Saturday 08 June 2019
Birmingham Conference and Events Centre
FACULTY OF FORENSIC & LEGAL MEDICINE
Mental Health Care and Learning
Disability Day for Healthcare
professionals /clinicians working in GFM
and SOM
Programme
08:45 – 09:15 Registration and refreshments
09:15 – 09:50 Excited delirium syndrome: from 19th century Massachusetts to
21st century Canada
Professor Keith Rix
09:50 – 10:30 "Houston, we have a problem!", managing acute disturbance
Dr Sotiris Posporelis
10:30 – 11:10 Acute Behavioural Disturbance in the E.R….What next?
Dr Richard Stevenson
10:10 – 11:40 Refreshments
11:40 – 12:30 The FFLM Guidelines on the Management of Acute Behavioural
Disturbance in Police Custody
Dr Margaret Stark
12:30 – 12:45 FFLM Update
Dr Margaret Stark
12:45 – 13:45 Lunch
13:45 – 14:30 Best practice in obtaining and presenting evidence in sexual
assault cases involving vulnerable complainants
Michelle Heeley QC, No 5 Chambers and Simon Rippon, Citadel Chambers
14:30 – 15:45 Psychological impact of rape and sexual assault and managing
risk to self
Raquel Machado Correia and Dr Danielle Jackson
15:45 – 16:00 Refreshments
16:00 – 16:30 Discussion
16:30 End of study day
This programme and all details are subject to alteration without notice
Speakers Professor Keith Rix
Honorary Consultant Forensic Psychiatrist, Norfolk and Suffolk NHS
Foundation Trust and Visiting Professor of Medical Jurisprudence, Institute of
Medicine, University of Chester
Professor Keith Rix is a consultant forensic psychiatrist. His involvement in the
forensic field began in the 1960’s when he lived in hostels in London with ex-
offenders and assessed prisoners for hostel admission. He moved to Leeds as
senior lecturer in psychiatry in 1983 and became a visiting consultant psychiatrist at
HM Prison, Leeds. He established the Leeds Magistrates’ Court Mental Health
Assessment and Diversion Scheme and the city’s forensic psychiatry service. He
has provided expert evidence to the courts for over thirty years, including evidence
on a pro bono basis in capital cases in the Caribbean and Africa, and he is the author
of Expert Psychiatric Evidence and lead author of the Royal College of Psychiatrists
report Responsibilities of psychiatrists who provide expert opinion to courts and
tribunals. He is also the editor of A Handbook for Trainee Psychiatrists and co-author,
with his wife Elizabeth Lumsden Rix, of Alcohol Problems. Until recently he was a
Chairman of the Fitness to Practise Panel of the Medical Practitioners Tribunal
Service and part-time lecturer in the Department of Law, De Montfort University,
Leicester. He is now Visiting Professor of Medical Jurisprudence, Institute of
Medicine, University of Chester, and Honorary Consultant Forensic Psychiatrist in
the Norfolk and Suffolk NHS Foundation Trust. In 2015 he was elected an Honorary
Fellow of the Faculty of Forensic & Legal Medicine of the Royal College of
Physicians.
Excited delirium syndrome: from 19th century Massachusetts to 21st century
Canada
This presentation identifies the origins of today’s ‘excited delirium syndrome’ in the
19th century concept of what has become known as ‘Bell’s mania’ but which on
proper inspection of the reported cases should probably have been called ‘Bell’s
delirium’. The controversial nature of the excited delirium syndrome is explored and
suggestions are made as to a pragmatic approach to diagnosis and classification
which may satisfy some of its critics and clarify the relationship between acute
behavioural disturbance and excited delirium syndrome. The possible
pathophysiology of the excited delirium syndrome is explored and the potentially
critical role of restraint is identified. Against this background the FFLM’s latest
guidance on the management of acute behavioural disturbance should be more
easily understood.
Speakers
Dr Sotiris Posporelis
Consultant Liaison Neuropsychiatrist, KCH, Honorary Senior Clinical Lecturer,
IoPPN
Dr Posporelis is a Consultant Liaison Neuropsychiatrist in the NHS. Employed by
South London and Maudsley NHS Foundation Trust, my main workplace is King's
College Hospital. He specializes in treatment and management of the psychiatric
complications and comorbidities of neurological disorders. He has a strong interest in
teaching and holds an Honorary Senior Clinical Lectureship at the Institute of
Psychiatry, Psychology and Neuroscience, King's College London as a Lead for the
MSc in Clinical Neuropsychiatry and Organiser of the Maudsley Grand Rounds. He
completed his Psychiatry training at the Maudsley Training Programme, as well as
an 18-month clinical research fellowship at Johns Hopkins University, Baltimore,
USA. He was awarded Researcher Trainee of the year in 2014. Currently, he is
working on reviewing management of acute disturbance in neuropsychiatric
disorders as well as looking into the potential cognitive benefits of Deep Brain
Stimulation.
https://www.linkedin.com/in/posporelis/
Pharmacological approaches to the management of Acute Behavioural
Disturbance
Dr Posporelis has co-authored the recently published joint BAP-NAPICU guidelines
for the clinical management of acute disturbance. This short session aspires to cover
the basics of safely and effectively managing acute disturbance in various clinical
settings.
