Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-27T07:09:20.396Z Has data issue: false hasContentIssue false

Section 2 - Medical and Psychological Intervention

Published online by Cambridge University Press:  09 May 2023

Masum Khwaja
Affiliation:
Imperial College of Science, Technology and Medicine, London
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Get access

Summary

Image of the first page of this content. For PDF version, please use the ‘Save PDF’ preceeding this image.'
Type
Chapter
Information
The Prevention and Management of Violence
Guidance for Mental Healthcare Professionals
, pp. 75 - 140
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References

National Institute for Health and Care Excellence. Violence and aggression: Short-term Management in Mental Health, Health and Community Settings. NICE Guideline NG10 [online]. 2015. www.nice.org.uk/guidance/ng10 [Accessed 25.9.2021].Google Scholar
Patel, M. X., Sethi, F. N., Barnes, T. R. et al. Joint BAP NAPICU evidence-based consensus guidelines for the clinical management of acute disturbance: De-escalation and rapid tranquillisation. Journal of Psychopharmacology 2018;32(6):601–40.Google Scholar
Royal College of Psychiatrists. Consensus statement on high-dose antipsychotic medication. College Report CR190 [online]. 2014. www.rcpsych.ac.uk/docs/default-source/members/faculties/rehabilitation-and-social-psychiatry/rehab-cr190.pdf?sfvrsn=d8397218_4 [Accessed 29.4.2022].Google Scholar
Swanson, J. W., Swartz, M. S., Van Dorn, R. A. et al. Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia. British Journal of Psychiatry. 2008;193(1):3743.Google Scholar
Appelbaum, P. S., Robbins, P. C., and Monahan, J. Violence and delusions: Data from the MacArthur Violence Risk Assessment Study. The American Journal of Psychiatry. 2000;157(4):566–72.Google Scholar
Látalová, K. Violence and duration of untreated psychosis in first-episode patients. International Journal of Clinical Practice 2014 Mar;68(3):330–5. https://doi.org/10.1111/ijcp.12327. Epub 2014 Jan 28. PMID: 24471741.Google Scholar
Witt, K., van Dorn, R., and Fazel, S. Risk factors for violence in psychosis: Systematic review and meta-regression analysis of 110 studies. PLOS One. 2013;8(2):e55942. https://doi.org/10.1371/journal.pone.0055942. Epub 2013 Feb 13. Erratum in: PLOS One. 2013;8(9). https://doi.org/10.1371/annotation/f4abfc20-5a38-4dec-aa46-7d28018bbe38. PMID: 23418482; PMCID: PMC3572179.Google Scholar
Goedhard, L. E., Stolker, J. J., Heerdink, E. R. et al. Pharmacotherapy for the treatment of aggressive behavior in general adult psychiatry: A systematic review. Journal of Clinical Psychiatry 2006;67(7):1013–24.Google Scholar
Fazel, S., Zetterqvist, J., Larsson, H., Långström, N., and Lichtenstein, P. Antipsychotics, mood stabilisers, and risk of violent crime. The Lancet 2014 Sep 27;384(9949):1206–14. https://doi.org/10.1016/S0140-6736(14)60379-2. Epub 2014 May 8. PMID: 24816046; PMCID: PMC4165625.Google Scholar
Victoroff, J., Coburn, K., Reeve, A., Sampson, S., and Shillcutt, S. Pharmacological management of persistent hostility and aggression in persons with schizophrenia spectrum disorders: a systematic review. Journal of Neuropsychiatry and Clinical Neurosciences 2014;26(4):283312.Google Scholar
Chengappa, K. N. R., Vasile, J., Levine, J. et al. Clozapine: Its impact on aggressive behavior among patients in a state psychiatric hospital. Schizophrenia Research 2002; 53(1–2):16.Google Scholar
Volavka, J., Czobor, P., Nolan, K. et al. Overt aggression and psychotic symptoms in patients with schizophrenia treated with clozapine, olanzapine, risperidone, or haloperidol. Journal of Clinical Psychopharmacology. 2004;24(2):225–8.Google Scholar
Krakowski, M. I., Czobor, P., Citrome, L., Bark, N., and Cooper, T. B. Atypical antipsychotic agents in the treatment of violent patients with schizophrenia and schizoaffective disorder. Archives of General Psychiatry 2006;63(6):622–9.Google Scholar
Frogley, C., Taylor, D., Dickens, G., and Picchioni, M. A systematic review of the evidence of clozapine’s anti-aggressive effects. International Journal of Neuropsychopharmacology 2012;15(9):1351–71.Google Scholar
Kraus, J. E., and Sheitman, B. B. Clozapine reduces violent behavior in heterogeneous diagnostic groups. Journal of Neuropsychiatry and Clinical Neurosciences 2005;17(1):3644.Google Scholar
Strassnig, M. T., Nascimento, V., Deckler, E. and Harvey, P. D. Pharmacological treatment of violence in schizophrenia. CNS Spectrums 2020;25(2):207–15.Google Scholar
Krakowski, M. I., Czobor, P. and Nolan, K. A. Atypical antipsychotics, neurocognitive deficits, and aggression in schizophrenic patients. Journal of Clinical Psychopharmacology 2008;28(5):485–93.Google Scholar
Krakowski, M. I. and Czobor, P. Neurocognitive impairment limits the response to treatment of aggression with antipsychotic agents. Schizophrenia Bulletin 2011;37 311–2.Google Scholar
National Institute for Health and Clinical Excellence. Borderline Personality Disorder: The NICE Guideline on Treatment and Management (Clinical Guideline CG78). London: The British Psychological Society & The Royal College of Psychiatrists, 2009.Google Scholar
National Institute for Health and Clinical Excellence. Antisocial Personality Disorder: Treatment, Management and Prevention Clinical Guideline CG77 [online]. 2009. www.nice.org.uk/guidance/cg77/resources/antisocial-personality-disorder-prevention-and-management-pdf-975633461701 [Accessed 29.4.2022].Google Scholar
National Institute of Clinical Excellence (NICE). Quality standard [QS88]. Personality disorders: borderline and antisocial. www.nice.org.uk/guidance/qs88/chapter/Quality-statement-4-Pharmacological-interventions [Accessed 24.9.2021].Google Scholar
