SPJs

1
Outcomes Study Professor Robert Snowden1,
Professor Nicola Gray2, and Ty Catrin staff 1
School of Psychology, Cardiff University 2 Ty
Catrin Personality Service, Pastoral Cymru
Self-Harm

• Self harm and attempted suicide
• Very strong evidence that both self-injurious
  behaviours reduce quite dramatically over a
  period of 24 months stay at Ty Catrin. This is
  evidenced for both males and females.
• Aggression
• For females, aggression reduces, though
  gradually, over a 24 month period. For males we
  do not have evidence of such a reduction.
• Genuine effect or artefact?
• Perhaps the most prolific self
  harmers/aggressors leave early? So tested this.
  Looked at length of time in study versus amount
  of self-harm or aggression (first full month in
  Ty Catrin).
• For self-injury, found POSITIVE correlations
  (self-injury ? .37 attempted suicide ?
  .30). For aggression, correlations were also
  POSITIVE (? .22) but not significant.
• Conclusion Ty Catrin keeps the prolific
  self-harmers longer and discharges those that are
  harming less (as they should!). Likewise, for
  those aggressing against others.
• What next?
• We dont yet have evidence for long-term
  follow-up (e.g., after discharge) but are
  gathering these data.
• Our results show a DECREASE in NEGATIVE
  behaviours. We now want to mirror this result by
  showing an INCREASE in POSITIVE behaviours. To
  this end we are now recording instances of
  positive behaviours in a manner similar to our
  AVS system.
• Pathway to a Better Future
• Llwybr at Well Dyfodol

• Aims
• Demonstrate significant change in key
  behavioural indicators for patients in Ty Catrin
• Background and method
• Aims
• During first 3 months of stay we complete a
  thorough assessment of each patient, that
  includes measures of Personality Disorder
  (including PCL-R), structured professional
  judgments (SPJ) of risk to others and the risk to
  the self.
• These assessments are done by full time clinical
  psychologists
• Monitored behaviour via AVS system throughout
  stay. For each incident its nature (e.g.,
  self-harm, being victimised, absconding, etc.) is
  recorded along with an ordinal measure of
  severity
• Database and project design/management and
  scientific analysis carried out under external
  supervision of Cardiff University (Professor
  Robert Snowden).

Attempted Suicide

• SPJs
• The gold-standard measure of risk of violence
  is the HCR20.
• Our population scores extremely high (M 31.4)
• Snowden et al. (2010) data from over 1000
  patients in independent sector MSUs M 18.5
• Similar results for self-injury risk (RoSP)
• Snowden, Taylor and Gray (2010) Risk assessment
  for future violence in individuals from an ethnic
  minority group. International Journal of Forensic
  Mental Health, 9, 118-123

Aggression