24^th International Conference on Psychiatry & Psychosomatic Medicine October 12-14, 2017 Park Inn by Radisson, London, UK

David Truswell has worked in community based mental health services in the UK for over thirty years developing services for people with complex care needs and enduring mental health problems including a forensic history in a career spanning the Voluntary Sector, Local Authority Services, and the NHS at a senior level. He has two Master’s level degrees, including a distinction level MBA. He is currently Chair of PLIAS Resettlement, a not-for-profit organization based in London working with offenders and ex-offenders to help improve life skills and self-confidence and reduce re-offending. He has written several articles on the issues faced by Black, Asian and minority ethnic communities in the mental health system.

The presentation is a summary overview of a three-year project delivered by PLIAS Resettlement, a UK not for profit organization working with offenders and ex-offenders. The Project was designed to address some of the shortcomings in the services and support for women in the criminal justice system identified in the Review of Women with Vulnerabilities in the Criminal Justice System by Baroness Corston in the UK in 2007. This involved developing and delivering a programme of personal development, vocational and soft skills for women who had criminal convictions, mental health difficulties or substance abuse issues and who originated from a Black, Asian or minority ethnic background. The project worked with 20 women per year with the goal of achieving a 75% success rate in getting programme graduates into paid work, education or training or voluntary work. The project worked through building confidence, skills and worked to improve family relationships. Group workshops, individual goal planning sessions and personal mentoring was central to the operation of the programme. The development of network links with a wide variety of local organizations helped to provide a wide range of work and trainingn opportunities for the programme candidates. The presentation explores the factors that contributed to the programmes success in achieving its goals and identifies recommendations for further progress using the Phoenix Project approach.

Prerna Kohli is a 100 Women Achievers Award Winner (2016) from the President of India, Mr. Pranab Mukherjee. She is a Clinical Psychologist, a Public Speaker, a Workshop Facilitator and a Holistic Practitioner. She offers heart-based workshops and lectures that focus on Life Balance, Self-awareness, and Inner Peace. She blends intuitive wisdom with a solid understanding and believes that “You can talk with a close friend or relative about what’s troubling you, yet it’s not the same as a professionally- trained experienced Psychologist who knows exactly what kind of help you need." Most of all, she creates a powerful holistic approach, specializing in the areas of emotional change. With over 20 years of experience, she has been providing families, individuals, parents and children counselling on being happy. Working with prison inmates is one of the numerous ways through which she repays her gratitude to the society, which has given her the opportunity to heal thousands of persons.

A prison, in general, is an extremely negative space from a psychological perspective. Research has indicated that effects of prisonization (institutionalization) are unique for everyone, and these can have serious negative impact on their postprison integration, but in almost all cases these negative effects are reversible. Tihar prison, New Delhi, India is the largest prison complex of South Asia and is styled as a correctional institution. Against a sanctioned capacity of 5200 inmates, the actual strength is around 12,000. While the goals and objective of the Tihar Jail are lofty, overcrowding, lack of modern facilities leads to multiple psychosomatic illnesses in the inmates during the period of incarceration. Another unfortunate reality is the extended and languishing prison stay of under-trials due to slow police investigation processes and even slower judicial systems. These under-trials have to suffer additional psychological stress as compared to the regular inmates because of the daily anxiety, uncertainty, helplessness, powerlessness, and despair involved. The National Mental Health Survey 2015-16, an all-India survey, has revealed that mental health has become a major issue in the country with 4 out of 10 women and 1 out of 10 men suffering from depression. My work with Tihar has shown that the number of cases of depression in the incarcerated exceeds the general population in the same socio-economic strata of society. There is a higher number of prisoners suffering from depression, anxiety and stress and the subsequent illness compared to the general population. My work has also shown that we need to treat these regular and under-trials inmates as highly vulnerable individuals and group therapy combined with some elements of individual counselling can go a long way in helping them integrate comfortably in society upon release. It has also shown that every prison can put in place systems/processes to achieve this without much financial investment.

Lucy Love is the Assistant Medical Director for Mountain Healthcare, a major provider of forensic medical services for complainants of sexual assault in the UK. She has been a Sexual Offences Examiner for 20 years, including the evaluation of child sexual abuse and regularly appears in court as an expert witness. She is a recognized trainer of Sexual Assault Nurse Examiners and Paediatric Medical Examiners in the UK and is an accredited Psychosexual Therapist in Kent.

Sexual violence may have a negative psychological impact on the victim. Some survivors will in time recover whilst others will go on to develop PTSD or suffer long term psychological sequelae, such as depression and anxiety. The Kent SARC, in conjunction with the Kent Mental Health Partnership Trust have developed a screening tool for nurses and crisis workers to assess which survivors are at risk of psychological harm and might benefit from rapid access to talking therapies, including EMDR. The screening tool and the pathway to permit rapid access to talking therapies is discussed and an early data set presented for patients treated through this pathway.

Sally has three areas of research interest. She has a published track record in each interest area – the association between urban design of the built environment and various impacts on health and wellbeing, such as increases and decreases in social cohesion, physical activity decision-making, delinquency and adolescent obesity; the psychological profiles of emotionally resilient emergency management, defense, forensic science and police practitioners after repeated exposure to occupational stressors and critical incidents as part of their work. This work is specifically interested in stress management and resiliency in these highly stressful occupations; and interagency collaboration in serious criminal investigations. This research looks at how police and lawyers use forensic science, forensic psychiatry and psychology, and forensic medicine in serious criminal cases. This research has a specific aim to discover how well understood the various forensic health disciplines are to police, lawyers and judges and to look at ways to make valuable expertise more readily understood and utilised in the criminal justice system

Forensic science is increasingly used by criminal justice personnel to assist in exonerating the innocent and establishing links to crime. With the increased use of forensic science the risk of unjust outcomes increases. One reason is the more serious the matter the more likely practitioners involved in a case are multi-disciplinary (police, medicine, law, forensic science), and multi-organisational in the private and government sectors (Health, Justice, legal, police). The importance of identifying effective multi-organisational information sharing is to prevent the ‘justice silo effect’. This is where practitioners from different organisations operate in isolation (with minimal or no information/expertise sharing). In this presentation the findings from a large Australia-wide project will be discussed. This project explored the extent of justice silos within Australia. We interviewed  121 police, scientists, lawyers, judges, coroners, and forensic medical practitioners. Two key findings from an initial analysis were that investigative meetings were rare in adult sexual assault cases, and further, many medical practitioners were invisible in investigative decision-making with this low level of visibility being due to lawyers, forensic scientists or police not being

aware of the expertise these practitioners offer. The aim of the current aspect of this project was to develop a flowchart that mapped the forensic and evidentiary process from initial reporting by an adult victim of sexual assault to the trial preparation stage. The flowchart would map the different agencies and practitioners involved in each step and include forensic feedback loops to advise practitioners of the quality of the evidence they collected/analysed. The rationale for creating this flowchart was to provide a visual aid that would identify the range of different agencies. By highlighting who was involved in a typical adult sexual assault investigation this flowchart could act as a means of preventing agency and practitioner silos.