Soloff, P. H. Algorithms for pharmacological treatment of personality dimensions: symptom-specific treatments for cognitive-perceptual, affective, and impulsive-behavioral dysregulation. Bulletin of the Menninger Clinic 1998;62(2):195214.Google Scholar
Tyrer, P. and Bateman, A. W. Drug treatment for personality disorders. Advances in Psychiatric Treatment 2018;10(5):389–98.Google Scholar
Block, H., George, S., Milanese, S. et al. Evidence for the management of challenging behaviours in patients with acute traumatic brain injury or post-traumatic amnesia: An umbrella review. Brain Impairment, 2021;22(1):119. https://doi.org/10.1017/BrImp.2020.5Google Scholar
Jacobson, R. R. Commentary: Aggression and impulsivity after head injury. Advances in Psychiatric Treatment 2018;3(3):160–3.Google Scholar
Khan, O., Ferriter, M., Huband, N., at al. Pharmacological interventions for those who have sexually offended or are at risk of offending. Cochrane Database of Systematic Reviews 2015;2015(2):Cd007989.Google Scholar
Ballard, C. and Waite, J. The effectiveness of atypical antipsychotics for the treatment of aggression and psychosis in Alzheimer’s disease. Cochrane Database of Systematic Reviews 2006(1):CD003476.Google Scholar
National Institute for Health and Care Excellence. Dementia: Assessment, management and support for people living with dementia and their carers. Guideline NG97 [online]. 2018. www.nice.org.uk/guidance/ng97/resources/dementia-assessment-management-and-support-for-people-living-with-dementia-and-their-carers-pdf-1837760199109 [Accessed 29.4.2022].Google Scholar
Stahl, S. M. and Morrissette, D. A. Stahl’s Illustrated: Violence: Neural Circuits, Genetics and Treatment. Cambridge: Cambridge University Press, 2014.Google Scholar
Ferrier, I. and Waite, J. The ECT Handbook, 4th ed. Cambridge: Cambridge University Press, 2019.Google Scholar
National Institute for Health and Care Excellence. Guidance on the Use of Electroconvulsive Therapy. Technology Appraisal Guidance TA59 [online]. 2009. www.nice.org.uk/guidance/ta59 [Accessed 29.4.2022].Google Scholar
Royal College of Psychiatrists. Statement on Electroconvulsive Therapy (ECT), CERT01/17 London: R; 2017 www.rcpsych.ac.uk/docs/default-source/about-us/who-we-are/electroconvulsive-therapy–-ect-ctee-statement-feb17.pdf?sfvrsn=2f4a94f9_2 [Accessed 29.4.2022].Google Scholar
Tharyan, P. and Adams, C. E. Electroconvulsive therapy for schizophrenia. Cochrane Database of Systematic Reviews 2005(2):Cd000076.Google Scholar
Commission CQ. Guidance for SOADS: Consent for Treatment and the SOAD Role under the Revised Mental Health Act. CQC, 2008.Google Scholar
Rogers, P., Leung, C. and Nicholson, T. R. J. Pocket Prescriber Psychiatry. Florida: CRC Press.Google Scholar
Citrome, L., Landbloom, R., Chang, C. T., and Earley, W. Effects of asenapine on agitation and hostility in adults with acute manic or mixed episodes associated with bipolar I disorder. Neuropsychiatric Disease and Treatment 2017;13:2955–63.Google Scholar
Hassaballa, H. A. and Balk, R. A. Torsade de pointes associated with the administration of intravenous haloperidol. American Journal of Therapeutics 2003;10(1):5860.Google Scholar
Hassaballa, H. A. and Balk, R. A. Torsade de pointes associated with the administration of intravenous haloperidol: a review of the literature and practical guidelines for use. Expert Opinion on Drug Safety 2003;2(6):543–7.Google Scholar
National Institute of Clinical Excellence. NICE guideline NG10 Appendix 15B: Clinical evidence – forest plots for review of rapid tranquillisation. [online] 2015. www.nice.org.uk/guidance/ng10/evidence/appendix-15b-pdf-2549889109 [Accessed 29.4.2022].Google Scholar
Huf, G., Coutinho, E. S., Adams, C. E. and TREC Collaborative Group. Rapid tranquillisation in psychiatric emergency settings in Brazil: Pragmatic randomised controlled trial of intramuscular haloperidol versus intramuscular haloperidol plus promethazine. BMJ 2007;335(7625):869.Google Scholar
Raveendran, N. S., Tharyan, P., Alexander, J., Adams, C. E. and TREC Collaborative Group. Rapid tranquillisation in psychiatric emergency settings in India: Pragmatic randomised controlled trial of intramuscular olanzapine versus intramuscular haloperidol plus promethazine. BMJ 2007;335(7625):865.Google Scholar
Paton, C., Adams, C. E., Dye, S. et al. The pharmacological management of acute behavioural disturbance: Data from a clinical audit conducted in UK mental health services. Journal of Psychopharmacology 2019;33(4):472–81.Google Scholar
Baker, J. A., Lovell, K. and Harris, N. A best-evidence synthesis review of the administration of psychotropic pro re nata (PRN) medication in in-patient mental health settings. Journal of Clinical Nursing 2008;17(9):1122–31.Google Scholar
National Institute for Health and Care Excellence. Violence: The Short-Term Management of Disturbed and Violent Behaviour in Inpatient Psychiatric Settings and Emergency Departments. NICE Clinical Guideline CG 25 [online]. 2005. www.ncbi.nlm.nih.gov/books/NBK305020/ [Accessed 29.4.2022]Google Scholar
Ostinelli, E. G., Brooke-Powney, M. J., Li, X. and Adams, C. E. Haloperidol for psychosis-induced aggression or agitation (rapid tranquillisation). Cochrane Database of Systematic Reviews. 2017;7:CD009377.Google Scholar
Hsu, W. Y., Huang, S. S., Lee, B. S. and Chiu, N. Y. Comparison of intramuscular olanzapine, orally disintegrating olanzapine tablets, oral risperidone solution, and intramuscular haloperidol in the management of acute agitation in an acute care psychiatric ward in Taiwan. Journal of Clinical Psychopharmacology 2010;30(3):230–4.Google Scholar
