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Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life

BACKGROUND: Older individuals (e.g., 55 years and over) constitute a growing proportion of the forensic mental health patient population. As a group, they are vulnerable to health outcomes similar to other individuals with serious mental disorders of the same age; however, these concerns can be comp...

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Autores principales: Tomlin, Jack, Walker, Kate, Yates, Jen, Dening, Tom, Völlm, Birgit, Griffiths, Chris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: F1000 Research Limited 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7613860/
https://www.ncbi.nlm.nih.gov/pubmed/36447787
http://dx.doi.org/10.3310/nihropenres.13248.2
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author Tomlin, Jack
Walker, Kate
Yates, Jen
Dening, Tom
Völlm, Birgit
Griffiths, Chris
author_facet Tomlin, Jack
Walker, Kate
Yates, Jen
Dening, Tom
Völlm, Birgit
Griffiths, Chris
author_sort Tomlin, Jack
collection PubMed
description BACKGROUND: Older individuals (e.g., 55 years and over) constitute a growing proportion of the forensic mental health patient population. As a group, they are vulnerable to health outcomes similar to other individuals with serious mental disorders of the same age; however, these concerns can be compounded by complex forensic-related care backgrounds and clinical presentations, lengthy periods of time spent in prison or psychiatric hospitals, substance use histories, and crime perpetration or victimisation. The healthcare needs and strengths of this group are not well understood. The aim of this study was to identify and describe the demographic, physical health, mental wellbeing, cognitive ability, and quality of life profiles of older forensic patients in community, low, medium, and high security settings in England. METHODS: A cross-sectional quantitative study design was used. N=37 forensic patients aged 55 years and over completed six questionnaires. Data were also collected from patient records. RESULTS: Most patients were male and were diagnosed with psychosis. The most frequently committed index offence types were violent offences. Patients were prescribed 7.6 medications on average and had average anticholinergic effect on cognition scores of 2.4. Nearly half the sample had diabetes, with an average BMI score of 31.7 (indicating obesity). Possible cognitive impairment was identified in 65% of the sample. Patients’ assessments of their recovery-related quality of life and mental wellbeing were comparable to published UK general population values. Assessments of quality of life were positively correlated with the ability to undertake everyday activities and cognitive performance. CONCLUSIONS: We suggest that forensic services are well-placed to provide holistic mental and physical care to this group but that they should co-develop with patients a greater range of age-appropriate meaningful activities that are mindful of mobility issues and consider implementing more cognition-based and physical health interventions.
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spelling pubmed-76138602022-11-28 Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life Tomlin, Jack Walker, Kate Yates, Jen Dening, Tom Völlm, Birgit Griffiths, Chris NIHR Open Res Research Article BACKGROUND: Older individuals (e.g., 55 years and over) constitute a growing proportion of the forensic mental health patient population. As a group, they are vulnerable to health outcomes similar to other individuals with serious mental disorders of the same age; however, these concerns can be compounded by complex forensic-related care backgrounds and clinical presentations, lengthy periods of time spent in prison or psychiatric hospitals, substance use histories, and crime perpetration or victimisation. The healthcare needs and strengths of this group are not well understood. The aim of this study was to identify and describe the demographic, physical health, mental wellbeing, cognitive ability, and quality of life profiles of older forensic patients in community, low, medium, and high security settings in England. METHODS: A cross-sectional quantitative study design was used. N=37 forensic patients aged 55 years and over completed six questionnaires. Data were also collected from patient records. RESULTS: Most patients were male and were diagnosed with psychosis. The most frequently committed index offence types were violent offences. Patients were prescribed 7.6 medications on average and had average anticholinergic effect on cognition scores of 2.4. Nearly half the sample had diabetes, with an average BMI score of 31.7 (indicating obesity). Possible cognitive impairment was identified in 65% of the sample. Patients’ assessments of their recovery-related quality of life and mental wellbeing were comparable to published UK general population values. Assessments of quality of life were positively correlated with the ability to undertake everyday activities and cognitive performance. CONCLUSIONS: We suggest that forensic services are well-placed to provide holistic mental and physical care to this group but that they should co-develop with patients a greater range of age-appropriate meaningful activities that are mindful of mobility issues and consider implementing more cognition-based and physical health interventions. F1000 Research Limited 2022-06-22 /pmc/articles/PMC7613860/ /pubmed/36447787 http://dx.doi.org/10.3310/nihropenres.13248.2 Text en Copyright: © 2022 Tomlin J et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Tomlin, Jack
Walker, Kate
Yates, Jen
Dening, Tom
Völlm, Birgit
Griffiths, Chris
Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life
title Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life
title_full Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life
title_fullStr Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life
title_full_unstemmed Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life
title_short Older forensic mental healthcare patients in England: demographics, physical health, mental wellbeing, cognitive ability and quality of life
title_sort older forensic mental healthcare patients in england: demographics, physical health, mental wellbeing, cognitive ability and quality of life
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7613860/
https://www.ncbi.nlm.nih.gov/pubmed/36447787
http://dx.doi.org/10.3310/nihropenres.13248.2
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