Can physiological monitoring identify imminent violence in MIO's?

• Research type

  Research Study

• Full title

  Can physiological monitoring identify imminent violence in mentally ill offenders?

• IRAS ID

  258068

• Contact name

  SJ O'Rourke

• Contact email

  suzanne.o'rourke@nhs.net

• Sponsor organisation

  The State Hospital

• Duration of Study in the UK

  0 years, 11 months, 26 days

• Research summary

  In addition to high rates of self-harm, up to 40% of mental health inpatients exhibit violent or assaultive behaviour. Current guidelines indicate the use of manual, mechanical or pharmaceutical restraints when necessary to minimise injuries but this process can be associated with physical trauma and even death. Restrained patients also report psychological problems, most notably post-traumatic stress disorder (PTSD), in addition to feeling angry, humiliated, punished and degraded . Patients may also be the subject to, or witness, aggression significantly compromising the therapeutic environment. Further, staff are at increased risk of physical injury, PTSD, emotional exhaustion and cardiovascular disease as a result of set behaviours.

  In forensic psychiatric practice, our ability to accurately predict violence using Structured Professional Judgement tools remains debateable with many tools demonstrating limited success in predicting inpatient violence. Wearable devices have been shown to successfully predict panic attacks, emotional states, emotional responses and agitation. Through use of these devices, it is possible that we are able to more accurately understand the physiological precursors of incidents that occur in real life, enabling preparation for, or avoidance of, aggressive incidents.

  The aim of the proposed study is to assess if a watch-like wristband monitoring device is able to detect the antecedents of violent and aggression incidents in a forensic psychiatric inpatient sample. We propose a small proof of concept study that would involve recruitment of twelve patients deemed to be at an increased risk for violent and aggressive episodes. Physiological data will be collected using Empatica’s E4 wristbands in parallel with incident reports and security data in order to determine if the device has the ability to alert staff to patterns of increasing agitation previously observed to precede incidents of violence.

  Our primary research question is:
  • Can imminent violence and aggression be predicted through real time physiological monitoring using a wristband?

• REC name

  Scotland A: Adults with Incapacity only

• REC reference

  19/SS/0016

• Date of REC Opinion

  28 Feb 2019

• REC opinion

  Favourable Opinion