Baldacara, L., Sanches, M., Cordeiro, D. C. and Jackoswski, A. P. Rapid tranquilization for agitated patients in emergency psychiatric rooms: A randomized trial of olanzapine, ziprasidone, haloperidol plus promethazine, haloperidol plus midazolam and haloperidol alone. Revista brasileira de psiquiatria (Sao Paulo, Brazil: 1999) 2011;33(1):30–9.Google Scholar
Belgamwar, R. B. and Fenton, M. Olanzapine IM or velotab for acutely disturbed/agitated people with suspected serious mental illnesses. Cochrane Database of Systematic Reviews 2005;2:CD003729.Google Scholar
Kishi, T., Matsunaga, S. and Iwata, N. Intramuscular olanzapine for agitated patients: A systematic review and meta-analysis of randomized controlled trials. Journal of Psychiatric Research 2015;68:198209.Google Scholar
Eli Lilly. Zyprexa powder for solution for injection 2009. www.ema.europa.eu/en/documents/product-information/zyprexa-epar-product-information_en.pdf [Accessed 29.4.2022]Google Scholar
Wright, P., Birkett, M., David, S. R. et al. Double-blind, placebo-controlled comparison of intramuscular olanzapine and intramuscular haloperidol in the treatment of acute agitation in schizophrenia. The American Journal of Psychiatry. 2001;158(7):1149–51.Google Scholar
Eli Lilly. Important safety information: Reported serious adverse events following use of Zyprexa Intramuscular (28 September) 2004. www.palliativedrugs.com/download/SafetyLetterzyprexa.pdf [Accessed 29.4.2022].Google Scholar
Ostinelli, E. G., Jajawi, S., Spyridi, S., Sayal, K., and Jayaram, M. B. Aripiprazole (intramuscular) for psychosis-induced aggression or agitation (rapid tranquillisation). Cochrane Database of Systematic Reviews 2018;1:CD008074.Google Scholar
Zimbroff, D. L., Marcus, R. N., Manos, G. et al. Management of acute agitation in patients with bipolar disorder: Efficacy and safety of intramuscular aripiprazole. Journal of Clinical Psychopharmacology 2007;27(2):171–6.Google Scholar
Broadstock, M. The effectiveness and safety of drug treatment for urgent sedation in psychiatric emergencies. A critical appraisal of the literature. NZHTA Report 2001; 4(1):2001.Google Scholar
Huf, G., Alexander, J., Gandhi, P. and Allen, M. H. Haloperidol plus promethazine for psychosis-induced aggression. Cochrane Database of Systematic Reviews 2016;11:CD005146.Google Scholar
Trec Collaborative Group. Rapid tranquillisation for agitated patients in emergency psychiatric rooms: A randomised trial of midazolam versus haloperidol plus promethazine. BMJ 2003;327(7417):708–13.Google Scholar
Alexander, J., Tharyan, P., Adams, C. et al. Rapid tranquillisation of violent or agitated patients in a psychiatric emergency setting: Pragmatic randomised trial of intramuscular lorazepam v. haloperidol plus promethazine. British Journal of Psychiatry 2004;185:63–9.Google Scholar
Allen, M. H., Feifel, D., Lesem, M. D. et al. Efficacy and safety of loxapine for inhalation in the treatment of agitation in patients with schizophrenia: A randomized, double-blind, placebo-controlled trial. Journal of Clinical Psychiatry 2011;72(10):1313–21.Google Scholar
Lesem, M. D., Tran-Johnson, T. K., Riesenberg, R. A. et al. Rapid acute treatment of agitation in individuals with schizophrenia: Multicentre, randomised, placebo-controlled study of inhaled loxapine. British Journal of Psychiatry 2011;198(1):51–8.Google Scholar
Shrewsbury, S. B., Hocevar-Trnka, J., Satterly, K. H. et al. The SNAP 101 double-blind, placebo/active-controlled, safety, pharmacokinetic, and pharmacodynamic study of INP105 (nasal olanzapine) in healthy adults. Journal of Clinical Psychiatry 2020;81(4):19m13086.Google Scholar
Ravi, A. D., Sadhna, D., Nagpaal, D. and Chawla, L. Needle free injection technology: A complete insight. International Journal of Pharmaceutical Investigation 2015;5(4):192–9.Google Scholar
Royal College of Psychiatrists. Use of licensed medicines for unlicensed applications in psychiatric practice. College report CR210. [online]. 2010. www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr210.pdf?sfvrsn=60c7f2d_2 [Accessed 29.4.2022].Google Scholar
Nobay, F., Simon, B. C., Levitt, M. A. and Dresden, G. M. A prospective, double-blind, randomized trial of midazolam versus haloperidol versus lorazepam in the chemical restraint of violent and severely agitated patients. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine. 2004;11(7):744–9.Google Scholar
Martel, M., Sterzinger, A., Miner, J., Clinton, J. and Biros, M. Management of acute undifferentiated agitation in the emergency department: A randomized double-blind trial of droperidol, ziprasidone, and midazolam. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine. 2005;12(12):1167–72.Google Scholar
Isbister, G. K., Calver, L. A., Page, C. B. et al. Randomized controlled trial of intramuscular droperidol versus midazolam for violence and acute behavioral disturbance: The DORM study. Annals of Emergency Medicine 2010;56(4):392–401 e1.Google Scholar
Sweetman, S. Martindale: The Complete Drug Reference. Medicines Complete Royal Pharmaceutical Society; 2009. www.medicinescomplete.com/mc/martindale/current/ [Accessed 29.4.2022].Google Scholar
Taylor, D., Okocha, C., Paton, C., Smith, S. and Connolly, A. Buccal midazolam for agitation on psychiatric intensive care wards. International Journal of Psychiatry in Clinical Practice 2008;12:309–11.Google Scholar
Parker, C. Midazolam for rapid tranquillisation: Its place in practice. Journal of Psychiatric Intensive Care 2014;11(01):6672.Google Scholar
Schwagmeier, R., Alincic, S. and Striebel, H. W. Midazolam pharmacokinetics following intravenous and buccal administration. British Journal of Clinical Pharmacology 1998;46(3):203–6.Google Scholar
Perkins, J., Ho, J. D., Vilke, G. M., and DeMers, G. American Academy of Emergency Medicine position statement: Safety of droperidol use in the emergency department. Journal of Emergency Medicine 2015;49(1):91–7.Google Scholar
