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Missing persons and mental health
Study 1 Missing an opportunity: Exploring the importance of mental health in cases of missing persons
Lucy Holmes, Research Manager, Missing People Dr. Penny Woolnough, Senior Research Officer, Police Scotland Graham J. Gibb, Braemar Mountain Rescue Association Raymond M. Lee , Emeritus Professor, Royal Holloway University of London Professor Mike Crawford, Imperial College London
Study 2 Mental health and missing people: A comparative study of police force data
With thanks to WPC Software
Categorising the data
Collecting the data Study 1
Study 2
Study 1
Study 2
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COMPACT data extracted using a script
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2 forces provided data on 2,688 and 2,719 incidents respectively, totalling 5,407 incidents.
01 02 03 04 05 06 07 08
01 02 03 04 05 06 07 08 09 10 11 12 13
Invited all police forces to send 10 closed cases per division
•
22 forces provided 2,198 urban and rural cases
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Cases were recorded between Jan 1996 – Aug 2003
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Missing person cases opened in calendar year 2010
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The challenge of individuals vs. incidents
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Two forces; one largely rural, one with a larger urban population
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Content analysis of case paperwork
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Force 1; 1,491 individuals
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Personal, geographical and psychological characteristics
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Force 2; 1,605 individuals
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Up to 70 pieces of information relating to each case
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Total individuals in study; 3,096
Analysing the data
Psychosis / schizophrenia Depression Psychological / anxiety related Dementia related Behaviour related condition Addiction problems Bipolar disorder Other psychiatric
Clinical and general diagnosis coded separately.
ADHD, autism, Asperger’s and related Alzheimer’s, dementia, amnesia and related Behavioural difficulties, paranoia and related Anxiety, panic attacks, phobia, PTSD and related Eating disorders Learning difficulties Bipolar disorder, manic, hypomania Mood related: depression and related Schizophrenia, psychosis and related Personality disorder, borderline, self-harmer Substance abuse Other Not classified
Study 1: Mental health profile - all cases
Study 1
Study 2
Age • Age ranged from 1 to 93 years • 57.7% of incidents involved adults • 42.4% of incidents involved under 18 year olds
Age • Age ranged from 1 to 110 years • 58.4% of individuals were adults • 41.6% of individuals were aged under 18 years
Sex • Male - 59.7% (incidents) • Female - 40.3% (incidents)
Sex • Male - 55.5% (individuals) • Female - 44.5% (individuals)
Clinical Diagnosis Unknown (no info in case paper) None psychiatric
Number of incidents
1,230
All Number of incidents
%
56.0
854
%
38.9
30
1.4
13
0.6
Depression
363
16.5
566
25.8
Psychosis / schizophrenia
156
7.1
157
7.1
Behaviour related condition
72
3.3
154
7.0
Dementia related condition
111
5.1
127
5.8
19
0.9
115
5.2
101
4.6
105
4.8
Other psychiatric condition
58
2.6
46
2.1
Manic depression/bipolar disorder
31
1.4
31
1.4
Addiction problems
27
1.2
30
1.4
2,198
100.0
2,198
100.1
Psychological/anxiety related condition Learning disability
Total
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Study 1: Findings
Study 1: Mental health profile - adults and children Under 18s
Diagnosis Psychosis / schizophrenia Depression Psychological/ anxiety related Dementia related Learning disability Behaviour related condition Addiction problems Bipolar disorder Other psychiatric None psychiatric Unknown Total
Clinical Number of % incidents
Adults
All Number of incidents
Clinical Number of % incidents
%
All Number of incidents
%
4
0.4
4
0.4
152
12.0
153 12.1
19
2.0
57
6.1
343
27.0
508 40.0
5
0.5
55
5.9
14
1.1
0 36
0.0 3.9
0 37
0.0 4.0
111 65
8.7 5.1
66
7.1
146
15.7
6
0.5
7
0.6
0
0.0
0
0.0
27
2.1
30
2.4
1 3 6 787
0.1 0.3 0.6 84.9
1 1 4 622
0.1 0.1 0.4 67.1
30 55 24 442
