Dr Katherine Morley

Senior Lecturer

Kate did her PhD research on genetic and environmental influences on smoking at the University of Queensland and the Queensland Institute of Medical Research in Australia, graduating in 2007. She then became a NHMRC Post-doctoral Training Fellow at the University of Melbourne, jointly based at the Centre for Molecular, Environmental, Genetic and Analytic Epidemiology and the Orygen Centre for Youth Mental Health. In 2009 Kate left Australia for the UK and the Department of Human Genetics at the Wellcome Trust Sanger Institute. There she worked on computational and statistical genetics projects for a number of years before moving to the Farr Institute of Health Informatics Research at University College London, and then to the Institute of Psychiatry, Psychology & Neuroscience (IoPPN).

Aims: Determine whether acute alcohol intoxication when individuals are detained under the Mental Health Act (MHA) police powers increases risk for a second detention within 3 months.

Design: Data from 1322 detentions under Section 135/136 of the MHA at the South London and Maudsley (SLaM) Centralised Place of Safety (CPoS) were extracted from electronic medical records, supplemented by clinical note review. Using logistic regression, including an interaction between alcohol intoxication and suicide attempt prior to detention, we estimated the association between intoxication and being detained again within three months.

Setting: SLaM CPoS, an emergency psychiatric care facility.

Participants: 866 individuals detained between 01/02/2017 and 21/05/2018.

Measurements: The outcome was MHA detention within 3 months of initial detention. Alcohol intoxication was based on self-report, clinical assessment, and breathalyser readings. Suicide attempt was based on clinical note review. Mental health diagnoses (depression, psychosis, personality disorder), drug intoxication (cannabinoids, cocaine, amphetamines), age, gender, ethnicity, and housing status were included as covariates.

Findings and conclusions: Within 3 months, 6.7% (n=58) of individuals were detained again.  In preliminary results, intoxication at initial detention did not increase odds of a second detention; odds ratio (OR) 0.86, 95% confidence interval (CI): 0.17-4.23.  However, those who were intoxicated and had attempted suicide had substantially greater odds (OR 3.94, CI 1.66-9.35). This was slightly higher than those who had attempted suicide but were not intoxicated (OR 3.25, CI 1.34-7.88). As MHA detentions have increased fourfold in the last decade, further exploration of the role of alcohol intoxication is needed.

Co-Authors

Dr Katherine I. Morley Mr John Robins Ms Kezia Ross Ms Matilde Rahtz Dr Vivienne Curtis Dr Nicola J. Kalk Affiliation for JR, NJK, KR, KIM: Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King ‘s College London Affiliation for MR, VC: Centralised Place of Safety, South London and Maudsley NHS Foundation Trust

Conflicts of interest:

No conflict of interest