Brook, S., Lucey, J. V., and Gunn, K. P. Intramuscular ziprasidone compared with intramuscular haloperidol in the treatment of acute psychosis. Journal of Clinical Psychiatry 2000;61(12):933–41.Google Scholar
Khan, S. S. and Mican, L. M. A naturalistic evaluation of intramuscular ziprasidone versus intramuscular olanzapine for the management of acute agitation and aggression in children and adolescents. Journal of Child and Adolescent Psychopharmacology 2006;16(6):671–7.Google Scholar
Barzman, D. H., DelBello, M. P., Forrester, J. J., Keck, P. E. and Jr., Strakowski, S. M. A retrospective chart review of intramuscular ziprasidone for agitation in children and adolescents on psychiatric units: prospective studies are needed. Journal of Child and Adolescent Psychopharmacology 2007;17(4):503–9.Google Scholar
Kohen, I., Preval, H., Southard, R. and Francis, A. Naturalistic study of intramuscular ziprasidone versus conventional agents in agitated elderly patients: retrospective findings from a psychiatric emergency service. American Journal of Geriatric Pharmacotherapy 2005 3(4):240–5.Google Scholar
Barak, Y., Mazeh, D., Plopski, I. and Baruch, Y. Intramuscular ziprasidone treatment of acute psychotic agitation in elderly patients with schizophrenia. American Journal of Geriatric Psychiatry 2006 14(7):629–33.Google Scholar
Ahmed, U., Jones, H. and Adams, C. E. Chlorpromazine for psychosis induced aggression or agitation. Cochrane Database of Systematic Reviews 2010 (4):Cd007445.Google Scholar
Royal College of Psychiatrists. Management of Imminent Violence: Clinical Practice Guidelines to Support Mental Health Services (Occasional Paper OP41). Royal College of Psychiatrists, 1998.Google Scholar
National Institute for Health and Care Excellence. Psychosis and Schizophrenia in Adults: Prevention and Management. Clinical Guideline CG178 [online]. 2014. www.nice.org.uk/guidance/cg178 [Accessed 29.4.2022].Google Scholar
National Institute for Health and Clinical Excellence. Venous Thromboembolism: Reducing the Risk Clinical Guideline CG 92 [online]. 2010. www.nice.org.uk/guidance/cg92 [Accessed 29.4.2022].Google Scholar
Sorrentino, A. Chemical restraints for the agitated, violent, or psychotic pediatric patient in the emergency department: Controversies and recommendations. Current Opinion in Pediatrics 2004;16(2):201–5.Google Scholar
Einfeld, S. L. Systematic management approach to pharmacotherapy for people with learning disabilities. Advances in Psychiatric Treatment 2018;7(1):43–9.Google Scholar
Allington-Smith, P. Mental health of children with learning disabilities. Advances in Psychiatric Treatment 2018;12(2):130–8.Google Scholar
National Institute for Health and Care Excellence. Antenatal and postnatal mental health: Clinical management and service guidance Clinical guideline CG192 [online]. 2020. www.nice.org.uk/guidance/cg192 [Accessed 29.4.2022].Google Scholar
McAllister-Williams, R. H., Baldwin, D. S., Cantwell, R. et al. British Association for Psychopharmacology consensus guidance on the use of psychotropic medication preconception, in pregnancy and postpartum 2017. Journal of Psychopharmacology 2017;31(5):519–52.Google Scholar

References

Walker, N. Crime and Punishment in Britain. 2nd ed. Edinburgh: Edinburgh University Press, 1968.Google Scholar
Cordess, C. and Cox, M. Forensic Psychotherapy: Crime, Psychodynamics and the Offender Patient, Vol. 1 Mainly Theory, and Vol. 2 Mainly Practice. London/Bristol, PA: Jessica Kingsley, 1996.Google Scholar
Garland, C. Understanding Trauma: A Psychoanalytical Approach. Tavistock Clinic Series. London: Taylor and Francis, 1998.Google Scholar
Crisford, H., Dare, H. and Evangeli, M. Offence-related posttraumatic stress disorder (PTSD) symptomatology and guilt in mentally disordered violent and sexual offenders. Journal of Forensic Psychiatry & Psychology 2008; 19(1):86107.Google Scholar
Glasser, M. Aspects of violence. Paper given to the Applied Section of the British Psychoanalytical Society, 1985. See Perelberg, R. J. (ed.) 1999, Psychoanalytic Understanding of Violence and Suicide. The New Library of Psychoanalysis. Abingdon: Routledge.Google Scholar
Glasser, M. On violence: A preliminary communication. The International Journal of Psycho-analysis Oct 1998; 79 (Pt 5):887902 PMID: 9871829Google Scholar
Allen, J. G. and Fonagy, P. Mentalizing in Practice. The Handbook of Mentalization Based Treatment. Chichester: Wiley & Sons, 2006.Google Scholar
Taubner, S., White, L. O., Zimmermann, J., Fonagy, F. and Nolte, T. Attachment-related mentalization moderates the relationship between psychopathic traits and proactive aggression in adolescence. Journal of Abnormal Child Psychology, 2013;41:929938.Google Scholar
Ogilvie, C. A., Newman, E., Todd, L. and Peck, D. The relationship between attachment & psychopathy: A meta-analysis. Aggression and Violent Behaviour. 2014; 19(4):322339.Google Scholar
Cassidy, J. and Shaver, P. Handbook of Attachment: Theory, Research & Clinical applications. New York: Guildford Press, 2016Google Scholar
Driscoll, H., Zinkivskay, A., Evans, K. and Campbell, A. Gender differences in social representations of aggression: The phenomenological experience of differences in inhibitory control? Br J Psychol. 2006 May;97(Pt 2):139–53. https://doi.org/10.1348/000712605X63073. PMID: 16613646.Google Scholar
O’Connor, J. and Crisford, H. Assessment and Interventions for Anger. Presentation at Royal Holloway, University of London, for the Doctorate in Clinic Psychology Training,England, 2017.Google Scholar
Copping, L. (2017). Gender differences in violence and aggression. In Sturmey, P. (ed.), The Wiley Handbook of Violence and Aggression. Chichester: John Wiley & Sons. https://doi.org/10.1002/9781119057574.whbva005.Google Scholar
