Stuart Thomas - Academia.edu (original) (raw)

Papers by Stuart Thomas

Psychiatry, Psychology and Law, 2016

While the high prevalence of offending and victimisation among young people is well established, ... more While the high prevalence of offending and victimisation among young people is well established, no study to date has compared official crime records of young people with mental illness with those without mental illness. This case linkage study sought to determine whether young people with a formal history of mental illness were more likely to have official histories of offending and victimisation than young people who had no recorded histories of mental illness. Results suggested that young people with a history of mental illness are particularly vulnerable to violence. While a weak association was established between violent offending and mental illness, a stronger relationship was found between victimisation and mental illness, especially violent victimisation. Consistent with literature regarding the victimÀoffender overlap, a history of offending placed young people at a substantially higher risk of victimisation. Implications of these results are discussed in the context of how public mental health services could better protect these vulnerable young people.

Medical Journal of Australia, 2010

hild sexual abuse (CSA) is common, and evidence suggests that 5%-10% of boys and girls experience... more hild sexual abuse (CSA) is common, and evidence suggests that 5%-10% of boys and girls experience severe abuse involving sexual penetration. 1 CSA is associated with an array of deleterious outcomes, including problems related to mental health, interpersonal functioning and substance use. 1-3 Studies of community samples have consistently shown a substantial association between reports of CSA and suicide attempts and other self-destructive behaviour in young people 4-8 and adults. 1-3,9-14 A major shortcoming of such studies is the reliance on self-report during adulthood of abuse that occurred during childhood, often using samples of individuals who have attempted suicide. To our knowledge, two prospective studies of CSA and self-destructive behaviour have been published to date, but these have yielded inconsistent findings. In one study, the sample size was small (183 CSA cases); 15 in the other, data on CSA victims were combined with those for victims of other forms of child abuse. 16 Neither study controlled for psychopathological conditions or followed patients into the peak ages for suicide. The aim of our study was to investigate the rate and risk of suicide and accidental fatal drug overdose in more than 2000 individuals-up to 44 years after experiencing CSA-and to examine other characteristics among CSA victims who die from self-harm. METHODS Child sexual abuse population

BMC psychiatry, Feb 7, 2018

Routine outcome measures are increasingly being mandated across mental health services in Austral... more Routine outcome measures are increasingly being mandated across mental health services in Australia and overseas. This requirement includes forensic mental health services, but their utility in such specialist services and the inter-relationships between the measures remain unclear. This study sought to characterise the risks, needs and stages of recovery of an entire cohort of forensic patients in one jurisdiction in Australia. Local expert groups, comprising of members of the forensic patient treating teams, were formed to gather information about the status and needs of all forensic patients in the State of New South Wales, Australia. The expert groups provided demographic information and completed three assessment tools concerning the risks, needs and stages of recovery of each forensic patient. The cohort of 327 forensic patients in NSW appears to be typical of forensic mental health service populations internationally when considering factors such as gender, diagnosis, and ind...

BMC psychiatry, May 28, 2016

Studies have suggested that people with intellectual disability are disproportionately involved i... more Studies have suggested that people with intellectual disability are disproportionately involved in crime both as perpetrators and victims. A case linkage design used three Australian contact-level databases, from disability services, public mental health services and police records. Rates of contact, and official records of victimisation and criminal charges were compared to those in a community sample without intellectual disability. Although people with intellectual disability were significantly less likely to have an official record of victimisation and offending overall, their rates of violent and sexual victimisation and offending were significantly higher. The presence of comorbid mental illness considerably increased the likelihood of victimisation and offending; several sex differences were also noted. People with intellectual disability are at increased risk for both violent and sexual victimisation and offending. The presence of comorbid mental illness aggravates the risk ...

The Journal of Forensic Psychiatry & Psychology, 2014

Appetitive violence is a form of proactive violence; its purpose is to generate or maintain a pos... more Appetitive violence is a form of proactive violence; its purpose is to generate or maintain a positive emotional state and possibly, to strengthen social bonds. Portrayals of an increasing frequency of youth acts of appetitive violence have contributed to a perception that aggressive delinquents are callous and predatory. However, the characteristics of youth who have engaged in appetitive violence and the nature of their violent behaviour have not yet been elucidated. This study compared demographic and psychological characteristics of 143 young violent offenders according to whether or not they had a history of appetitive violence. It was hypothesised that youth with a history of appetitive violence would score higher on a measure of psychopathy and that their violence would be perpetrated within the context of a group assault. Results revealed that acts of appetitive violence were perpetrated exclusively by males and were more likely to occur when co-offenders were present. Psychopathy did not differentiate youth whose index offence was appetitive from those whose violent index offence was not. These results suggest that appetitive violence perpetrated by young offenders is the product of social factors rather than individual psychopathology.

