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BMC Psychiatry

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Open Access 01-12-2015 | Research article

Triage, decision-making and follow-up of patients referred to a UK forensic service: validation of the DUNDRUM toolkit

Authors: Mark Freestone, Deborah Bull, Roz Brown, Neil Boast, Faye Blazey, Paul Gilluley

Published in: BMC Psychiatry | Issue 1/2015

Abstract

Background

Forensic medium secure services in the UK are a scarce but essential resource providing care for those in the criminal justice system with severe mental disorder. Appropriate allocation of beds to those most in need is essential to ensure efficient use of this resource. To improve decision-making processes in a UK forensic service, an admissions panel utilized the DUNDRUM 1&2 (D1 & D2) triage instruments.

Methods

Demographic, diagnostic and clinical information on a prospective sample of referrals to a UK adult forensic service was gathered (n = 195). D1 and D2 measures were scored by a panel of clinical managers considering referral information and clinician opinion in reaching their ratings; those not admitted were also followed up.

Results

Within the sample, D1 ratings were predictive of decisions to admit (AUC = .79) and also differentiated between levels of security (F(4) = 16.54, p < .001). Non-admission was not significantly associated with increased risk of offending at follow-up. Items relating to self-harm and institutional behaviour did not show a predictive relationship with the panel decision to admit.

Conclusions

Use of a structured professional judgement tool showing good predictive validity has improved transparency of decisions and appears to be associated with more efficient use of resources, without increased risk to the public.

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Title: Triage, decision-making and follow-up of patients referred to a UK forensic service: validation of the DUNDRUM toolkit
Authors: Mark Freestone
Deborah Bull
Roz Brown
Neil Boast
Faye Blazey
Paul Gilluley
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: BMC Psychiatry / Issue 1/2015
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-015-0620-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Triage, decision-making and follow-up of patients referred to a UK forensic service: validation of the DUNDRUM toolkit

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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