Perelberg, R. Psychoanalytic Understanding of Violence and Suicide. The New Library of Psychoanalysis. London: Routledge, 1998.Google Scholar
Yakeley, J. Psychodynamic approaches to violence. British Journal of Psychiatric Advances, 2018; 24(2):8392.Google Scholar
National Institute for Health and Care Excellence. Violence and aggression. Short-term management in mental health, health and community settings. Updated edition. Nice Guideline NG10. 2015.Google Scholar
Markham, S. Red-teaming the Panopticon (mobilising adaptive change in secure and forensic settings). Journal of Forensic Psychiatry and Psychology, 2017; 29(1):1636.Google Scholar
Doctor, R. Dangerous Patients: A Psychodynamic Approach to Risk Assessment and Management. Forensic Psychotherapy Monograph Series, London: Routledge, 2003.Google Scholar
Beck, R. and Fernandez, E. Cognitive-behavioral therapy in the treatment of anger: A meta-analysis. Cognitive Therapy and Research, 1988; 22(1):6374.Google Scholar
Henwood, K. S., Chou, S. and Browne, K. D. A systematic review and meta-analysis on the effectiveness of CBT informed anger management. Aggression and Violent Behaviour 2015; 25B:280–92.Google Scholar
Novaco, R. W. Anger and coping with stress: Cognitive behavioural interventions. In Forest, J. A. P. A. N. and Rathjen, D. P. (eds.), Cognitive Behaviour Therapy: Research and Application. New York: Plenum Press, 1978, pp. 135–73.Google Scholar
Miller, W. R. and Rollnick, S., Motivational interviewing: Helping people change. New York: Guilford Press, 2013Google Scholar
Davies, W. Overcoming Anger and Irritability: A Self-Help Guide Using Cognitive Behavioural Techniques. 2nd ed. London: Robinson, 2009Google Scholar
Meichenbaum, D. Stress inoculation training: A preventative and treatment approach. In Lehrer, P. M., Woolfolk, R. L. and Sime, W.E. (eds.), Principles and Practice of Stress Management, 3rd ed. New York: Guilford Press, 2007, pp. 497516.Google Scholar
Novaco, R. W., Stress inoculation: A cognitive therapy for anger and its application to a case of depression. Journal of Consulting and Clinical Psychology, 1977;45(4):600–8.Google Scholar
Horner, R. H., Dunlap, G., Koegel, R. L. et al. Toward a technology of ‘non-aversive’ behavioural support. Journal of the Association for Persons with Severe Handicaps 1990; 15(3):125–32.Google Scholar
Allen, D., James, W., Evans, J., Hawkins, S., and Jenkins, R. Positive behavioural support: Definition, current status and future directions. Learning Disability Review, 2005; 10(2):411.Google Scholar
Gore, N. J. , McGill, P. , Toogood, S. et al. Definition and scope for positive behaviour support. International Journal of Positive Behaviour Support 2013;3(2):1423.Google Scholar
NHS Protect. Meeting needs and reducing distress: Guidance for the prevention and management of clinically related challenging behaviour in NHS settings. 2013. Available at www.crisisprevention.com/CPI/media/Media/Blogs/Meeting-needs-and-reducing-distress-NHS-Protect-CB.pdf [Accessed 24 April 2022].Google Scholar
Bateman, A. W. and Fonagy, P. Mentalization-based treatment of BPD. J Pers Disord. 2004 Feb;18(1):3651. https://doi.org/10.1521/pedi.18.1.36.32772. PMID: 15061343.Google Scholar
Bateman, A. and Fonagy, P. Psychotherapy for Borderline Personality Disorder. Mentalization Based Treatment. USA. Oxford University Press. 2004.Google Scholar
Bateman, A., O’Connell, J., Lorenzini, N., Gardner, T. and Fonagy, P. A randomised controlled trial of mentalization-based treatment versus structured clinical management for patients with comorbid borderline personality disorder and antisocial personality disorder. BMC Psychiatry. 2016 Aug 30;16(1):304. https://doi.org/10.1186/s12888-016-1000-9. PMID: 27577562; PMCID: PMC5006360.Google Scholar
Linehan, M. DBT Skills Training Manual. New York: Guilford Press, 2015Google Scholar
Bion, W.R. Learning from Experience. London: Tavistock, 1962Google Scholar
Gordon, J. and Kirtchuk, G. (eds.) Psychic Assaults and Frightened Clinicians: Countertransference in Forensic Settings, London: Karnac Books, 2008.Google Scholar
Ching, L., Hillen, T., Reiss, D., Kirtchuk, G., Scott, S. and Maier, M. The interpersonal dynamics consultation in physical health settings: A model for reflective practice. BJPsych Advances 2013; 25(2):122–30.Google Scholar
Cooper, A. and Lousada, J., Borderline Welfare: Feeling and Fear of Feeling in Mod-ern Welfare. London: Karnac, 2005Google Scholar
NHS England. The Five Year Forward View for Mental Health. 2016. www.england.nhs.uk/publication/the-five-year-forward-view-for-mental-health/ [Accessed 25 April 2022].Google Scholar
Vaspe, A. Psychoanalysis, The NHS, and Mental Health Work Today: Psychoanalytic Ideas. London: Karnac, 2017.Google Scholar
Adshead, G., Ferrito, M., and Bose, S. Recovery after homicide narrative shifts in therapy with homicide perpetrators. Criminal Justice and Behaviour, 2015; 42(1):7081.Google Scholar
Main, T. The hospital as a therapeutic institution. Bulletin of the Menninger Clinic 1946; 10:6670.Google Scholar
Rapoport, R. N. Community as Doctor. London: Tavistock Publications, 1960.Google Scholar
Rutter, D. and Tyrer, P. The value of therapeutic communities in the treatment of personality disorder: A suitable place for treatment? Journal of Psychiatric Practice 2003 Jul;9(4):291302. https://doi.org/10.1097/00131746-200307000-00004. PMID: 15985944.Google Scholar
Lees, J., Manning, N. and Rawlings, B. A culture of enquiry: Research evidence and the therapeutic community. Psychiatric Quarterly 2004 Fall;75(3):279–94. https://doi.org/10.1023/b:psaq.0000031797.74295.f8. PMID: 15335230.Google Scholar
