•  Near-lethal suicide attempts in prisoners

Suicide is the leading cause of death in prisons in England and Wales and places a considerable burden on prison and NHS resources yet there is little information on the psychiatric, psychological and social risk factors for suicide in prison resulting from case-controlled methodology. Using case-controlled methodology of near-fatal suicide attempts 100 prisoners who have carried out near lethal suicide attempts together with 100 matched controls will be interviewed and assessed on psychiatric, psychological and social measures.

• Risk factors for violent offending in psychiatric patients

Little is known about the potentially treatable risk factors for offending in psychiatric patients. Hitherto research has focused on “static” factors that are not amenable to change, such as age and gender. An understanding of the treatable (“dynamic”) risk factors would be invaluable for clinical practice and training.

• Mental health of prisoners

The rising number of prisoners, their high psychiatric morbidity, and the increasing number of prison suicides are factors that will challenge PCTs as they begin managing the prison medical service. Services to improve the detection, treatment and management of mentally disordered offenders are under-researched areas that would have important national and international implications.

• Older criminals

Currently there are 10 million older adults in the UK that will increase to 20 million in a decade. Criminal behaviour in this age group is poorly understood, as its connection to mental illness. 

• Personality disorder and offending

The current interest in personality disorder and offending has failed to establish links beyond simple associations. The personality disorders are most closely associated with offending, the risk factors for such offending, and how can they be modified are research questions that need addressing.

• Treatment of psychiatric patients and adverse outcomes

The association between SSRI prescribing and suicide, and SSRI prescribing and violent crime is being investigated from a population perspective, and in patients with mood and anxiety disorders (in Sweden). In addition, a retrospective case-control study of patients with psychosis who commit homicide after leaving hospital is being undertaken.