Epidemiology and psychiatric sciences, Jan 13, 2014

Background. The Camberwell Assessment of Need - Forensic Version (CANFOR) is a standardised asses... more Background. The Camberwell Assessment of Need - Forensic Version (CANFOR) is a standardised assessment tool specifically designed to assess needs for care in forensic psychiatric populations. The original English version of the instrument has shown good psychometric properties. The aim of this study was to validate the Italian version of the CANFOR-staff tool. Method. After translation and back-translation, the Italian CANFOR tool was administered to a sample of 50 forensic psychiatric patients. Convergent validity was tested using the Brief Psychiatric Rating Scale (BPRS) and the Global Assessment of Functioning (GAF) by applying Kendall's tau-b. Inter-rater and test-retest reliabilities were measured by ICCs for need dimensions (total and unmet) and Cohen's kappa coefficients for individual need items. Results. Regarding convergent validity, a higher number of needs (total and unmet) were associated with more severe psychiatric symptoms (BPRS). Higher numbers of unmet need...

Actas españolas de psiquiatría

One of seven people admitted in prison has a diagnosis of a severe mental disorder and it is nece... more One of seven people admitted in prison has a diagnosis of a severe mental disorder and it is necessary to assess their needs. CANFOR was developed in 2004 to assess the specific needs of the forensic mental health services users. Adaptation and validation of CANFOR into Spanish was done and the psychometric properties were tested. After translation and back translation, we administered the CANFOR to a sample of 90 users of the penitentiary mental health services in Catalonia. Inter-rater and test-retest reliability coefficients for each of the 25 domains were high: moderate to almost perfect (0,44 to 1). Regarding concurrent validity a negative correlation was found between GAF (p<0,01); LSP in all its subscales(p<0,01-p<0,05 ) and needs as assessed with CANFOR. the Spanish version of CANFOR retains the psychometric properties described in the original version. It has been proved that the Spanish version is valid and reliable, so it can be considered an optimal instrument f...

Griffith Law Review, 2014

This special issue of the Griffith Law Review is dedicated to an examination of the relationships... more This special issue of the Griffith Law Review is dedicated to an examination of the relationships and intersections between disability, criminal law and legal theory. Despite the centrality of disability to the doctrines, operation and reform of criminal law, disability continues to inhabit a marginal location in legal theoretical engagement with criminal law. This special issue proceeds from a contestation of disability as an individual, medical condition and instead explores disability's social, political and cultural contexts. This kind of approach directs critical attention to questioning many aspects of the relationships between disability and criminal law which have otherwise been taken for granted or overlooked in legal scholarship. These aspects include the differential treatment of people with disability by criminal law, the impact of core legal concepts such as capacity on criminal legal treatment of people with disability, and the role of disability in ordering and legitimising criminal law. It is hoped that the special issue will contribute to the shifting of disability from its peripheral location in legal theoretical scholarship much more to the centre of critical and political engagement with criminal law.

SSRN Electronic Journal, 2010

Monitoring and oversight of human rights in closed environments: proceedings of a roundtable / ed... more Monitoring and oversight of human rights in closed environments: proceedings of a roundtable / edited by Bronwyn Naylor [et al.] ISBN 9780987233714 1. Respect for persons-Law and Legislation-Australia. 2. Correctional institutions-Law and Legislation-Australia. 3. Mental health facilities-Law and Legislation-Australia. 4. Alien detention centers-Law and Legislation-Australia. 5. Human Rights Monitoring-Australia. 342.94085 Published with the financial assistance of the Australian Research Council under an ARC Linkage project 'Applying Human Rights in Closed Environments: A Strategic Framework for Compliance'.

Sexual Abuse, 2010

Adolescent sexual offending represents an ongoing social, judicial, clinical, and policy issue fo... more Adolescent sexual offending represents an ongoing social, judicial, clinical, and policy issue for services. The current study investigated the characteristics, criminal versatility, and rates of recidivism of a cohort of 156 male adolescent sexual offenders who were referred for psychological assessments by the courts between 1996 and 2007 in Singapore. Analyses revealed that specialists (sex-only offenders; n = 71, Mfollow-up = 56.99 months, SDfollow-up = 31.33) and generalists (criminally versatile offenders; n = 77, Mfollow-up = 67.83 months, SDfollow-up = 36.55) differed with respect to offense characteristics (e.g., sexually assaulting familial victims) and recidivistic outcomes. Although both groups sexually reoffended at roughly the same rate (14.3% vs. 9.9%), consistent with their typology, significantly more of the generalists reoffended violently (18.2% vs. 1.4%), sexually and/or violently (27.3% vs. 11.3%), nonviolently (37.7% vs. 16.9%), and engaged in any further crimi...