Pearce, S., Scott, L., Attwood, G. et al. Democratic therapeutic community treatment for personality disorder: randomised controlled trial. British Journal of Psychiatry 2017 Feb;210(2):149–56. https://doi.org/10.1192/bjp.bp.116.184366. Epub 2016 Dec 1. PMID: 27908900.Google Scholar
Royal College of Psychiatrists. Enabling Environment Awards. www.rcpsych.ac.uk/quality/qualityandaccreditation/enablingenvironments.aspx [Accessed 25 April 2022].Google Scholar
Kalvin, C. B. and Bierman, K. L. Child and adolescent risk factors that differentially predict violent versus nonviolent crime. Aggressive Behavior 2017 Nov;43(6):568–77. https://doi.org/10.1002/ab.21715. Epub 2017 Jun 8. PMID: 28597509; PMCID: PMC5640463.Google Scholar
Evans, D. P. COVID-19 and violence: A research call to action. BMC Women’s Health 2020 Nov 10;20(1):249. https://doi.org/10.1186/s12905-020-01115-1. PMID: 33172466; PMCID: PMC7653443.Google Scholar
Gilligan, J. Can psychoanalysis help us to understand the causes and prevention of violence? Psychoanalytic Psychotherapy 2016;30(2):125–37.Google Scholar
Whiting, D., Lichtenstein, P. and Fazel, S. Violence and mental disorders: A structured review of associations by individual diagnoses, risk factors, and risk assessment. Lancet Psychiatry 2021 Feb;8(2):150–61. https://doi.org/10.1016/S2215-0366(20)30262-5. Epub 2020 Oct 20. PMID: 33096045.Google Scholar
National Institute for Health & Clinical Excellence. Drug misuse – Psychosocial Interventions. NICE CG 51. Issued July 2007. www.nice.org.uk/guidance/cg51/evidence/drug-misuse-psychosocial-interventions-full-guideline-195261805 [Accessed 25 April 2022].Google Scholar
National Institute for Health & Clinical Excellence. Coexisting severe mental ill-ness and substance misuse: Community health and social care services. NICE Guideline NG58. Issued 2016. www.nice.org.uk/guidance/NG58 [Accessed 25 April 2022].Google Scholar
Tyrer, P. Nidotherapy: A new approach to the treatment of personality disorder. Acta Psychiatrica Scandinavica 2002 Jun;105(6):469–71; discussion:471–2. https://doi.org/10.1034/j.1600-0447.2002.01362.x. PMID: 12059852.Google Scholar
Tyrer, P. The importance of nidotherapy and environmental change in the management of people with complex mental disorders. International Journal of Environmental Research and Public Health 2018;15(5):972.Google Scholar
Tyrer, P., Sensky, T. and Mitchard, S. Principles of nidotherapy in the treatment of persistent mental and personality disorders. Psychother Psychosom 2003, Nov–Dec, 72(6):350–6.Google Scholar
Ministry of Health New Zealand. Family Violence Assessment and Intervention Guideline. Child abuse and intimate partner violence. 2016 www.health.govt.nz/publication/family-violence-assessment-and-intervention-guideline-child-abuse-and-intimate-partner-violence [Accessed 25 April 2022].Google Scholar
Carerstrust. The Triangle of Care. Carers Included: A Guide to Best Practice in Mental Health Care. 2013. https://carers.org/downloads/resources-pdfs/triangle-of-care-england/the-triangle-of-care-carers-included-second-edition.pdf [Accessed 24 April 2022].Google Scholar

References

Royal College of Psychiatrists. Healthcare Commission National Audit of Violence 2006–7 Final Report – Working Age Adult Services. www.dynamis.training/wp-content/uploads/violence-audit-report.pdf [Accessed 28.4.2022].Google Scholar
Royal College of Psychiatrists. Standards for Inpatient Mental Health Services. Third edition. [online 2019]. www.rcpsych.ac.uk/docs/default-source/improving-care/ccqi/ccqi-resources/rcpsych_standards_in_2019_lr.pdf?sfvrsn=edd5f8d5_2 [Accessed 25.4.2022].Google Scholar
Care Quality Commission. Key lines of enquiry for healthcare services. 2020. www.cqc.org.uk/guidance-providers/healthcare/key-lines-enquiry-healthcare-services [Accessed 26.4.2022].Google Scholar
National Institute of Clinical Excellence. Violence and aggression: short-term management in mental health, health and community settings. NICE guideline NG10 28 May 2015. www.nice.org.uk/guidance/ng10/resources/violence-and-aggression-shortterm-management-in-mental-health-health-and-community-settings-pdf-1837264712389 [Accessed 26.4.2022].Google Scholar
National Association of Psychiatric Inpatient Units (NAPICU). National Minimal Standards for Psychiatric Intensive Care in General Adult Services. September 2014. https://napicu.org.uk/publications/national-minimum-standards/ [Accessed 26.4.2022].Google Scholar
Safe Wards. www.safewards.net/ [Accessed 26.4.2022].Google Scholar
Star Wards. 2004. www.starwards.org.uk/ [Accessed 26.4.2022].Google Scholar
The Strategy Unit. Midlands and Lancashire Commissioning Support Unit. November 2019 [online]. www.strategyunitwm.nhs.uk/publications/exploring-mental-health-inpatient-capacity [Accessed 14.4.2022].Google Scholar
Royal College of Psychiatrists. Quality Networks and Accreditation. www.rcpsych.ac.uk/improving-care/ccqi/quality-networks-accreditation [Accessed 26.4.2022].Google Scholar
O’Sullivan, O. P., Chang, N. H., Njovana, D., Baker, P. and Shah, A. Quality improvement in forensic mental health: The East London forensic violence reduction collaborative. BMJ Open Quality 2020 Sep;9(3):e000803. https://doi.org/10.1136/bmjoq-2019-000803. PMID: 32928782; PMCID: PMC7488843.Google Scholar
NHS England. Implementing the Five Year Forward View for Mental Health. www.england.nhs.uk/wp-content/uploads/2016/07/fyfv-mh.pdf [Accessed 26.4.2022]Google Scholar
National Institute of Clinical Excellence. Violence and aggression: Service user experience in adult mental health services. Quality standard [QS14] Published: 13 December 2011. Last updated: 31 July 2019. www.nice.org.uk/guidance/qs14 [Accessed 26.4.2022].Google Scholar
Beer, M. D., Pereira, S. M. and Paton, C. Psychiatric Intensive Care. 2nd ed. Cambridge, England: Cambridge University Pres, 2008.Google Scholar