2.4 4.3 1.9 34.8
927
99.8
927
99.8
1268
99.9
60
4.7
127 10.0 68 5.4
30 2.4 45 3.5 9 0.7 232 18.3 100. 1269 1
• Adults with a mental health diagnosis are more vulnerable to going missing on more than one occasion • 13% of all cases (21% adults / 3% of young people) reported to have previously attempted suicide • Fatal outcomes overinflated - majority related to suicide • 40 attempted suicide • No relationship between presence / absence of mental health diagnosis and outcome • Sample sizes too small to look at type of diagnosis and outcome 14% reported missing from a medical establishment 9% reported missing by medical / hospital staff 5% traced by medical staff 4% located at medical establishments
17%
Poor data recording for some categories of information
• Alcohol problems appear higher than normal - almost 10% of all cases (16% adults) • In 10% of all cases (15% of adults) the missing person had consumed alcohol at time they were last seen • High level of drug and alcohol abuse and co-morbidity (but comorbidity figures appear lower than national estimates) • Overall, illicit drug and alcohol problems are higher in this study than previous missing persons studies
Adults Number of % of all individuals adults
Reported condition No mental health problem reported
Children Number of % of all individuals children
758
41.9
998
77.5
51
2.8
159
12.3
113
6.3
1
0.1
68
3.8
4
0.3
380
21.0
29
2.3
192
10.6
8
0.6
119
6.6
3
0.2
All Number of individuals
%
1,756
56.7
Mood related: depression and related
409
13.2
ADHD, autism, Asperger’s and related
210
6.8
Schizophrenia, psychosis and related
200
6.5
Other
147
4.7
Substance abuse
122
3.9
Learning difficulties
115
3.7
Alzheimer’s, dementia, amnesia and related
114
3.7
Personality disorder, borderline, self-harm
105
3.4
Bipolar disorder, manic, hypomania
72
2.3
Anxiety, panic attacks, phobia, PTSD and related
55
1.8
Behavioural difficulties, paranoia and related
51
1.6
Eating disorders
13
0.4
3
0.1
Not classified
Study 2: Mental health profile by age group - all cases
Reported condition No mental health problem reported ADHD, autism, Asperger’s and related Alzheimer’s, dementia, amnesia and related Bipolar disorder, manic, hypomania Mood related: depression and related Schizophrenia, psychosis and related Substance abuse
• Potentially high level of non-diagnosis (at least 18% general diagnosis)
Study 2: Mental health profile - all cases
Study 1: Findings
• • • •
• Mental health diagnoses appear greater in the missing person population than the general population
Study 2: Key findings • Repeat missing incidents – Age – Sex – Mental health
• Duration missing – F1, 89% found within 2 days – F2, 90.8% found within 2 days
• Gender and mental health • Substance use and mental health • Missing from location
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Discussion • The two studies presented provide complementary findings and develop our knowledge base. Replication and expansion would further support this. • There is a paucity of detail about diagnosed conditions, reported conditions, missing from location and found location, as well as wider outcomes. • In both studies, people with mental health problems represent a large proportion of missing incidents and individuals.
Recommendations: Prevention; Protection; Provision •
Mental health perspective
Prevention •
Awareness raising among health and social care professionals
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Awareness raising / educational work with people with mental health problems
Protection •
Early intervention / prevention of repeat missing
• Repeat missing incidents
Provision
• Cost
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Better information recording
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Improved information sharing
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Inter-professional education.
• Implications of the new approach to missing persons
Further research • Replication - bigger and better sample of data – we are still happy to accept data for Study 2, please approach a member of the team if you can help.
Lucy Holmes, Research Manager, Missing People
[email protected] https://www.missingpeople.org.uk/ Penny Woolnough, Senior Research Officer, Police Scotland
[email protected] http://www.scotland.police.uk/
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