Abstract
AimsRoughly 25% of the prison population are known to meet the criteria for attention-deficit/hyperactivity disorder (ADHD), a five-fold increase on the general population. Medium secure psychiatric services receive a high percentage of referrals from the prison service. ADHD has primary symptoms of inattention, hyperactivity and impulsivity. Untreated ADHD could clearly have a detrimental impact on the effectiveness of therapeutic interventions, as well as increasing incidents of violence, aggression and other transgressive behaviours.There are two aims: To screen the medium secure services population at the Spinney Hospital, Atherton, UK for ADHD, using a validated screening tool. This would generate candidates for further structured clinical assessment for ADHD; To implement ADHD screening as a feature of the Admission Care Plan within medium secure services at the Spinney.MethodThe study population is the medium secure service at The Spinney Hospital, Atherton. At the time of study this was 52 male service users.The team members have evaluated several screening tools. The tool eventually chosen was the B-BAARS, which is a simple 6-question tool that is validated for use in adults. The tool takes around 1 minute to complete. All 52 service users were screened between 20/01/2021 and 30/01/2021.Result1 of the 52 service users had a current diagnosis of ADHD and was being treated with medication. 3 of the 52 service users had childhood diagnoses of ADHD that had lapsed in adulthood and who were untreated. Of the remaining 51 service users without a current diagnosis of ADHD, 9 were positive on screening as worthy of further assessment (17.65%). Assessments of the 9 service users positive in screening will be completed by medical and psychology disciplines.ConclusionThere appears to be clear merit for routine screening for ADHD within medium secure psychiatric services, given the service user population and the results described above. As a result of this survey, within The Spinney Hospital the B-BAARS will be incorporated into the Admission Care Plan of all new admissions to medium secure services as a Quality Improvement Intervention. Over time this will be re-audited and there will be assessment of any impact on incidents and positive engagement with activities.
Highlights
25% of the prison population are known to meet the criteria for attention-deficit/hyperactivity disorder (ADHD), a five-fold increase on the general population
There appears to be clear merit for routine screening for ADHD within medium secure psychiatric services, given the service user population and the results described above
Mean age (± SD) was 36.1 (± 12.6) years, and 4 of these patients were female. 13 patients (76%) accepted a handheld ECG
Summary
This pilot study demonstrated such interactive components of Psychiatry teaching continue to be well received and can be effectively delivered remotely. To assess patient and clinician acceptability of handheld 6-lead ECG, for obtaining information about cardiac rhythm and electrical intervals, in acute general adult mental health ward inpatients who refuse traditional 12-lead ECG. We developed a Standard Operating Procedure for use of handheld 6-lead ECG and provided training for junior doctors on the four wards that were the subject of our original audit These doctors were able to offer the device to patients on their wards who refused 12-lead ECG. Our initial findings from this pilot suggest that handheld 6-lead ECG may be acceptable, both to clinicians and patients, as a means of obtaining information on cardiac rhythm and electrical intervals for patients who refuse 12-lead ECGs
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