Background: As the first point of contact with the criminal justice system, police contact may provide an opportunity to identify those at risk of adverse mental health and other outcomes. At a population level, information on the contact young people have with police is lacking. Objectives: This study aimed to establish the prevalence of first police contact for young people (as persons of interest, victims and witnesses), the patterns and sociodemographic correlates of contact and the incidence of first police contact for those identified with emotional and/or behavioural vulnerabilities at school entry. Methods: In a NSW-based longitudinal, population-based sample of 79,802 young people followed to a maximum age of 14 years, record linkage methodology was employed to address the stated objectives, utilizing Cox proportional regression. Findings: A total of 14.5% of children had had a first contact with police following school entry, with contact as a victim being most common. An increased incidence of police contact was identified for children assessed as having emotional and/or behavioural vulnerability at school entry, even after adjustment for key potential confounders. Conclusions: Contact with police during childhood is not uncommon. Children with emerging emotional and behavioural vulnerabilities in early life may be at increased risk of early police contact. Identifying young people who make early contact with police may present an opportunity to intervene with a group of young people at risk not only of further contact with the criminal justice system, but a range of adverse outcomes including the development of mental illnesses.

Abstract Aims Although violence is a vital public health problem, no prospective studies have tested for subsequent vulnerability to violence, as a victim or witness, in members of the general population with a range of psychiatric symptoms, or evaluated the importance of higher symptom burden on this vulnerability. Methods We used successive waves of a household survey of Southeast London, taken 2 years apart, to test if association exists between psychiatric symptoms (symptoms of psychosis, common mental disorders, post-traumatic stress disorder and personality disorder) and later victimisation, in the form of either witnessing violence or being physically victimised, in weighted logistic regression models. Statistical adjustment was made for prior violence exposure, sociodemographic confounders, substance/alcohol use and violence perpetration. Sensitivity analyses were stratified by violence perpetration, sex and history of mental health service use. Results After adjustments, psychiatric symptoms were prospectively associated with reporting any subsequent victimisation (odds ratio (OR) 1.88, 95% confidence interval (CI) 1.25–2.83), a two times greater odds of reporting witnessed violence (OR 2.24, 95% CI 1.33–3.76) and reporting physical victimisation (OR 1.76, 95% CI 1.01–3.06). One more symptom endorsed was accompanied by 47% greater odds of subsequent victimisation (OR 1.47, 95% CI 1.16–1.86). In stratified analyses, statistical associations remained evident in non-perpetrators, and among those without a history of using mental health services, and were similar in magnitude in both men and women. Conclusions Psychiatric symptoms increase liability to victimisation compared with those without psychiatric symptoms, independently of a prior history of violence exposure and irrespective of whether they themselves are perpetrators of violence. Clinicians should be mindful of the impact of psychiatric symptoms on vulnerability to victimisation, including among those with common psychiatric symptoms and among those who are not considered at risk of perpetrating violence.

Background Parental criminal offending is an established risk factor for offending among offspring, but little evidence is available indicating the impact of offending on early childhood functioning. We used data from a large Australian population cohort to determine associations between exposure to parental offending and a range of developmental outcomes at age 5 years. Method Multi-generation data in 66 477 children and their parents from the New South Wales Child Development Study were combined using data linkage. Logistic and multinomial regressions tested associations between any and violent offending histories of parents (fathers, mothers, or both parents) obtained from official records, and multiple measures of early childhood developmental functioning (social, emotional–behavioural, cognitive, communication and physical domains) obtained from the teacher-reported 2009 Australian Early Development Census. Results Parental offending conferred significantly increased risk of vulnerability on all domains, particularly the cognitive domain. Greater risk magnitudes were observed for offending by both parents and by mothers than by fathers, and for violent than for any offending. For all parental offending exposures, vulnerability on multiple domains (where medium to large effects were observed) was more likely than on a single domain (small to medium effects). Relationships remained significant and of comparable magnitude following adjustment for sociodemographic covariates. Conclusions The effect of parental offending on early childhood developmental outcomes is pervasive, with the strongest effects on functioning apparent when both parents engage in violent offending. Supporting affected families in early childhood might mitigate both early developmental vulnerability and the propensity for later delinquency among these offspring.

