Brooker Charlie, Tocque Karen, Paul Sheila
Royal Holloway, University of London, United Kingdom.
University of Chester, United Kingdom.
J Forensic Leg Med. 2018 Feb;54:44-49. doi: 10.1016/j.jflm.2017.12.018. Epub 2018 Jan 3.
A one year audit was undertaken of the mental health (MH) status of adult attendees to the Thames Valley Sexual Assault Centres (SARC). There were 301 relevant referrals over the twelve month period of whom 126 (42%) either fully or partially completed the mental health assessments. 38% (n = 66) of the population did not consent to the research. Participation in the study was felt inappropriate by the case clinician in the rest of the cases. To summarise the findings: 36% were moderately or severely depressed; 30% experienced moderate to severe anxiety; 28% were drinking at hazardous/harmful levels; and 12% had a drug problem that was moderate to severe. Self harm affected 45% of the sample with the greater majority cutting themselves and self-harming before the age of 17. Admission to a psychiatric in-patient unit was not uncommon and 19% had been admitted an average of three times each. The figure of 19% admitted to a psychiatric hospital is 90 times higher than for the general female population. 42% of the total sample were being prescribed medication for their mental health problem. The paper concludes that: there should be agreement nationally on the use of a standardised set of mental health outcome measures which are used in all assessments; there should be a move towards the commissioning of expert psychological support that is offered in a SARC and the pathways for specialist mental health care out of the SARCs. Finally, forensic physicians and general practitioners needs a greater awareness of the mental health sequalae of sexual assault and they then need to make prompt referrals to the appropriate services.
对泰晤士河谷性侵犯中心(SARC)成年来访者的心理健康(MH)状况进行了为期一年的审计。在这十二个月期间,有301例相关转诊病例,其中126例(42%)全部或部分完成了心理健康评估。38%(n = 66)的人群不同意参与研究。在其余病例中,病例临床医生认为参与该研究不合适。总结研究结果如下:36%的人有中度或重度抑郁;30%的人经历中度至重度焦虑;28%的人饮酒量处于有害/危险水平;12%的人有中度至重度药物问题。45%的样本存在自我伤害行为,其中大多数人在17岁之前就开始割伤自己并实施自我伤害。入住精神病住院病房的情况并不少见,19%的人平均每人入院三次。19%入住精神病医院的比例比一般女性人群高90倍。42%的总样本因心理健康问题正在接受药物治疗。该论文得出结论:全国应就使用一套标准化的心理健康结果测量指标达成一致,这些指标应用于所有评估;应朝着委托在性侵犯中心提供专家心理支持以及性侵犯中心之外的专科心理健康护理途径的方向发展。最后,法医和全科医生需要更清楚地认识到性侵犯对心理健康的后遗症,然后需要及时转诊到适当的服务机构。