Department of Health. Health Building Note 03-01: Adult acute mental health units. 2013. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/147864/HBN_03-01_Final.pdf [Accessed 26.4.2022].Google Scholar
National Association of Psychiatric Inpatient Units (NAPICU). Design Guidance for Psychiatric Intensive Care Units. 2017. https://napicu.org.uk/wp-content/uploads/2017/05/Design-Guidance-for-Psychiatric-Intensive-Care-Units-2017.pdf [Accessed 26.4.2022].Google Scholar
NIDUS UK. Nidotherapy. Better Mental Health through Environmental Change. https://nidotherapy.com [Accessed 26.4.2022].Google Scholar
Carmel, H. and Hunter, M. Psychiatrists injured by patient attack. Bulletin of the American Academy of Psychiatry and the Law 1991;19(3):309–16. PMID: 1777692.Google Scholar
James, D. V., Fineberg, N. A., Shah, A. K. and Priest, R. G. An increase in violence on an acute psychiatric ward: A study of associated factors. British Journal of Psychiatry 1990 Jun;156:846–52. https://doi.org/10.1192/bjp.156.6.846. PMID: 2207515.Google Scholar
NHS England. Mental Health Staffing Framework. www.england.nhs.uk/6cs/wp-content/uploads/sites/25/2015/06/mh-staffing-v4.pdf [Accessed 26.4.2022].Google Scholar
The Kings Fund and Gilburt, H. Securing money to improve mental health care … but no staff to spend it on. October 2019. www.kingsfund.org.uk/blog/2019/10/mental-health-staff-shortage [Accessed 26.4.2022].Google Scholar
Department of Health and Social Care. Statutory guidance. Code of Practice: Mental Health Act 1983. [online] Published 2015. Last updated 2017. www.gov.uk/government/publications/code-of-practice-mental-health-act-1983 [Accessed 26.4.2022].Google Scholar
Weaver, T., Madden, P., Charles, V. et al. Comorbidity of substance misuse and mental illness in community mental health and substance misuse services. British Journal of Psychiatry 2003 Oct;183:304–13. https://doi.org/10.1192/bjp.183.4.304. PMID: 14519608.Google Scholar
Department of Health. Dual diagnosis in mental health inpatient and day hospital settings. Guidance on the assessment and management of patients in mental health inpatient and day hospital settings who have mental ill-health and substance use problems. October 2006. www.drugsandalcohol.ie/17765/1/DOH_Dual_diagnosis_in_mental_health_inpatient_and_day_settings.pdf [Accessed 26.4.2022].Google Scholar
DrugWise. Promoting Evidence based information on drugs, alcohol and tobacco. www.drugwise.org.uk/new-psychoactive-substances/ [Accessed 26.4.2022].Google Scholar
Shafi, A., Gallagher, P., Stewart, N., Martinotti, G. and Corazza, O. The risk of violence associated with novel psychoactive substance misuse in patients presenting to acute mental health services. Human Psychopharmacology 2017 May;32(3). https://doi.org/10.1002/hup.2606. Epub 2017 Jun 19. PMID: 28631373.Google Scholar
Smith, M. Barnet, Enfield and Haringey Mental Health Trust to use sniffer dogs in St. Ann’s Hospital wards to clamp down on drug use. Tottenham and Wood Green Independent, December 2015. www.thetottenhamindependent.co.uk/news/14130697.barnet-enfield-and-haringey-mental-health-trust-to-use-sniffer-dogs-in-st-anns-hospital-wards-to-clamp-down-on-drug-use/ [Accessed 26.4.2022].Google Scholar
Nash, M. Who let the dogs in? The use of drug sniffer dogs in mental health settings. Journal of Psychiatric and Mental Health Nursing 2005 Dec;12(6):745–9. https://doi.org/10.1111/j.1365-2850.2005.00918.x. PMID: 16336601.Google Scholar
Institute of Clinical Excellence. Coexisting severe mental illness and substance misuse: community health and social care services. NICE guideline [NG58]. 30 November 2016. www.nice.org.uk/guidance/NG58 [Accessed 26.4.2022].Google Scholar
Department of Health. Health Policy Implementation Guide. Dual Diagnosis Good Practice Guide. www.dualdiagnosis.co.uk/uploads/documents/originals/Dual_Diagnosis_Good_Practice_Policy_Implementation_Guide.PDF [Accessed 26.4.2022].Google Scholar
Care Quality Commission. Sexual safety on mental health wards. 2017. Last Updated 2018. www.cqc.org.uk/publications/major-report/sexual-safety-mental-health-wards [Accessed 26.4.2022].Google Scholar
National Collaborating Centre for Mental Health. Sexual Safety Collaborative. Standards and guidance to improve sexual safety on mental health and learning disabilities inpatient pathways. London: National Collaborating Centre for Mental Health; 2020. www.rcpsych.ac.uk/docs/default-source/improving-care/nccmh/sexual-safety-collaborative/sexual-safety-collaborative–-standards-and-guidance.pdf?sfvrsn=1eb6a5b7_2 [Accessed 26.4.2022].Google Scholar
Department of Health. Mental health policy implementation guide: National minimum standards for general adult services in psychiatric intensive care units (PICU) and low secure environments. 2002. https://napicu.org.uk/wp-content/uploads/2013/04/2002-NMS.pdf [Accessed 26.4.2022].Google Scholar
NAPICU. Joint BAP NAPICU evidence-based consensus guidelines for the clinical management of acute disturbance: De-escalation and rapid tranquillisation. 2018. https://napicu.org.uk/publications/joint-bap-napicu-evidence-based-consensus-guidelines-for-the-clinical-management-of-acute-disturbance-de-escalation-and-rapid-tranquillisation/ [Accessed 26.4.2022].Google Scholar
RCPsych. Rethinking risk to others in mental health services. College Report (CR201). [online 2017]. www.rcpsych.ac.uk/docs/default-source/improving-care/better-mh-policy/college-reports/college-report-cr201.pdf?sfvrsn=2b83d227_4 [Accessed 18.4.2022].Google Scholar
Bowers, L. and Park, A. Special observation in the care of psychiatric inpatients: A literature review. Issues in Mental Health Nursing 2001 Dec;22(8):769–86. https://doi.org/10.1080/01612840152713018. PMID: 11881179.Google Scholar
