Predicting time to recall in patients conditionally released from a secure forensic hospital: A survival analysis

Jewell, Amelia; Cocks, Christopher; Cullen, Alexis E.; Fahy, Tom; Dean, Kimberlie

doi:10.1016/j.eurpsy.2017.11.005

Cited by 13 publications

(10 citation statements)

References 25 publications

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“…A literature search of existing research on recall identified only four studies: Riordan et al (2006), O'Sullivan et al (2013), Chiringa et al (2014) and Jewell et al (2018). Findings from these studies have helped to identify the factors that can contribute to the likelihood of FSUs being recalled, including lack of social support, substance misuse and a history of mental health issues prior to the index admission.…”

Section: Introductionmentioning

confidence: 99%

Making sense of being recalled: a grounded theory

Rye

Canvin

Harrison

et al. 2019

JFP

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Purpose A high proportion of forensic mental health service users (FSUs) are recalled to secure hospitals from conditional discharge in the community. The limited research on recall to date has preliminarily identified why FSUs are recalled, but not how they make sense of the process. The purpose of this paper is to develop a conceptual understanding of how FSUs make sense of being recalled to hospital. Design/methodology/approach A constructivist grounded theory approach was used. Semi-structured interviews were carried out with 11 FSUs from different levels of forensic service security who had been recalled varying numbers of times across a wide timeframe. Findings A theoretical model was constructed to illustrate the process of how FSUs make sense of being recalled. FSUs appraise being recalled on a continuum from negative to positive, based on their experiences when conditionally discharged and their reflections on the circumstances of being recalled. The nature of their appraisal appears to reciprocally influence their subsequent attitudes towards and their engagement with forensic services. Research limitations/implications The proposed mechanism of how FSUs make sense of being recalled, particularly their dynamic appraisal of it, should now be investigated longitudinally. Future qualitative research could explore forensic service staff perspectives on recall. Practical implications Enhancing the positivity of FSUs’ appraisals about being recalled may improve their attitudes about and engagement with forensic services. Originality/value This is the first research study to construct a theoretical model of recall.

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Section: Introductionmentioning

confidence: 99%

Making sense of being recalled: a grounded theory

Rye

Canvin

Harrison

et al. 2019

JFP

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“…On the other hand, one can interpret this in favor of the Safe pilot group because even if the matched controls had a potentially more efficient violence prevention measure due to their medication, the Safe pilot-patients were only involved in about 10% of the violent episodes. Other research has found that pharmaceutical treatment has reduced the risk of being returned to a forensic hospital (e.g 21…”

Section: Discussionmentioning

confidence: 99%

<p>Violence after discharge from forensic units in the safe pilot study: a prospective study with matched pair design</p>

Bjørkly¹,

Wærstad²,

Selmer³

et al. 2019

PRBM

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ObjectiveThis paper reports on a prospective naturalistic study of violent recidivism after discharge from forensic mental health. Main aims were to find predictors of violence and to test the feasibility of a matched pair design for this purpose.MethodsPatients from the Safe pilot project (n=18) and a group of controls (n=18) were matched on 10 variables, such as diagnosis, seriousness of violence, setting after discharge, and risk management plans. All the Safe pilot patients had been through repeated measurement of dynamic risk factors of violence the year before discharge to develop efficient risk management plans for use after discharge. We wanted to test whether violent recidivism during follow-up would be lower and less serious in the Safe pilot group.ResultsWe found no significant between-group difference concerning number of patients with violent recidivism. However, the Safe pilot patients had significantly lower rates of violence and fewer severe violent episodes. In the control group, there was a significant association between a high number of risk management plans and high rates of violence. There was a statistical trend for the opposite association in the Safe pilot group.ConclusionWe discuss this in terms of a possible gap between the development and implementation of plans.

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“…Factors associated with a shorter time until recalled were younger age, non-white ethnicity, history of substance abuse, early childhood maladjustment, depot medication, and having been known to mental health services. Remarkably, treatment with clozapine reduced the risk of recall ( Jewell et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Differences Between Readmitted and Non-readmitted Women in an Italian Forensic Unit: A Retrospective Study

Rossetto¹,

Clerici

Franconi³

et al. 2021

Front. Psychol.

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The main objective of this study was to compare readmitted (RW) and non-readmitted (NRW) female psychiatric patients after being conditionally or unconditionally released from Italian inpatient forensic psychiatry services, in order to identify variables that were significantly linked with readmission. This study included all patients who were discharged from the female Residences for the Execution of the Security Measure (REMS) of Castiglione delle Stiviere from January 2008 to June 2015 who were not readmitted until December 31, 2018 (48). In addition, data were collected on female patients who were discharged from the same REMS before 2008 and readmitted from January 2008 to December 2018 (42). A key finding of our study was that the readmission into a female REMS was positively associated with the presence of substance use disorders (SUD) and a primary diagnosis on Axis II. To a lesser extent, younger age, being unconditionally discharged when first released, having had a shorter length of inpatient stay and having committed a crime against property for the first REMS admission was also variables that were apparently linked with readmission. The present research continues the previous research on gender-specific mentally ill offenders. Hence, the decision to proceed separately with a sample of men only and one of women only. For all these reasons, young female patients with personality disorder and SUD perhaps should remain longer in REMS and be released with conditions. In most European countries, the length of stay depends on the clinical condition and risk assessment, with some exceptions where the courts set a maximum length of stay at the outset, as in Italy. All the factors listed above influence the risk assessment. Finally, from integrating these findings into the increasing international literature on conditional release and considering the recent changes in the Italian forensic treatment model, we recommend continuing research on individual risk and protective factors as well as risk assessment instruments on conditionally and unconditionally released inpatients with genders studied separately.

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Predicting time to recall in patients conditionally released from a secure forensic hospital: A survival analysis

Abstract: Time to recall can be predicted by a range of factors that are readily available to clinical teams. Further research is required to determine if targeted interventions can modify the likelihood or time to recall for conditionally released forensic patients.

Cited by 13 publications

References 25 publications

Making sense of being recalled: a grounded theory

Making sense of being recalled: a grounded theory

<p>Violence after discharge from forensic units in the safe pilot study: a prospective study with matched pair design</p>

Differences Between Readmitted and Non-readmitted Women in an Italian Forensic Unit: A Retrospective Study

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