The impact of a night confinement policy on patients in a high secure inpatient mental health service.

Purpose – From 2012, all high-secure forensic mental health services in England began operating a policy of confining patients to their locked bedrooms overnight to increase service efficiency and reduce costs. The purpose of this paper is to assess the views of staff and patients concerning the policy and examine the specific impact of the policy on patients. Design/methodology/approach – Measures of patients’ sleep hygiene, patients’ behaviour, ward atmosphere, engagement with therapy and adverse incidents were taken both before and after the night confinement (NC) policy was implemented. Both patients and staff also expressed their views of the impact of the NC policy. Findings – Results provide converging evidence that the impact of the NC policy on patients is negligible. There were no consistent negative effects of confining patients overnight. Rather, patients and staff were broadly positive about the impact that the practice had on patients. Practical implications – Confining patients to locked bedrooms overnight does not exert any consistent influence, positive or negative, on patients’ sleep hygiene, behaviour or engagement with therapy, and patients expressed a broadly positive view of the practice of NC. Thus, a NC policy may have a contribution to make to the provision an effective high-secure mental health service. Originality/value – The study provides convincing evidence that secure inpatient mental health services that are considering the adoption of a NC policy may do so without fear of a negative impact on patients

Policing Hate Crime: Exploring the Issue with a Cohort of Sworn Police Officers

Globally, there has been a trend in rising levels of hate crime that scholars have argued is reflective of significant social problems within society. Research into hate crime has typically focused on the police and their subsequent response to this crime type, with many findings reporting that the police are racist, homophobic and Islamophobic, to name but a few. However, existing research seldom captures the insights and experiences of sworn police officers, as much of the data is gathered from third parties. This paper presents the empirical findings from a Delphi study conducted with one police force in Australia, sampling sworn New South Wales (NSW) police officers between October 2020 and October 2021. The findings focus on four overarching areas: defining hate crime, perpetrators of hate crime, victims of hate crime, and responses to hate crime. These themes capture the perspectives of NSW police officers in relation to operational and organisational practice in respect of hate crime. Drawing on a Delphi method, the research outlines police perceptions of the nature of hate crime, as well as capturing how hate crime can be effectively reported, recorded, and responded to. Conclusions and implications are considered. These include the requirement for a clearer definition and targeted education strategies aimed at improving knowledge and understanding relating to hate crime. Future directions include the development of a standardised approach to reporting, recording, and responding to hate crime

Four-jointed knock-out delays renal failure in an ADPKD model with kidney injury

Autosomal Dominant Polycystic Kidney Disease is characterised by the development of fluid-filled cysts in the kidneys which lead to end-stage renal disease (ESRD). In the majority of cases, the disease is caused by a mutation in the Pkd1 gene. In a previous study, we demonstrated that renal injury can accelerate cyst formation in Pkd1 knock-out (KO) mice. In that study, we found that after injury four-jointed (Fjx1), an upstream regulator of planar cell polarity and the Hippo pathway, was aberrantly expressed in Pkd1 KO mice compared to WT. Therefore, we hypothesised a role for Fjx1 in injury/repair and cyst formation. We generated single and double deletion mice for Pkd1 and Fjx1, and we induced toxic renal injury using the nephrotoxic compound 1,2-dichlorovinyl-cysteine. We confirmed that nephrotoxic injury can accelerate cyst formation in Pkd1 mutant mice. This caused Pkd1 KO mice to reach ESRD significantly faster; unexpectedly, double KO mice survived significantly longer. Cyst formation was comparable in both models, but we found significantly less fibrosis and macrophage infiltration in double KO mice. Taken together, these data suggest that Fjx1 disruption protects the cystic kidneys against kidney failure by reducing inflammation and fibrosis. Moreover, we describe, for the first time, an interesting (yet unidentified) mechanism that partially discriminates cyst growth from fibrogenesis. © 2019 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland

Access to non-violent pornography in a secure forensic hospital

The current research explores non-violent pornography within secure hospital settings. It includes a systematic review (n = 40 papers), followed by a qualitative study comprising semi-structured interviews (n = 24, six patients and 18 staff) and staff focus groups (n = 22 staff). The systematic review identified six themes; (1) pornography is inconsistently defined, (2) pornography exposure can increase general aggression, (3) pornography exposure may increase the risk for sexual aggression, (4) pornography exposure can increase aggression supportive beliefs, (5) pornography exposure impacts negatively on those with a violent predisposition, and (6) pornography is educational for men not identifying as heterosexual. The semi-structured interviews and focus groups revealed four themes; (1) staff members hold diverse beliefs about pornographic material, (2) pornography is difficult to obtain and use for patients who do not identify as heterosexual, (3) pornography is used for specific functions, and (4) frequent exposure to pornography can have negative effects for staff members. Implementation of individualised and multi-disciplinary decision-making, continual monitoring of access and consideration of the functions of pornography are argued as beneficial, with suggestions for future research outlined

