Do community mental health teams caring for severely mentally ill patients adjust treatments and services based on patients' antisocial or criminal behaviours?
BACKGROUND
Antisocial behaviour is common among patients with severe mental illness (SMI) requiring hospitalisation.


OBJECTIVE
To determine whether differential treatments and services are provided to patients with SMI who engage in antisocial behaviour.


METHODS
A random sample of 161 inpatients with SMI were recruited from general adult wards and assessed at baseline and two years later. Information on symptoms, aggressive behaviour, substance misuse, and service use was obtained from patients and clinical files.


RESULTS
Past antisocial behaviours were not associated with type or intensity of treatments and services. Severity of positive symptoms, aggressive behaviour, and illicit drug use were positively associated with the frequency of CMHT contact, but not with the type of CMHT, type of medication, or other treatments and benefits.


CONCLUSIONS
While the frequency of meetings with CMHTs increased with the severity of antisocial behaviours, no specific treatments were provided to patients with SMI engaging in antisocial behaviours.
Hodgins
S
S
Department of Forensic Mental Health Science, Institute of Psychiatry, King's College London, Box PO 23 De Crespigny Park, Denmark Hill, London SE5 8AF, UK. s.hodgins@kcl.ac.uk
Cree
A
A
Khalid
F
F
Patel
K
K
Sainz-Fuertes
R
R
Sainz-Fuentes
R
R
Shortt
M
M
Mak
T
T
Riaz
M
M
D000328:Adult; D000374:Aggression / Q000523:psychology; D000437:Alcoholism / Q000175:diagnosis / Q000534:rehabilitation; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D001714:Bipolar Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D003156:Community Mental Health Services / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D003415:Crime / Q000331:legislation & jurisprudence*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care / Q000706:statistics & numerical data; D010348:Patient Care Team / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D012008:Recurrence; D012559:Schizophrenia / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D006113:United Kingdom; D014600:Utilization Review / Q000706:statistics & numerical data; D014754:Violence / Q000331:legislation & jurisprudence / Q000517:prevention & control / Q000706:statistics & numerical data
D013287:Illicit Drugs