Bowers, L., Simpson, A. and Alexander, J. Patient-staff conflict: results of a survey on acute psychiatric wards. Social Psychiatry and Psychiatric Epidemiology. 2003 Jul;38(7):402–8. https://doi.org/10.1007/s00127-003-0648-x. PMID: 12861448.Google Scholar
Flood, C., Bowers, L. and Parkin, D. Estimating the costs of conflict and containment on adult acute inpatient psychiatric wards. Nursing Economics 2008 Sep-Oct;26(5):325330, 324. PMID: 18979699.Google Scholar
Lambert, K., Chu, S., Duffy, C. et al. The prevalence of constant supportive observations in high, medium and low secure services. BJPsych Bulletin 2018 Apr;42(2):5458. https://doi.org/10.1192/bjb.2017.14. Epub 2018 Feb 6. PMID: 29405902; PMCID: PMC6001855.Google Scholar
NHS. The Atlas of Shared Learning. Reducing ‘enhanced observations’ on a mental health ward. [online]. 2019. www.england.nhs.uk/atlas_case_study/reducing-enhanced-observations-on-a-mental-health-ward/ [Accessed 26.4.2022]Google Scholar
Cardell, R. and Pitula, C. R. Suicidal inpatients’ perceptions of therapeutic and nontherapeutic aspects of constant observation. Psychiatric Services 1999 Aug;50(8):1066–70. https://doi.org/10.1176/ps.50.8.1066. PMID: 10445656.Google Scholar
Reen, G. K., Bailey, J., Maughan, D. L. and Vincent, C. Systematic review of interventions to improve constant observation on adult inpatient psychiatric wards. International Journal of Mental Health Nursing 2020 Jun;29(3):372–86. https://doi.org/10.1111/inm.12696. Epub 2020 Feb 12. PMID: 32048785.Google Scholar
Department of Health. Positive and Proactive Care: Reducing the need for restrictive interventions. [online] 2014. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/300293/JRA_DoH_Guidance_on_RP_web_accessible.pdf [Accessed 26.4.2022].Google Scholar
Stevenson, S. Heading off violence with verbal de-escalation. Journal of Psychosocial Nursing and Mental Health Services 1991 Sep;29(9):610. PMID: 1941731.Google Scholar
Care Quality Commission. Brief guide: Restraint (physical and mechanical). [online]. www.cqc.org.uk/sites/default/files/20180322_900803_briefguide-restraint_physical_mechanical_v1.pdf [Accessed 26.4.2022].Google Scholar
NAPICU. NAPICU position on the monitoring, regulation and recording of the extra care area, seclusion and long-term segregation use in the context of the Mental Health Act 1983: Code of Practice (2015). 2016. https://napicu.org.uk/wp-content/uploads/2016/10/NAPICU-Seclusion-Position-Statement.pdf [Accessed 26.4.2022].Google Scholar
Dix, R., Betteridge, C. and Page, M. (2008) Seclusion: Past, present and future. In Psychiatric Intensive Care, 2nd ed., ed. Beer, D., Pereira, S. M. and Paton, C.. Cambridge: Cambridge University Press, pp. 106–23.Google Scholar
National Association of Psychiatric Intensive Care (NAPICU). Managing acute disturbance in the context of COVID-19 [online]. Updated December 2020. https://napicu.org.uk/wp-content/uploads/2020/12/NAPICU-Guidance_rev5_15_Dec.pdf [Accessed 26.4.2022].Google Scholar
Royal College of Psychiatrists. The National Audit of violence (2003 – 2005). Final Report. [online]. 2005. www.wales.nhs.uk/documents/FinalReport-violence.pdf [Accessed 26.4.2022].Google Scholar
NICE. Service user experience in adult mental health services. Quality standard [QS14]. Quality statement 8: Inpatient meaningful activities. Published: 13 December 2011. Updated July 2019. [online]. www.nice.org.uk/guidance/qs14/chapter/Quality-statement-8-Inpatient-meaningful-activities [Accessed 26.4.2022].Google Scholar
Mental Health Foundation. How to look after your mental health using exercise. [online]. www.mentalhealth.org.uk/publications/how-to-using-exercise [Accessed 26.4.2022].Google Scholar
Rahman, M., Taylor, C., Abdullahi, R. et al. Nile Ward PICU violence reduction quality improvement project. Published online by Cambridge University Press, 18 June 2021. www.cambridge.org/core/journals/bjpsych-open/article/nile-ward-picu-violence-reduction-quality-improvement-project/18A86956B08923300E523FA803F2C0FD [Accessed 26.4.2022].Google Scholar
Psychological Professions Network England. Implementing the NHS Long Term Plan: Maximising the Impact of the Psychological Professions. [online] 2019. www.nwppn.nhs.uk/attachments/article/2578/PPN_Long_Term_Plan_Online_Single_compressed.pdf# [Accessed 26.4.2022].Google Scholar
The University of Manchester. Talk, Understand, Listen for In-Patient Settings (TULIPS). [online] https://sites.manchester.ac.uk/tulips/ [Accessed 26.4.2022].Google Scholar
Berry, K. Acute inpatient wards: Time to implement psychological therapies. University of Manchester: blog [online]. June 2021. https://blog.policy.manchester.ac.uk/posts/2021/06/acute-inpatient-wards-time-to-implement-psychological-therapies/ [Accessed 26.4.2022].Google Scholar
The Association of Psychological Therapies. What does RAID® stand for in mental health? [online]. www.apt.ac/what-does-raid-stand-for-in-mental-health.html [Accessed 26.4.2022].Google Scholar
Royal College of Psychiatrists. COVID-19: Guidance for clinicians. www.rcpsych.ac.uk/about-us/responding-to-covid-19/responding-to-covid-19-guidance-for-clinicians [Accessed 6.10.2022].Google Scholar
Royal College of Nursing. COVID-19 guidance on mental health care delivery. [online]. Updated June 2021. www.rcn.org.uk/clinical-topics/mental-health/professional-guidance/covid-19-guidance-on-mental-healthcare-delivery [Accessed 21.5.2022].Google Scholar
Care Quality Commission. CQC finds mental health inpatient services coped well with coronavirus (COVID-19) but there will have been ‘significant unmet need’ during lockdown. [online 2020]. Available at: www.cqc.org.uk/news/releases/cqc-finds-mental-health-inpatient-services-coped-well-coronavirus-covid-19-there-will [Accessed 6.10.2022].Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×