Background Little is known about the relative extent of crime against people with severe mental illness (SMI). Aims To assess the prevalence and impact of crime among people with SMI compared with the general population. Method A total of 361 psychiatric patients were interviewed using the national crime survey questionnaire, and findings compared with those from 3138 general population controls participating in the contemporaneous national crime survey. Results Past-year crime was experienced by 40% of patients v. 14% of controls (adjusted odds ratio (OR) = 2.8, 95% CI 2.0–3.8); and violent assaults by 19% of patients v. 3% of controls (adjusted OR = 5.3, 95% CI 3.1–8.8). Women with SMI had four-, ten- and four-fold increases in the odds of experiencing domestic, community and sexual violence, respectively. Victims with SMI were more likely to report psychosocial morbidity following violence than victims from the general population. Conclusions People with SMI are at greatly increased risk of crime and associated morbidity. Violence prevention policies should be particularly focused on people with SMI.

Background. The link between psychotic disorders and violent offending is well established; knowledge about risk of post-illness-onset offending across the full spectrum of psychiatric disorders is lacking. We aimed to compare rates of any offending and violent offending committed after the onset of illness, according to diagnostic group, with population controls.Method. A 25% random sample of the Danish population (n = 521 340) was followed from their 15th birthday until offending occurred. Mental health status was considered as a time-varying exposure in a Poisson regression model used to examine the duration from service contact to the offence.Results. Males with any psychiatric contact had an incidence rate ratio (IRR) of 2.91 [95% confidence interval (CI) 2.80-3.02] for any offending; 4.18 (95% CI 3.99-4.38) for violent offending. Associations were stronger for women (IRR 4.17, 95% CI 3.95-4.40 for any offending; 8.02, 95% CI 7.20-8.94 for violent offending). Risk was similar across diagnostic groups for any offending in males, while variation between diagnostic groups was seen for male violent and female offending, both any and violent.Conclusions. Risk of offending, particularly violent offending, was elevated across a range of mental disorders following first contact with mental health services. The extent of variation in strength of effect across diagnoses differed by gender.

Background. There is a well-established association between psychotic disorders and subsequent offending but the extent to which those who develop psychosis might have a prior history of offending is less clear. Little is known about whether the association between illness and offending exists in non-psychotic disorders. The aim of this study was to determine whether the association between mental disorder and offending is present prior to illness onset in psychotic and non-psychotic disorders.Method. In a nested case-control study, cases (n=101 890) with a first psychiatric contact during the period 1995 to 2006 were identified and matched by age and gender to population-based controls (n=2 236 195). Exposure was defined as prior criminal and violent offending.Results. Males with one offence had an incidence rate ratio (IRR) of 2.32 [95% confidence interval (CI) 2.26-2.40] for psychiatric admission whereas two or more convictions yielded an IRR of 4.97 (95% CI 4.83-5.11). For violent offending the associations were stronger and IRRs of 3.97 (95% CI 3.81-4.12) and 6.18 (95% CI 5.85-6.52) were found for one and several offences respectively. Estimates for females were of a similar magnitude. The pattern was consistent across most diagnostic subgroups, although some variability in effect sizes was seen, and persisted after adjustment for substance misuse and socio-economic status (SES).Conclusions. A prior history of offending is present in almost one in five patients presenting to mental health services, which makes it an important issue for clinicians to consider when assessing current and future risks and vulnerabilities.

