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Psychiatric patients at greatest risk and in greatest need: impact of the supervision register policy

By Jonathan Bindman, Andrew Beck, Graham Thornicroft, Martin Knapp and George Szmukler


Background: Mental health provider trusts in England were required in 1994 to establish local Supervision Registers of patients at risk. Aims: To identify the factors associated with registration, and obtain clinicians' views on its effectiveness. Method: At a random sample of 14 trusts data were collected from case notes, keyworkers and responsible medical officers. Results: A sample of 133 registered patients were more disabled and had more extensive histories of violence and self-harm than 126 comparison patients on the upper tier of the Care Programme Approach (CPA). Those registered were a heterogeneous group. For some there was little evidence of risk. In most cases clinicians did not believe registration had improved care. Conclusions: The Supervision Register policy has not resulted in the identification of a well-defined group. Its effectiveness is limited by the lack of operationalised measures of risk

Topics: HV Social pathology. Social and public welfare. Criminology, RA Public aspects of medicine
Publisher: Royal College of Psychiatrists
Year: 2000
DOI identifier: 10.1192/bjp.177.1.33
OAI identifier:
Provided by: LSE Research Online
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