Alina Haines

Offending outcomes of a mental health youth diversion pilot scheme in England

BACKGROUND A youth justice diversion scheme designed to enhance health provision for young people with mental health and developmental problems as soon as they enter the youth justice system has been piloted in six areas of England. AIM As part of a wider evaluation of the first youth justice diversion scheme outside the USA, our aim here was to examine re-offending. We sought to test the hypothesis that a specialised service for young people with mental health difficulties would be associated with reductions in re-offending. In addition, we examined factors associated with the re-offending that occurred. METHODS Two hundred and eight young offenders with access to the diversion scheme and 200 without were compared in four geographical area pairings to allow for socio-demographic contextual differences. Officially recorded re-offending was ascertained for 15-30 months after study entry. We also tested characteristics associated with re-offending among everyone entering the diversion scheme (n = 870). RESULTS There was no statistically significant difference in re-offending rates between the diversion and comparison samples, but those with access to diversion had significantly longer periods of desistance from offending than those who did not. In multivariate analysis, the only significant characteristic associated with re-offending was history of previous offending. CONCLUSIONS Prevention of re-offending is only one of the potentially beneficial outcomes of diversion of young people who are vulnerable because of mental health problems, but it is an important one. The advantage of longer survival without prevention of re-offending suggests that future research should explore critical timings for these young people. The equivocal nature of the findings suggests that a randomised controlled trial would be justified.

Persecution or protection? Understanding the differential public response to two road-based surveillance systems

Over the past decade, drivers in the UK have become subject to increasing amounts of surveillance as they go about their daily activities. Both speed cameras and Automatic Number Plate Recognition (ANPR) systems watch over ever-expanding portions of the road network with a view to the identification of motor vehicles being used in an illegal manner, potentially leading to the offending individual being traced and punished and the protection of ‘law-abiding’ road users. Both technologies also generate large volumes of data which could be used to increase the State’s knowledge about our movements. As such, the two systems have many similarities. However, the public reception of the two technologies has shown marked differences. This article combines the findings of two separate research projects, one of which focused on speed cameras and the other on ANPR, but both of which included an exploration of the surveillance experience of UK drivers. The findings suggest that, while both forms of surveillance have their supporters and opponents, the ways in which these positions are justified show some significant difference. It is proposed that this can be explained in terms of differences in the ‘criminal’ nature of the populations who constitute their respective behavioural foci, along with strategies adopted in the marketing of the two systems. Drivers, as a result, occupy a complex role which veers between the dominance of the identities of offender and victim, alternatively protected by and problematized by state surveillance of their activities which increasingly intrudes into their lives.

Care home manager attitudes to balancing risk and autonomy for residents with dementia

ABSTRACT Objective: To determine how care home managers negotiate the conflict between maintaining a safe environment while enabling the autonomy of residents with dementia. This is important because there is limited research with care home managers; yet, they are key agents in the implementation of national policies. Method: Semi-structured interviews were conducted with 18 managers from care homes offering dementia care in the Northwest of England. Data were analysed using a thematic analysis approach. Results: There were three areas in which care home staff reported balancing safety and risk against the individual needs of residents. First, the physical environment created a tension between safety and accessibility to the outside world, which meant that care homes provided highly structured or limited access to outdoor space. Second, care home managers reflected a balancing act between an individuals autonomy and the need to protect their residents’ dignity. Finally, care home managers highlighted the ways in which an individuals needs were framed by the needs of other residents to the extent that on some occasions an individuals needs were subjugated to the needs of the general population of a home. Conclusion: There was a strong, even dominant, ethos of risk management and keeping people safe. Managing individual needs while maintaining a safe care home environment clearly is a constant dynamic interpersonal process of negotiating and balancing competing interests for care home managers.

Assessing Protective Factors for Violence Risk in U.K. General Mental Health Services Using the Structured Assessment of Protective Factors

Violence risk assessment and management are key tasks in mental health services and should be guided by validated instruments covering both risk and protective factors. This article is part of an international effort to validate the Structured Assessment of Protective Factors (SAPROF) for violence. The SAPROF, Historical, Clinical, Risk Management–20 (HCR-20) and the Psychopathy Checklist–Screening Version (PCL-SV) were administered in a sample of 261 patients in U.K. forensic, general inpatient, and community mental health settings. There was significant variation between these groups on SAPROF scores with fewer protective factors in the forensic group. The prospective validity of the SAPROF for nonviolence in the general inpatient and community samples was moderate (area under the curve [AUC] = .60). Adoption of the SAPROF or similar instruments as a supplement to risk-focused assessments has the potential to improve awareness of protective factors and enhance therapeutic engagement in a range of mental health services.

Factors Impacting Perceived Safety Among Staff Working on Mental Health Wards

Background Safety at work is a core issue for mental health staff working on in-patient units. At present, there is a limited theoretical base regarding which factors may affect staff perceptions of safety. Aims This study attempted to identify which factors affect perceived staff safety working on in-patient mental health wards. Method A cross-sectional design was employed across 101 forensic and non-forensic mental health wards, over seven National Health Service trusts nationally. Measures included an online staff survey, Ward Features Checklist and recorded incident data. Data were analysed using categorical principal components analysis and ordinal regression. Results Perceptions of staff safety were increased by ward brightness, higher number of patient beds, lower staff to patient ratios, less dayroom space and more urban views. Conclusions The findings from this study do not represent common-sense assumptions. Results are discussed in the context of the literature and may have implications for current initiatives aimed at managing in-patient violence and aggression. Declaration of interest None. Copyright and usage

Diversion in youth justice: a pilot study of effects on self-reported mental health problems

As part of a larger study to evaluate the effects of a Liaison and Diversion scheme in community youth justice services, staff of newly established Youth Justice Liaison and Diversion (YJLD) teams undertook observational ratings and administered self-report mental health and risk measures to young people referred to this pathway. The overall objectives of the YJLD project were to divert young people from the criminal justice system and to coordinate other services in order to reduce their likelihood of reoffending and the extent of their mental health problems. Data were collected from five local authority areas in different parts of England. Young people thereby referred had an average of 5.4 h of contact with youth justice staff. For a sample of young people on whom data were available at the beginning and end of that process, there was evidence of a significant reduction in problems and a small but significant correlation between the amount of individual contact time with YJLD staff and the extent of change observed. Absence of a comparison sample limits the drawing of firm conclusions; however, recommendations are made for future controlled experimental studies.