Differential predictive validity of the Historical, Clinical and Risk Management Scales (HCR-20) for inpatient aggression.

The Historical, Clinical and Risk Management Scales (HCR-20) may be a better predictor of inpatient aggression for selected demographic and clinical groups but homogeneity of study samples has prevented definitive conclusions. The aim of this study, therefore, was to test the predictive validity of the HCR-20 as a function of gender, diagnosis, age, and ethnicity while controlling for potential covariates. A pseudo-prospective cohort study (n=505) was conducted in a UK secure/forensic mental health setting using routinely collected data.

Predictive validity of the HCR-20 for inpatient self-harm.

Background: Few instruments have been developed to assess the risk of self-harm by psychiatric patients and the evidence for their predictive validity is limited. Given that individuals who self-harm may also engage in other-directed aggression, and that the behaviour can be a precursor to violence, we tested whether, and for which groups, the commonly used violence risk assessment HCR-20 demonstrated predictive validity for self-harm.

Procedures: A pseudo-prospective cohort study (N=504) was conducted in a UK secure/forensic mental health setting using routinely collected data.

Off-licence prescribing and regulation in psychiatry: current challenges require a new model of governance.

The growing worldwide use of pharmaceuticals is managed in some countries by a regulatory system which sharply divides legal use into licensed and unlicensed categories. We examine how for the range of psychotropics this simultaneously restricts the possible benefits to patients, prescribers and producers in some domains, while failing to manage the risks in others. A more flexible system, which shares at an earlier stage experience and evidence on benefits and risks in patients, previously marginalized on the grounds of age, diagnosis or comorbidity, would aid the development of safer, more effective 'real-world prescribing'.

Governance, choice and the global market for mental health.

The provision of health services to vulnerable members of the population should be regarded as one of the prime duties of government. However, it will be apparent to any reader of that access to effective mental healthcare varies widely across the world, an impression powerfully reinforced for those who have the chance to visit and work in countries facing different developmental challenges. On World Mental Health Day 2010, the Secretary-General of the United Nations called for this shortfall to be remedied (United Nations, 2010).

Patients' complaints at a large psychiatric hospital: can they lead to better patient services?

Purpose: Little is known about complaints made by psychiatric patients. The aim of this study is to analyse complaints made by, or behalf of, inpatients at a large independent psychiatric hospital.

Design/methodology/approach: The hospital's complaints register was used to identify and study complaints made during 2006.

Characteristics of low IQ arsonists at psychiatric assessment.

We conducted a retrospective study of arsonists referred for psychiatric assessment and found that 88/202 (43.6%) had an IQ of 85 or below. The low IQ group showed more evidence of childhood temperamental disturbance, and a later pattern of internal problems rather than external factors expressing themselves as fire-setting.

Interpretation and knowledge of human rights in mental health practice.

The Human Rights Act is sometimes misunderstood as being an obstruction to the provision of safe and effective mental health care, allowing patients to cry 'human rights abuse' too easily. In reality, however, little is known about how human rights are protected and promoted in psychiatric care. This article provides an overview, for nurses, of how human rights are currently understood to be protected in mental health care and steps that could improve the protection of rights.

Gender differences amongst adult arsonists at psychiatric assessment.

Reports of gender differences amongst arsonists at psychiatric assessment are not uncommon, however some are based on relatively small samples. A new retrospective study highlighting gender differences could help to confirm or refute the current state of knowledge. The aim of the current study was to examine gender differences amongst a sample of 167 adult arsonists (129 males and 38 females).