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Tong K, Smith D, Mohan C, Hickey P, Taylor E, McLoughlin L, Kennedy HG, O'Neill C. Psychiatric court reports and diversion outcomes in a remand prison over three years. Ir J Psychol Med 2021:1-11. [PMID: 34629124 DOI: 10.1017/ipm.2021.64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES There has been a notable increase in requests for psychiatric reports from District Courts for persons remanded to Ireland's main remand prison, Cloverhill. We aimed to identify if reports were prepared for persons with severe mental illness and if they led to therapeutic benefits such as diversion to healthcare. Measures of equitability between Cloverhill and other District Courts were explored. METHODS For District Court-requested reports completed by the Prison Inreach and Court Liaison Service (PICLS) at Cloverhill Prison from 2015 to 2017, we recorded clinical variables and therapeutic outcomes such as diversion to inpatient psychiatric settings. RESULTS Of 236 cases, over half were diverted to inpatient or outpatient psychiatric care. One-third of remand episodes were admitted to a psychiatric hospital, mainly in non-forensic settings. Nearly two-thirds had major mental illness, mainly schizophrenia and related conditions. Almost half had active psychosis. Cases in Cloverhill District Court and other District Courts were similarly likely to have active psychosis (47% overall) and hospital admission (33% overall). Voluntary reports were more likely to identify active psychosis, with over 90% diverted to inpatient or outpatient community treatment settings. CONCLUSIONS This is the first large scale study of diversion outcomes following requests for psychiatric advice from District Courts in Ireland. Requests were mainly appropriate. Over half led to diversion from the criminal justice system to healthcare settings. There is a need for a complementary network of diversion initiatives at every stage of the criminal justice system to effectively divert mentally ill individuals to appropriate settings at the earliest possible stage.
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Affiliation(s)
- Kezanne Tong
- Senior Registrar, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Prison Inreach and Court Liaison Service, Cloverhill Prison, Dublin, Ireland
| | - Damian Smith
- Consultant Forensic Psychiatrist, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Prison Inreach and Court Liaison Service, Cloverhill Prison, Dublin, Ireland
| | - Christopher Mohan
- Registrar, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
| | - Philip Hickey
- Forensic Community Mental Health Nurse, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Prison Inreach and Court Liaison Service, Cloverhill Prison, Dublin, Ireland
| | - Enda Taylor
- Forensic Community Mental Health Nurse, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Prison Inreach and Court Liaison Service, Cloverhill Prison, Dublin, Ireland
| | - Lisa McLoughlin
- Consultant Forensic Psychiatrist, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
| | - Harry G Kennedy
- Consultant Forensic Psychiatrist and Executive Clinical Director, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Clinical Professor in Forensic Psychiatry, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Conor O'Neill
- Consultant Forensic Psychiatrist, National Forensic Mental Health Service, Central Mental Hospital, Dundrum, Dublin, Ireland
- Clinical Senior Lecturer, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
- Prison Inreach and Court Liaison Service, Cloverhill Prison, Dublin, Ireland
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Homelessness amongst psychiatric Inpatients: a cross-sectional study in the mid-west of Ireland. Ir J Med Sci 2021; 191:321-326. [PMID: 33590473 DOI: 10.1007/s11845-021-02546-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/04/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND This cross-sectional study sought to establish the prevalence of homelessness amongst inpatients in two psychiatric units in Ireland and explore the perceived relationship between psychiatric illness and homelessness. METHODS The study employed a semi-structured interview format utilising a specifically designed questionnaire which received ethical approval from the Limerick University Hospitals Group ethics committee. RESULTS Fifty psychiatric inpatients were interviewed. Fifteen were either "currently" homeless (n = 8) or had experienced "past" homelessness (n = 7). Those who had experienced homelessness were more likely to have a psychotic illness. A majority of those who had experienced homelessness believed that psychiatric illness contributed to their homelessness. Involuntary admission rates were more than double for patients in the homeless group. A number of participants also reported that a lack of accommodation was preventing their discharge. CONCLUSION Homelessness affects a significant number of psychiatric patients and can be both a contributory factor to, and consequence of, mental illness. With homelessness at unprecedented levels, there is a need for the development of tailored programmes aimed at supporting these vulnerable groups.
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