Do community mental health teams caring for severely mentally ill patients adjust treatments and services based on patients' antisocial or criminal behaviours?

Eur Psychiatry. 2009 Sep;24(6):373-9. doi: 10.1016/j.eurpsy.2009.07.009. Epub 2009 Sep 1.

Abstract

Background: Antisocial behaviour is common among patients with severe mental illness (SMI) requiring hospitalisation.

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

Method: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aggression / psychology
  • Alcoholism / diagnosis
  • Alcoholism / rehabilitation
  • Antisocial Personality Disorder / diagnosis
  • Antisocial Personality Disorder / epidemiology
  • Antisocial Personality Disorder / rehabilitation*
  • Bipolar Disorder / diagnosis
  • Bipolar Disorder / epidemiology
  • Bipolar Disorder / rehabilitation
  • Combined Modality Therapy / statistics & numerical data
  • Commitment of Mentally Ill / legislation & jurisprudence*
  • Commitment of Mentally Ill / statistics & numerical data
  • Community Mental Health Services / legislation & jurisprudence*
  • Community Mental Health Services / statistics & numerical data
  • Crime / legislation & jurisprudence*
  • Cross-Sectional Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Illicit Drugs
  • Male
  • Middle Aged
  • Outcome and Process Assessment, Health Care / statistics & numerical data
  • Patient Care Team / legislation & jurisprudence*
  • Patient Care Team / statistics & numerical data
  • Patient Readmission / legislation & jurisprudence
  • Patient Readmission / statistics & numerical data
  • Psychiatric Status Rating Scales
  • Psychotic Disorders / diagnosis
  • Psychotic Disorders / epidemiology
  • Psychotic Disorders / rehabilitation*
  • Recurrence
  • Schizophrenia / diagnosis
  • Schizophrenia / epidemiology
  • Schizophrenia / rehabilitation*
  • Substance-Related Disorders / diagnosis
  • Substance-Related Disorders / epidemiology
  • Substance-Related Disorders / rehabilitation
  • United Kingdom
  • Utilization Review / statistics & numerical data
  • Violence / legislation & jurisprudence
  • Violence / prevention & control
  • Violence / statistics & numerical data

Substances

  • Illicit Drugs