The high prevalence of serious mental illness (SMI) in prisons remains a challenge for mental hea... more The high prevalence of serious mental illness (SMI) in prisons remains a challenge for mental health services. Many prisoners with SMI do not receive care. Screening tools have been developed but better detection has not translated to higher rates of treatment. In New Zealand a Prison Model of Care (PMOC) was developed by forensic mental health and correctional services to address this challenge. The PMOC broadened triggers for referrals to mental health teams. Referrals were triaged by mental health nurses leading to multidisciplinary team assessment within specified timeframes. This pathway for screening, referral and assessment was introduced within existing resources. The PMOC was implemented across four prisons. An AB research design was used to explore the extent to which mentally ill prisoners were referred to and accepted by prison in-reach mental health teams and to determine the proportion of prison population receiving specialist mental health care. The number of prisoner...
Objective: To review persons charged or convicted with homicide referred to the Western Australia... more Objective: To review persons charged or convicted with homicide referred to the Western Australian Forensic Psychiatric Service.Method: Review of case note of referrals over a five-year period.Results: Data from 42 cases were collected. Offenders and victims belonged to a variety of ethnic backgrounds. There were four cases of multiple homicide. The majority of perpetrators and victims were males. A significant number had a pre-existing major psychiatric disorder, about half of who were under psychiatric care at the time of the offence. Half of the patients were diagnosed with schizophrenia or delusional disorder. A gun was used in one fifth of the cases.Conclusions: The survey highlights the importance of risk management and assertive community follow-up in those with psychosis.
BackgroundIt is well recognised that prisoners with serious mental illness (SMI) are at high risk... more BackgroundIt is well recognised that prisoners with serious mental illness (SMI) are at high risk of poor outcomes on return to the community. Early engagement with mental health services and other community agencies could provide the substrate for reducing risk.AimTo evaluate the impact of implementing an assertive community treatment informed prison in‐reach model of care (PMOC) on post‐release engagement with community mental health services and on reoffending rates.MethodsOne hundred and eighty prisoners with SMI released from four prisons in the year before implementation of the PMOC were compared with 170 such prisoners released the year after its implementation.ResultsThe assertive prison model of care was associated with more pre‐release contacts with community mental health services and contacts with some social care agencies in some prisons. There were significantly more post‐release community mental health service engagements after implementation of this model (Z = −2.388...
The high prevalence of serious mental illness (SMI) in prisons remains a challenge for mental hea... more The high prevalence of serious mental illness (SMI) in prisons remains a challenge for mental health services. Many prisoners with SMI do not receive care. Screening tools have been developed but better detection has not translated to higher rates of treatment. In New Zealand a Prison Model of Care (PMOC) was developed by forensic mental health and correctional services to address this challenge. The PMOC broadened triggers for referrals to mental health teams. Referrals were triaged by mental health nurses leading to multidisciplinary team assessment within specified timeframes. This pathway for screening, referral and assessment was introduced within existing resources. The PMOC was implemented across four prisons. An AB research design was used to explore the extent to which mentally ill prisoners were referred to and accepted by prison in-reach mental health teams and to determine the proportion of prison population receiving specialist mental health care. The number of prisoner...
Objective: To review persons charged or convicted with homicide referred to the Western Australia... more Objective: To review persons charged or convicted with homicide referred to the Western Australian Forensic Psychiatric Service.Method: Review of case note of referrals over a five-year period.Results: Data from 42 cases were collected. Offenders and victims belonged to a variety of ethnic backgrounds. There were four cases of multiple homicide. The majority of perpetrators and victims were males. A significant number had a pre-existing major psychiatric disorder, about half of who were under psychiatric care at the time of the offence. Half of the patients were diagnosed with schizophrenia or delusional disorder. A gun was used in one fifth of the cases.Conclusions: The survey highlights the importance of risk management and assertive community follow-up in those with psychosis.
BackgroundIt is well recognised that prisoners with serious mental illness (SMI) are at high risk... more BackgroundIt is well recognised that prisoners with serious mental illness (SMI) are at high risk of poor outcomes on return to the community. Early engagement with mental health services and other community agencies could provide the substrate for reducing risk.AimTo evaluate the impact of implementing an assertive community treatment informed prison in‐reach model of care (PMOC) on post‐release engagement with community mental health services and on reoffending rates.MethodsOne hundred and eighty prisoners with SMI released from four prisons in the year before implementation of the PMOC were compared with 170 such prisoners released the year after its implementation.ResultsThe assertive prison model of care was associated with more pre‐release contacts with community mental health services and contacts with some social care agencies in some prisons. There were significantly more post‐release community mental health service engagements after implementation of this model (Z = −2.388...
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Papers by Krishna Pillai