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Early findings from a national study of discharges from 32 National
Health Service medium secure units revealed that nearly twice as many
patients than expected were discharged back to prison.
To compare the characteristics of those discharged back to prison with
those discharged to the community, and consider the implications for
ongoing care and risk.
Prospective cohort follow-up design. All forensic patients discharged
from 32 medium secure units across England and Wales over a 12-month
period were identified. Those discharged to prison were compared with
those who were discharged to the community.
Nearly half of the individuals discharged to prison were diagnosed with a
serious mental illness and over a third with schizophrenia. They were a
higher risk, more likely to have a personality disorder, more symptomatic
and less motivated than those discharged to the community.
Findings suggest that alternative models of prison mental healthcare
should be considered to reduce risks to the patient and the public.
Relatives of people with psychosis experience high levels of distress and require support. Family interventions have been shown to be effective in improving outcomes but are difficult to access and not suitable for all relatives.
To assess the feasibility and effectiveness of a supported self-management package for relatives of people with recent-onset psychosis.
A randomised controlled trial (n = 103) comparing treatment as usual (TAU) in early intervention services with TAU plus the Relatives' Education And Coping Toolkit (REACT) intervention (trial identifier: ISRCTN69299093).
Compared with TAU only, those receiving the additional REACT intervention showed reduced distress and increased perceived support and perceived ability to cope at 6-month follow-up.
The toolkit is a feasible and potentially effective intervention to improve outcomes for relatives. A larger trial is needed to reliably assess the clinical and cost-effectiveness of REACT, and its impact on longer-term outcomes.
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