Psychology, Crime & Law, 2013

This article may be used for research, teaching, and private study purposes. Any substantial or s... more This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden. The publisher does not give any warranty express or implied or make any representation that the contents will be complete or accurate or up to date. The accuracy of any instructions, formulae, and drug doses should be independently verified with primary sources. The publisher shall not be liable for any loss, actions, claims, proceedings, demand, or costs or damages whatsoever or howsoever caused arising directly or indirectly in connection with or arising out of the use of this material.

Psychology, Public Policy, and Law, 2011

A relational model of authority (Tyler & Lind, 1992) emphasizes the role of procedural justice (t... more A relational model of authority (Tyler & Lind, 1992) emphasizes the role of procedural justice (the fairness of methods used to achieve outcomes) in public support for and evaluation of the police. Using both quantitative and qualitative methods, this study tested the model in the context of victim-police interactions. In-depth interviews were conducted with 110 people who had reported a crime (personal or property) to the police in the previous year. Quantitative findings supported the predictions that higher perceived antecedents of procedural justice would be associated with higher perceived legitimacy (obligation to obey the law), outcome fairness, and satisfaction with the contact. Antecedents of procedural justice were a stronger predictor of outcome fairness and satisfaction than the realization of a desired outcome, and a stronger predictor of legitimacy than criminal history. Qualitative findings supported these results. It appears that procedural justice has the potential for helping to motivate individuals with criminal history to obey the law. Implications for evaluation of police performance are discussed.

Psychological Medicine, 2007

BackgroundMental health clinicians are frequently asked to assess the risks presented by patients... more BackgroundMental health clinicians are frequently asked to assess the risks presented by patients making threats to kill, but there are almost no data to guide such an evaluation.MethodThis data linkage study examined serious violence following making threats to kill and the potential role of mental disorder. A total of 613 individuals convicted of threats to kill had their prior contact with public mental health services established at the time of the index offence. The group's subsequent criminal convictions were established 10 years later using the police database. Death from suicidal or homicidal violence was also established.ResultsWithin 10 years, 44% of threateners were convicted of further violent offending, including 19 (3%) homicides. Those with histories of psychiatric contact (40%) had a higher rate (58%) of subsequent violence. The highest risks were in substance misusers, mentally disordered, young, and those without prior criminal convictions. Homicidal violence w...

Policing and Society, 2013

ABSTRACT

Journal of Forensic Nursing, 2012

Limit-setting and de-escalation are commonly used nursing interventions that are critical to the ... more Limit-setting and de-escalation are commonly used nursing interventions that are critical to the effective maintenance of the therapeutic milieu and the prevention and management of aggression in forensic mental health units. However, despite their purported importance, the techniques used in these interventions are rarely described. Further, these techniques are seldom based on empirical research or derived from a theory or model of aggression or interpersonal behavior. The purpose of this review is to examine the extant literature on limit-setting and de-escalation and consider how these activities could be enhanced. In concluding, this review emphasizes the potential benefits of drawing upon (1) a model of aggressive behavior and (2) a theory and literature examining interpersonal behavior, to enhance limit-setting and deescalation skills.

International Journal of Forensic Mental Health, 2012

The accuracy of the Content should not be relied upon and should be independently verified with p... more The accuracy of the Content should not be relied upon and should be independently verified with primary sources of information. Taylor and Francis shall not be liable for any losses, actions, claims, proceedings, demands, costs, expenses, damages, and other liabilities whatsoever or howsoever caused arising directly or indirectly in connection with, in relation to or arising out of the use of the Content. This article may be used for research, teaching, and private study purposes. Any substantial or systematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distribution in any form to anyone is expressly forbidden.