Psychopathic Processing and Personality Assessment (PAPA): Exploring factor structure

Purpose: The current study explored the structure of the newly developed Psychopathic Processing and Personality Assessment (PAPA) among a non-forensic sample. Design: The primary aim was to assess whether the factor structure of the PAPA could be confirmed in a large community sample (n = 1,850), comprising three subsamples of adult men (n = 189, 248 and 198) and women (n = 499, 469 and 247). It was predicted that the four-factor solution originally proposed in earlier studies (i.e. dissocial tendencies; emotional detachment; disregard for others; lack of sensitivity to emotion) would be replicated; and produce a multi-dimensional structure consistent across sex. Findings: Although exploratory analysis indicated a four-factor solution, the structure was different with ‘lack of sensitivity to emotion’ being replaced by ‘responsiveness to perceived aggression’. Confirmatory analyses supported this structure among women, yet a three-factor structure was preferred for men that excluded emotional detachment. Research implications: The study highlights the importance of attending to sex differences when assessing for psychopathy. Originality: This is the first confirmatory factor analysis completed on the PAPA, with the findings conveying its value when assessing for psychopathic traits among a community sample

Psychopathy and trauma: Exploring a potential association

This research presents a series of linked studies exploring the association between psychopathy and trauma. It comprises a systematic review (n = 58), followed by an expert Delphi (n = 19), and patient file trawl using a male forensic psychiatric patient sample (n = 66). An association between psychopathy and developmental trauma was predicted. It was further predicted that different types of trauma would be associated with different subtypes of psychopathy and that the severity of trauma would be important. The systematic review identified the following core themes: presence of Post-Traumatic Stress Disorder and/or symptoms; trauma type; trauma/abuse variables; and sex differences. The ensuing Delphi study indicated the specific variant of psychopathy to be important, with secondary psychopathy particularly relevant. The final study found that the severity of developmental trauma related differentially to primary and secondary psychopathy. Implications and directions for future research are discussed, most notably with regards to the conceptualisation of psychopathy

Facial emotion recognition and sleep in mentally disordered patients: A natural experiment in a high security hospital

We investigated the relationship between a change in sleep quality and facial emotion recognition accuracy in a group of mentally-disordered inpatients at a secure forensic psychiatric unit. Patients whose sleep improved over time also showed improved facial emotion recognition while patients who showed no sleep improvement showed no change in emotion recognition

Impacting on factors promoting intra-group aggression in secure psychiatric settings

Three preliminary and linked studies investigate the impact of making alterations to factors considered relevant to engaging in and experiencing intra-group aggression (bullying) among adult male patients detained in a single secure forensic hospital. Study one (n = 44) outlines the institutional factors, attitudes towards bullying and environmental factors that increase the likelihood of engaging in bullying and or being victimised. Study two (n = 56 patients and 113 staff) assesses the effect of three variations of intervention that aimed to reduce intra-group aggression through direct alteration of the physical and psychosocial environment, using data from both patients and staff. Study three (n = 414) looks at the effects of two variations of the intervention used in study two, which offered patients’ participation in individual and communal activities. It was predicted that changes to the physical and social environment would produce a reduction in the factors shown to predict intra-group aggression. Attitudes supportive of bullying and the presence of social hierarchies each increased the likelihood of engaging in bullying. Indirect changes to the social environment on the wards had more positive effects than those incorporating direct alterations to the physical and social environment. The differences in effectiveness of the two approaches are discussed in relation to the established predictors of intra-group aggression. The research concludes by noting the preliminary nature of the research and outlining potential directions for future research and interventions

The experience of launching a psychological hotline across 21 countries to support Ukrainians in wartime

The current work and further steps of the psychological hotline launched by the National Psychological Association of Ukraine (NPA) are discussed along with a call for action to mental health professionals worldwide. Design/methodology/approach – This paper describes the training and support of the NPA’s hotline staff as well as reflections on the hotline’s work from June 2022 to April 2023. Findings – With broad international support, the NPA’s psychological hotline currently operates in 21 countries providing psychological assistance and referrals to other service providers within Ukraine and abroad. We propose further steps of its work, including international collaboration. Originality/value – Providing citizens of Ukraine with broad public access to evidence-based remote psychological support through NPA’s hotlines is a high priority considering the war’s negative impact on mental health diverse and the limited capacity of the state mental health system. Keywords: crisis interventions, psychological hotline, psychological first aid, Russian invasion, Russian-Ukrainian war, war-related traum