The Fixated Threat Assessment Centre: preventing harm and facilitating care

The main risk of death or serious harm to public figures in western countries comes not from terrorists or criminals, but from the activities of lone individuals with intense pathological fixations, the majority of whom are mentally disordered. We report preliminary efficacy data from the Fixated Threat Assessment Centre (FTAC), the first joint police/National Health Service unit in the United Kingdom, which was set up to assess and manage such risks. One hundred consecutive cases assessed as being of moderate or high concern were examined. Eighty-six per cent suffered from psychotic illness. Following FTAC intervention, 57% were admitted to hospital by local psychiatric services, and 26% taken on by community psychiatric teams. Concern levels were reduced to low through FTAC interventions in 80% of cases. FTAC proved able to catalyse suitable health outcomes which both benefited the patients and reduced risk to public figures. The advantages of joint police-National Health Service units are discussed.

[1]  David Callaway,et al.  Risk factors for approach behavior toward the u.s. congress , 2003 .

[2]  David V James,et al.  Abnormal attentions toward the British Royal Family: factors associated with approach and escalation. , 2010, The journal of the American Academy of Psychiatry and the Law.

[3]  R. McIvor,et al.  Stalkers and their Victims (2nd edn) , 2009, British Journal of Psychiatry.

[4]  David V James,et al.  A research review of public figure threats, approaches, attacks, and assassinations in the United States. , 2004, Journal of forensic sciences.

[5]  R. Purcell,et al.  Study of stalkers. , 1999, The American journal of psychiatry.

[6]  R. Coulthard.  Book Review: Daniel McNaughton: His Trial and the Aftermath , 1979 .

[7]  R L Stubblefield,et al.  Behavioral sciences and the law. , 1966, The American journal of orthopsychiatry.

[8]  Susan J. Adams,et al.  Harassment of Members of Parliament and the Legislative Assemblies in Canada by individuals believed to be mentally disordered , 2009 .

[9]  Mario J. Scalora,et al.  Use of Threat Assessment for the Protection of the United States Congress , 2008 .

[10]  Steve. Poole.  The politics of regicide in England, 1760–1850 , 2001 .

[11]  David V. James,et al.  Persistence in stalking: a comparison of associations in general forensic and public figure samples , 2010 .

[12]  David V James,et al.  Stalkers and harassers of British royalty: an exploration of proxy behaviours for violence. , 2011, Behavioral sciences & the law.

[13]  Paul E. Mullen,et al.  STALKERS and their victims: Assessing and managing the stalker , 2000 .

[14]  R. T. Phillips.  Assessing presidential stalkers and assassins. , 2006, The journal of the American Academy of Psychiatry and the Law.

[15]  David V. James,et al.  Stalking Risk Profile : Guidelines for the Assessment and Management of Stalkers , 2009 .

[16]  P. Mullen,et al.  Vexatious litigants and unusually persistent complainants and petitioners: from querulous paranoia to querulous behaviour. , 2006, Behavioral sciences & the law.

[17]  S. Hucker.  Daniel McNaughton: His trial and the aftermath: Edited by D.J. West and A. Walk. London: Gaskell Books/Royal College of Psychiatrists, 1977, 185 pp. , 1978 .

[18]  Mario J Scalora,et al.  The relationship of mental illness to targeted contact behavior toward state government agencies and officials. , 2003, Behavioral sciences & the law.

[19]  F. Farnham,et al.  Factors Associated with Escalation and Problematic Approaches Toward Public Figures * , 2011, Journal of forensic sciences.

[20]  David V. James,et al.  The fixated and the pursuit of public figures , 2009 .

[21]  David V James,et al.  Attacks on the British Royal family: the role of psychotic illness. , 2008, The journal of the American Academy of Psychiatry and the Law.

[22]  Mario J Scalora,et al.  An epidemiological assessment of problematic contacts to members of Congress. , 2002, Journal of forensic sciences.

[23]  S. Çakır.  Stalking: Psychiatric Perspectives and Practical Approaches. , 2007, The American journal of psychiatry.

[24]  F. Farnham,et al.  Outcome of psychiatric admission through the courts. In RDS Occasional Paper , 2002 .

[25]  J R Meloy,et al.  Stalkers and harassers of royalty: the role of mental illness and motivation , 2009, Psychological Medicine.

[26]  F. Farnham,et al.  The role of mental disorder in attacks on European politicians 1990–2004 , 2007, Acta psychiatrica Scandinavica.