International Journal of Forensic Mental Health, 2011

The Short-Term Assessment of Risk and Treatability (START) assists risk assessment for seven risk... more The Short-Term Assessment of Risk and Treatability (START) assists risk assessment for seven risk outcomes based on scoring of risk and protective factors and assignment of clinically-informed risk levels. Its predictive validity for violence and self-harm has been established in males with schizophrenia, but accuracy across pathologically diverse samples is unknown. Routine START assessments and 3-month risk outcome data of N = 527 adult, inpatients in a UK secure mental health facility were collected. The sample was divided into diagnostic groups; predictive validity was established using receiver operating characteristics regression (rocreg) analysis in which potential covariates were controlled. In most single-diagnosis groups START risk factors ('vulnerabilities'), protective factors ('strengths'), and clinically-informed estimates predicted multiple risk outcomes with effect sizes similar to previous research. Self-harm was not predicted among patients with an organic diagnosis. The START risk estimates predicted physical aggression in all diagnostic groups, and verbal aggression, self-harm and self-neglect in most diagnostic groups. The START can assist assessment of aggressive, selfharm, and self-neglect across a range of diagnostic groups. Further research with larger sample sizes of those with multiple diagnoses is required.

British Medical Bulletin, 2004

The health needs of displaced populations vary widely. The question as to the demands displaced p... more The health needs of displaced populations vary widely. The question as to the demands displaced populations place on health care resources and health care providers in their destination countries or regions remains the subject of great debate and contention. Internationally, health care workers are faced with complex challenges in providing care to displaced populations. This paper highlights some of the key health issues for displaced populations around the globe. Whilst 'Band Aid' solutions to existing health problems are useful in the short term, the paper describes the need for long-term public health prevention and educational strategies to enable displaced communities full access to and participation in their new 'home' communities.

BMC Psychiatry, 2013

Background: The increase in prisoner population is a troublesome reality in several regions of th... more Background: The increase in prisoner population is a troublesome reality in several regions of the world. Along with this growth there is increasing evidence that prisoners have a higher proportion of mental illnesses and suicide than the general population. In order to implement strategies that address criminal recidivism and the health and social status of prisoners, particularly in mental disordered offenders, it is necessary to assess their care needs in a comprehensive, but individual perspective. This assessment must include potential harmful areas like comorbid personality disorder, substance misuse and offending behaviours. The Camberwell Assessment of Need-Forensic Version (CANFOR) has proved to be a reliable tool designed to accomplish such aims. The present study aimed to validate the CANFOR Portuguese version. Methods: The translation, adaptation to the Portuguese context, back-translation and revision followed the usual procedures. The sample comprised all detainees receiving psychiatric care in four forensic facilities, over a one year period. A total of 143 subjects, and respective case manager, were selected. The forensic facilities were chosen by convenience: one prison hospital psychiatric ward (n=68; 47.6%), one male (n=24; 16.8%) and one female (n=22; 15.4%) psychiatric clinic and one civil security ward (n=29; 20.3%), all located nearby Lisbon. Basic descriptive statistics and Kappa weighted coefficients were calculated for the inter-rater and the test-retest reliability studies. The convergent validity was evaluated using the Global Assessment of Functioning and the Brief Psychiatric Rating Scale scores. Results: The majority of the participants were male and single, with short school attendance, and accused of a crime involving violence against persons. The most frequent diagnosis was major depression (56.1%) and almost half presented positive suicide risk. The reliability study showed average Kappa weighted coefficients of 0.884 and 0.445 for inter-rater and test-retest agreement, respectively. The convergent validity study presented highly significant correlations between unmet needs scores, GAF and BPRS scores. Conclusions: The CANFOR Portuguese version revealed similar psychometric properties to the original English version. Moreover, the results of the reliability and validity studies indicate that the tool is appropriate for individual care needs assessment and as a guide for the mental health and social interventions in forensic psychiatric services.

Acta Psychiatrica Scandinavica, 2013

JRP. Comparing violence in schizophrenia patients with and without comorbid substance-use disorde... more JRP. Comparing violence in schizophrenia patients with and without comorbid substance-use disorders to community controls. Objective: This study examined crime and violence in patients with schizophrenia with and without comorbid substance-use disorders. Method: A case-linkage design was used to compare patterns of violence and offending between 4168 schizophrenia patients drawn from a statewide public mental health register, both with and without comorbid substance-use disorders, and a randomly selected community control group who had never been diagnosed with schizophrenia. Results: Schizophrenia patients were significantly more likely than controls to be guilty of violent and non-violent offences, and to have been involved in family violence. Even schizophrenia patients without comorbid substance-use disorders had a significantly elevated risk of violence; this group were more than twice as likely as controls to have a violent conviction. The elevation of violence risk in schizophrenia patients was higher in females (OR = 8.59) than males (OR = 2.25). Conclusion: The increased risk of violent offending in schizophrenia cannot be solely attributed to the effects of comorbid substance misuse, although comorbidity certainly heightens the likelihood of criminality. In addition to offending, people with schizophrenia are more likely than community controls to come to the attention of police via their involvement in family violence incidents. Schizophrenia is a particularly strong risk factor for violence in females.