The characteristics and needs of older forensic psychiatric patients: a cross-sectional study in secure units within one UK regional service

Lorito, Claudio Di; Völlm, Birgit; Dening, Tom

doi:10.1080/14789949.2019.1659390

Cited by 17 publications

(36 citation statements)

References 26 publications

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“…First, we suggest that researchers should be explicit in describing how their sample relates to the overall population it represents, including reports of inclusion and exclusion criteria, proportion of eligible participants who agreed to participate, and the attrition rate. Such reporting would enable the reader to better gauge the risk for bias in the sample [see (44,45), for examples of clear reporting].…”

Section: Suggestions For Improved Reporting Practicesmentioning

confidence: 99%

Perspectives on Recruitment and Representativeness in Forensic Psychiatric Research

et al. 2021

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Participant representativeness and statistical power are crucial elements of robust research with human participants, both of which relate to the successful recruitment of research participants. Nevertheless, such core features may often not be fully reported or duly considered in psychiatric research. Building on our experiences of collecting data in the context of forensic mental health services, we discuss issues regarding participant recruitment and representativeness in our field with its particular characteristics. A quick sampling and brief overview of the literature in four specialized forensic mental health journals is presented, demonstrating that published manuscripts rarely describe the data in sufficient detail for the reader to assess sample representativeness and statistical power. This lack of transparency leads not only to difficulties in interpreting the research; it also entails risks relating to the already meager evidence base of forensic mental health services being relevant only to a subset of patients. Accordingly, we provide suggestions for increased transparency in reporting and improved recruitment of research participants. We also discuss the balance of ethical considerations pertinent to the pursuit of increased participation rates in forensic mental health research.

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Section: Suggestions For Improved Reporting Practicesmentioning

confidence: 99%

Perspectives on Recruitment and Representativeness in Forensic Psychiatric Research

et al. 2021

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“…(i) Systematic reviews and empirical studies around older forensic populations (Di Lorito, Dening, & Völlm, 2018;Di Lorito, Vӧllm, & Dening, 2018;Di Lorito, Castelletti, Tripi, Gandellini, Dening, & Völlm, 2017).…”

Section: Data Collectionmentioning

confidence: 99%

Ageing in forensic psychiatric secure settings: the voice of older patients

Lorito

Dening

Völlm

2018

The Journal of Forensic Psychiatry & Psychology

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Older patients account for around 20% of the population in secure forensic psychiatric services in the UK. However, little qualitative research has investigated the experience of ageing in secure settings. This study aimed to gather the individual views of a sample of patients over 50 years old in the UK at different levels of security. Fifteen participants were selected and underwent one-on-one qualitative interviews. The interviews were analysed through thematic analysis, which generated seven themes: Self-agency, activities, social life, practical matters, recovery, physical health and service improvement. Study findings highlighted the complexity of ageing in secure settings. Despite the positive feedback reported in aspects such as physical health care, education opportunities, staff and support of religious practices, participants experienced added barriers to recovery, caused by social isolation/withdrawal and activities/treatment that did not respond to their complex age-related needs, generating poor motivation to engage. Our findings call for the development/implementation of programmes tailored to the unique needs of older patients. This process requires an active involvement of the primary stakeholders and further patientcentred research.

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“…Forensic mental healthcare patients aged 50 and over constitute about 20% of the UK forensic mental healthcare inpatient population (Di Lorito et al, 2019;Di Lorito et al, 2018b). This proportion is likely to increase as the population ages (World Health Organization, 2017); indeed, the number of forensic inpatients over 65 in Scotland increased by 50% and those aged 56-65 by 27% between 2013(Scottish Government, 2021.…”

Section: Introductionmentioning

confidence: 99%

“…Older patients are more likely to be diagnosed with depression, organic brain syndrome, or delusional disorder (Coid et al, 2002). Disabling health issues are more prevalent in older patients; these include cognitive decline, mobility problems and sensory impairment (Di Lorito et al, 2019). The number of medications given to older patients has been found to double throughout placement in secure hospitals, highlighting a decline in health (Lightbody et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life

et al. 2022

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Background: Older individuals (e.g., 55 years and over) constitute a growing proportion of the forensic mental health patient population. As a group, they are vulnerable to health outcomes similar to other individuals with serious mental disorders of the same age; however, these concerns can be compounded by complex forensic-related care backgrounds and clinical presentations, lengthy periods of time spent in prison or psychiatric hospitals, substance use histories, and crime perpetration or victimisation. The healthcare needs and strengths of this group are not well understood. The aim of this study was to identify and describe the demographic, physical health, mental wellbeing, cognitive ability, and quality of life profiles of older forensic patients in community, low, medium, and high security settings in England. Methods: A cross-sectional mixed-methods study design was used. N=37 forensic patients aged 55 years and over were interviewed and completed questionnaires. Data were also collected from patient records. Results: Most patients were male and were diagnosed with psychosis. The most frequently committed index offence types were violent offences. Patients were prescribed 7.6 medications on average and had average anticholinergic effect on cognition scores of 2.4. Nearly half the sample had diabetes, with an average BMI score of 31.7 (indicating obesity). Possible cognitive impairment was identified in 65% of the sample. Patients’ assessments of their recovery-related quality of life and mental wellbeing did not differ from published UK general population values. Assessments of quality of life were positively correlated with the ability to undertake everyday activities and cognitive performance. Conclusions: We suggest that forensic services are well-placed to provide holistic mental and physical care to this group but that they should co-develop with patients a greater range of age-appropriate meaningful activities that are mindful of mobility issues and consider implementing more cognition-based and physical health interventions.

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The characteristics and needs of older forensic psychiatric patients: a cross-sectional study in secure units within one UK regional service

Cited by 17 publications

References 26 publications

Perspectives on Recruitment and Representativeness in Forensic Psychiatric Research

Perspectives on Recruitment and Representativeness in Forensic Psychiatric Research

Ageing in forensic psychiatric secure settings: the voice of older patients

Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life

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