Speakers
Dr Richard Stevenson
Emergency Medicine Consultant
Richard has been an Emergency Medicine Consultant since 2014, with sub-
speciality interests in toxicology, substance misuse and mental health.
Acute Behavioural Disturbance in the E.R…What next??
ABD has risen in frequency over the years within the UK. New strategies on how to
recognise the condition and effective treatments are slowly coming to light. This
presentation will aim to build confidence for practitioners and provide insight into the
underlying physiology of ABD
Speakers
Dr Margaret Stark
President FFLM, Chair of FFLM Forensic Science Subcommittee
Margaret Stark is the President of the FFLM. She is the Chairman of the Forensic
Science Sub-Committee, Lead Facilitator for the Faculty’s course in General
Forensic Medicine, and an educational advisor for the Faculty’s examinations. She
has been a forensic physician for 30 years, currently working with the Metropolitan
Police Service (MPS), and in Sussex. Previously she was a Principal in General
Practice and the first Medical Director of the Forensic Healthcare Services for the
MPS.
She is the Responsible Officer and Appraisal Lead for Care & Custody Health (Ltd).
She worked in Sydney, Australia, for over three years as Director of the Clinical
Forensic Medicine Unit for NSW Police and was appointed as an Adjunct Professor
at Sydney University. She has a breadth of experience in all aspects of clinical
forensic medicine in both the UK and Australia and has been directly involved in the
establishment of Faculties in both countries.
She was the Founding Academic Dean for the FFLM and was awarded the David
Jenkins Professorship in Forensic and Legal Medicine 2011/12. She is an Associate
Editor for the Journal of Forensic & Legal Medicine and has written extensively in
the field, in particular co-authoring the three editions of Symptoms and Signs of
Substance Misuse and Stark’s ‘Clinical Forensic Medicine’, the fourth edition due to
be published in 2019.
She has been involved in a number of qualitative and quantitative research projects
on a range of topics including clinical forensic medicine, custodial care, forensic
science, death certification, education and training, injuries and the use of force,
substance misuse, and traffic medicine including the UK Government research into
cannabis and driving. She has a Masters in medical education and has
comprehensive teaching experience as an information provider, on-the-job educator,
facilitator, assessor, and planner.
The FFLM Guidelines on the Management of Acute Behavioural Disturbance in
Police Custody
The Guidelines on the Management of ABD in police custody have been updated
and were published in April 2019 See: https://fflm.ac.uk/wp-
content/uploads/2019/05/AcuteBehaveDisturbance_Apr19-FFLM-RCEM.pdf. The
Guideline Review Panel was expanded and feedback from members of the FFLM
was considered. The Guidelines have been co-badged by the Royal College of
Emergency Medicine. An outline of the content of the Guidelines will be presented
with illustrative cases.
Speakers
Ms Raquel Machado Correia
Consultant Clinical Psychologist
Ms Correia is an experienced consultant clinical psychologist with 16 years’ post-
qualification experience. She is chartered by the British Psychological Society (BPS)
and registered with the Health Care and Professions Council (HCPC). She is also an
EMDR Europe accredited consultant and clinical supervisor and a member of the
EMDR UK & Ireland Association. Ms Correia works for the Havens (London’s Sexual
Assault Referral Centre) - King’s College Hospital NHS Foundation Trust -
specialising in the field of traumatic stress, sexual assault and sexual health. She
has worked in a variety of settings ranging from primary, secondary, in-patient and
tertiary care, having worked with a wide breadth of presentations, from acute to
enduring, and mild to severe. In addition to direct work with individuals, she also
provides supervision to psychology trainees and qualified clinical and counselling
psychologists and medical professionals. She is actively involved in providing
teaching and training for various professional groups such as the Metropolitan
Police, the Crown Prosecution Service, medical students, clinical psychology
trainees and multidisciplinary teams. She has presented at several national and
international conferences and training programmes. Her research area of interest is
on trauma and sexual assault.
Psychological impact of rape and sexual assault and managing risk to self
This presentation will outline the importance of risk assessment and management by
considering the context in which we work and the standards expected within SARC’s.
Risk cannot be understood without considering the context of our clients in terms of
their background, early experiences, and current mental health difficulties as a result
of the impact of a sexual assault. Discussion of a number of vulnerability models to
understand how early experiences can lead to current and future risk is an important
part of understanding risk assessment and management. The prevalence of sexual
assault is under-reported but high in the UK and worldwide, so we will share
statistics to help us set the scene of the potential scale of risk of suicide and self-
harm. An understanding of the client group can also assist and so discussion of
research conducted within the Havens looking at adolescents in the service will be
shared in terms of reported mental health problems. We will also share a structured
approach to support risk assessment and management that will consider risk factors,
protective factors and the importance of multidisciplinary working.
