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Managing the impact of violence on mental health, including among witnesses and those affected by homicide

Shepherd, Jonathan Paul and Bisson, Jonathan Ian 2012. Managing the impact of violence on mental health, including among witnesses and those affected by homicide. Royal College of Psychiatrists.

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There is a strong evidence base for trauma-focused psychological treatments to treat PTSD and for both psychological and pharmacological interventions to treat comorbid conditions such as anxiety, depression and substance use disorders commonly found in individuals injured in and otherwise affected by violence.2,8 Trauma-focused cognitive–behavioural therapy for patients with acute PTSD or acute stress disorder reduces the risk of chronic PTSD.9 Formal screening and triage of everyone exposed to traumatic events in primary care and in emergency department settings has been found to be inefficient and wasteful.10 However, raised awareness among health professionals and trained volunteers in community and criminal justice settings can result in more individuals affected by violence and other crime accessing the support and treatment they need. Individuals injured or affected by violence in other ways who demonstrate evidence of mental health effects should be referred by Victim Support or other competent support agencies to primary care for further assessment. The stepped care approach summarised in Fig. 1 takes account of co-existing mental health conditions. The Royal College of Psychiatrists is championing the introduction of this pathway in collaboration with the Royal College of General Practitioners, the College of Emergency Medicine and Victim Support, acknowledging that a wide range of third-sector and statutory agencies can provide effective services. The College can help by increasing awareness of this approach, highlighting the training opportunities for staff who deliver the interventions, and supporting the work of other sectors in this context. Psychiatrists themselves can identify and implement ways in which this pathway can be facilitated in their services, for example ensuring that psychiatrists and other mental health professionals/counsellors are trained to recognise and manage mental health disorders that occur following violence.

Item Type: Monograph (Other)
Date Type: Completion
Status: Unpublished
Schools: Dentistry
Additional Information: Position Statement PS01/2012
Publisher: Royal College of Psychiatrists
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Last Modified: 04 Jun 2017 07:52

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