Background There is considerable media, political and public interest on both sides of the Atlantic in an alleged rise in violence among military personnel returned from conflicts in Iraq and Afghanistan. This study explores violence among a large sample of UK military personnel, a proportion of whom had been deployed to Iraq/Afghanistan. The aims were to estimate the prevalence of self-reported violence, examine the impact of deployment and combat experiences on subsequent violence and the association with post-deployment mental health problems and alcohol misuse. Methods This study formed part of a questionnaire-based cohort study established to explore the impact of deployment on mental health among UK military personnel. The sample was randomly selected from all military personnel serving in the UK Armed Forces between 2003 and 2007. A total of 9986 participants from all Services were included, some had been deployed and some had been trained but not deployed. Special Forces were excluded. Data, collected by questionnaire, included information on deployment experiences, socio-demographic and military characteristics, pre-enlistment antisocial behaviour, and post-deployment health outcomes. The main violence outcomes were self –report measures of interpersonal violence. Results 6.2% of the sample reported interpersonal violence in the last month. Deployment showed a stronger association with subsequent violence among reservists (OR=2.98 (1.50–5.93),P=0.002) than among regulars (OR=1.26 (0.96–1.67),P=0.098) when compared to their non-deployed counterparts. Performing a combat role whilst deployed was associated with a significantly increased likelihood of violence among regulars (OR=1.90 (1.38–2.75), P<0.001) and the risk of violence increased with the number of traumatic events experienced (P<0.001)). Violence on homecoming was also associated with mental health problems such as PTSD (OR=4.8 (3.2–7.2) P<0.001) and alcohol misuse (OR=3.1 (2.5–3.9) P<0.001). Conclusion Military deployment, in particular combat exposure, increased the risk of subsequent violence among military personnel and the risk of violence increased with increasing number of traumatic events experienced on deployment. Valuable information on risk factors for violence among military personnel is provided, especially regarding increased risk among deployed reservists and among personnel who report post-deployment mental health problems and alcohol misuse.

OBJECTIVE:Clinicians often consider whether or not offenders with psychosis have a history of offending pre-dating the onset of their illness. The typology of offenders based on age at first offence, developed in the field of criminology, has been recently extended to mentally disordered groups, but this ignores the potential role of illness onset. METHOD:Using a large UK cohort of individuals with both psychosis and offending histories (n=331), we compared those with a history of offending pre-dating their illness (pre-morbid offenders) to those who commenced offending after becoming unwell (post-morbid offenders). We compared the demographic, clinical and offending pattern characteristics of the two groups. RESULTS:198 (60%) had offended before the onset of psychosis. These pre-morbid offenders were more likely to be male, have a lower pre-morbid IQ and have had a history of neurological abnormality. Pre-morbid offenders also committed more crime overall, but this was due to an excess of acquisitive, drug and minor offending, rather than violent offending, which was comparable to the post-morbid offending group. CONCLUSION:Currently, standardised clinical risk assessment tools view offenders with mental illness as a homogenous group with respect to life-course patterns of offending in relation to illness. Taking account of an individual's pathway to offending may improve risk assessment and management.

Background There is growing concern about an alleged rise in violent behaviour amongst military personnel returning from deployment to Iraq and Afghanistan. The aims of this study were to determine the prevalence of violence in a sample of UK military personnel following homecoming from deployment in Iraq and to examine the impact of deployment-related experiences, such as combat trauma, on violence, and the role of sociodemographics and pre-enlistment antisocial behaviour. Method This study used baseline data from a cohort study of a large randomly selected sample of UK Armed Forces personnel in service at the time of the Iraq war (2003). Regular personnel ( n =4928) who had been deployed to Iraq were included. Data, collected by questionnaire, included information on deployment experiences, sociodemographic and military characteristics, pre-enlistment antisocial behaviour, post-deployment health outcomes and a self-report measure of physical violence in the weeks following return from deployment. Results Prevalence of violence was 12.6%. This was strongly associated with pre-enlistment antisocial behaviour [adjusted odds ratio (aOR) 3.6, 95% confidence interval (CI) 2.9–4.4]. After controlling for pre-enlistment antisocial behaviour, sociodemographics and military factors, violence was still strongly associated with holding a combat role (aOR 2.0, 95% CI 1.6–2.5) and having experienced multiple traumatic events on deployment (aOR for four or more traumatic events 3.7, 95% CI 2.5–5.5). Violence on homecoming was also associated with mental health problems such as post-traumatic stress disorder (aOR 4.8, 95% CI 3.2–7.2) and alcohol misuse (aOR 3.1, 95% CI 2.5–3.9). Conclusions Experiences of combat and trauma during deployment were significantly associated with violent behaviour following homecoming in UK military personnel. Post-deployment mental health problems and alcohol misuse are also associated with increased violence.