Needs and risks of patients in a state-wide inpatient forensic mental health population

Authors

  • Ariel Segal,

    1. School of Psychology, Psychiatry & Psychological Medicine, Monash University, and
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  • Michael Daffern,

    Corresponding author
    1. School of Psychology, Psychiatry & Psychological Medicine, Monash University, and
    2. Victorian Institute of Forensic Mental Health, Melbourne, Victoria, Australia; and
    3. Division of Psychiatry, School of Community Health Sciences, The University of Nottingham, and
    4. Peaks Academic and Research Unit, Nottinghamshire Healthcare NHS Trust, Nottingham, UK
      Michael Daffern, Centre for Forensic Behavioural Science, 505 Hoddle Street, Clifton Hill, VIC, 3068, Australia. Email: michael.daffern@med.monash.edu.au
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  • Stuart Thomas,

    1. School of Psychology, Psychiatry & Psychological Medicine, Monash University, and
    2. Victorian Institute of Forensic Mental Health, Melbourne, Victoria, Australia; and
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  • Murray Ferguson

    1. School of Psychology, Psychiatry & Psychological Medicine, Monash University, and
    2. Victorian Institute of Forensic Mental Health, Melbourne, Victoria, Australia; and
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  • Ariel Segal, BA.

  • Michael Daffern, PhD.

  • Stuart Thomas, PhD.

  • Murray Ferguson, BSc.

Michael Daffern, Centre for Forensic Behavioural Science, 505 Hoddle Street, Clifton Hill, VIC, 3068, Australia. Email: michael.daffern@med.monash.edu.au

ABSTRACT

Routine needs assessments have become mandated requirements for public mental health services. However, the appropriateness of these generic health needs assessments to specialist populations remains questionable. This study sought to assess individual needs assessed using a widely used clinician rated assessment (Health of the Nation Outcome Scales-Secure; HoNOS-Secure), a subjective needs assessment that considers both staff and patient perspectives (Camberwell Assessment of Need-Forensic version; CANFOR), and a measure of risk for general criminal recidivism (Level of Service Inventory: Screening Version; LSI:SV) in a secure forensic mental health service. Results revealed significant positive correlations between staff ratings on HoNOS-Secure, CANFOR total needs, and CANFOR met needs scores, but no significant association between CANFOR ratings or HoNOS-Secure ratings and LSI:SV scores. Although patients and staff reported the same number of needs overall according to CANFOR (7.2 vs. 7.5, P > 0.05), patients reported that more of these needs were unmet (3.1 vs. 2.3, P < 0.05). Differences between staff and patient ratings of need suggest that needs assessments should include patient perspectives to facilitate more collaborative and comprehensive care planning. Divergent perspectives between patients and staff may impair patient engagement in treatment and therefore negatively impact on outcome. Service planning issues and opportunities for future research are discussed.

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