services in the 12 months before death.…”

Section: Collection Of Suicide Data From Mental Health Servicesmentioning

confidence: 99%

“…Mental health services rate only a small minority of individuals (approximately 10%) who have died by suicide as at high immediate risk at last contact. 10 Maximising the time horizon in this study meant that a greater number of potentially high risk individuals were included. We also thought that these more inclusive criteria were more comparable with the GPs ratings (which had no time cut off).…”

Section: Ratings Of Riskmentioning

confidence: 99%

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Assessment and Management of Suicide Risk in Primary Care

Saini

While

Chantler

et al. 2014

Crisis

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Background: Risk assessment and management of suicidal patients is emphasized as a key component of care in specialist mental health services, but these issues are relatively unexplored in primary care services. Aims: To examine risk assessment and management in primary and secondary care in a clinical sample of individuals who were in contact with mental health services and died by suicide. Method: Data collection from clinical proformas, case records, and semistructured face-to-face interviews with general practitioners. Results: Primary and secondary care data were available for 198 of the 336 cases (59%). The overall agreement in the rating of risk between services was poor (overall κ = .127, p = .10). Depression, care setting (after discharge), suicidal ideation at last contact, and a history of self-harm were associated with a rating of higher risk. Suicide prevention policies were available in 25% of primary care practices, and 33% of staff received training in suicide risk assessments. Conclusion: Risk is difficult to predict, but the variation in risk assessment between professional groups may reflect poor communication. Further research is required to understand this. There appears to be a relative lack of suicide risk assessment training in primary care.

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“…This needs to be embedded in all local policy initiatives and priorities and into the philosophy of care within the local workforce. Risk assessment should be based on understanding of individual circumstances and intent, utilising a narrative approach, not through use of actuarial risk-assessment checklists (RCPsych, 2010;NICE, 2004NICE, & 2011Appleby et al, 2012).…”

Section: Synthesis Of Evidence To Inform the Resource Contentmentioning

confidence: 99%

Enabling practitioners working with young people who self-harm

Foster

Birch²,

Allen

et al. 2015

The Journal of Mental Health Training, Education and Practice

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Purpose: This paper outlines a UnitedKingdom based interdisciplinary workforce development project that had the aim of improving service delivery for children and young people who self-harm or are feeling suicidal.Approach: This innovative practice-higher-education partnershiputilised an iterative consultation process to establish the local workforce need and then facilitated the systematic synthesis and presentation of evidence-based clinical guidelines in a practical format, for staff working directly with young people who self-harm in nonmental health settings.Outcomes: The development, content and structure of this contextualised resourceis presented, along with emerging outcomes and learning from the team.It is anticipated that this may also be a useful strategy and resource for other teams in other areas and is intended to provide a template that can be adapted by other localities to meet the specific needs of their own workforce.Practical Implications: The paper demonstrates how higher education-practice partnershipscan make clinical guidelines and research evidence in a field often thought of as highly specialist,accessible to all staff. It also shows a process of liaison and enhanced understanding across universal/specialist mental health service thresholds. Originality/Value: This paperdemonstrates how collaborative partnerships can work to bridge the gap between evidence-based guidelinesand their implementation in practice, through innovative multi-agency initiatives.

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National Confidential Inquiry into Suicide and Homicide by People with Mental Illness

Cited by 174 publications

References 3 publications

Forensic psychiatry and general psychiatry: re-examining the relationship

Forensic psychiatry and general psychiatry: re-examining the relationship

Assessment and Management of Suicide Risk in Primary Care

Enabling practitioners working with young people who self-harm

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