Speakers
Dr Danielle Jackson
Clinical Psychologist
Dr Danielle Jackson is a Chartered Clinical Psychologist with HCPC registration. She
completed her doctoral training at the University of Surrey. She has five years post-
qualification experience working mostly with children, young people and their
families/carers in a range of settings. Prior to her doctoral training Dr Jackson has
worked with a range of clinical presentations in a range of settings, across the
lifespan. This has included outpatient, community, primary care, inpatient and prison
settings. She currently offers psychological assessment and therapy to children,
young people and their families at the Havens. Danielle also conducts Achieving
Best Evidence interviews with children and young people as their Video Recorded
Statement following an allegation of a sexual assault, abuse or exploitation as part of
the pilot Havens Forensic Interview Service. Dr Jackson has also worked on a
number of large research trials. Her research interests include trauma, help-seeking
in BME ex-offenders and her doctoral dissertation focused on Early Intervention
teams views on spiritual crisis.
Psychological impact of rape and sexual assault and managing risk to self
This presentation will outline the importance of risk assessment and management by
considering the context in which we work and the standards expected within SARC’s.
Risk cannot be understood without considering the context of our clients in terms of
their background, early experiences, and current mental health difficulties as a result
of the impact of a sexual assault. Discussion of a number of vulnerability models to
understand how early experiences can lead to current and future risk is an important
part of understanding risk assessment and management. The prevalence of sexual
assault is under-reported but high in the UK and worldwide, so we will share
statistics to help us set the scene of the potential scale of risk of suicide and self-
harm. An understanding of the client group can also assist and so discussion of
research conducted within the Havens looking at adolescents in the service will be
shared in terms of reported mental health problems. We will also share a structured
approach to support risk assessment and management that will consider risk factors,
protective factors and the importance of multidisciplinary working.
Speakers
Michelle Heeley QC
Criminal QC and Recorder
Michelle is a criminal QC, she prosecutes and defends in the most serious of
offences, from rape to murder. She was appointed a Recorder in 2012 and is
approved to preside over Serious Sexual Offence cases. Since 2017 Michelle has
been the Director of Advocacy Training on the Midland Circuit and has trained over
200 barristers in the art of questioning vulnerable witnesses. Michelle also works with
the Inns of Court College of Advocacy delivering advocacy training overseas.
Best practice in obtaining and presenting evidence in sexual assault cases
involving vulnerable complainants
Michelle and Simon will look at early intervention from Psychiatrists and
Intermediaries, encouraging inter disciplinary working with the Police to achieve the
best first account evidence. They will also look at how barristers have been trained to
assist vulnerable witnesses and what the courts can do to ensure vulnerable
complainants are protected
Speakers
Simon Rippon
Barrister, Citadel Chambers
Following his call to the bar in 1996 Mr. Rippon was employed as a Case Review
Manager at the Criminal Cases Review Commission, where his role was to conduct
investigations into alleged miscarriages of justice and report to the commissioners
with recommendations as to the viability of returning the case to the Court of Appeal.
Having practiced locally for several years he joined Citadel Chambers in 2011. Since
then he has established a predominantly defence practice. The majority of his
practice concerns allegations of serious sexual offences. In recent years he has
defended in multiple trials lasting several months concerning grave sexual
allegations made by children. He is also regularly instructed to represent those
charged with homicide, armed robbery, significant drug importations and
conspiracies to supply, fraud and other offences of dishonesty, offences against the
person, and death by dangerous driving. He has previously lectured on identification
evidence and on how to effectively mitigate following conviction.
Best practice in obtaining and presenting evidence in sexual assault cases
involving vulnerable complainants
Michelle and Simon will look at early intervention from Psychiatrists and
Intermediaries, encouraging inter disciplinary working with the Police to achieve the
best first account evidence. They will also look at how barristers have been trained to
assist vulnerable witnesses and what the courts can do to ensure vulnerable
complainants are protected
Examinations
Have you thought about taking the
Diploma of Legal Medicine (DLM)? Are you interested in the interface between clinical practice and the law? Then
you may find studying for the Diploma of Legal Medicine of benefit for your
work.
The Faculty of Forensic & Legal Medicine’s Diploma of Legal Medicine leads to
the postnominal DLM.
This qualification may be of interest to a wide range of healthcare professionals:
Dentists, doctors, nurses, and paramedics;
Legal advisors, file handlers and case reviewers working in the various
Regulatory settings (GDC, GMC, NMC, HCPC), or for the medical defence
organisations (MDOs), and within NHS England.
Individuals who provide professional or expert witness evidence in various
disciplines may also find this qualification of benefit for their role.
The DLM examination has a one-paper format consisting of 150 best-of-five
multiple-choice questions to be completed within three hours. Candidates are
tested on a wide range of topics in Legal Medicine as set out in the published
Syllabus. See: https://fflm.ac.uk/exams/dlm/.
The next exam is on Friday 11 October 2019, at the Royal College of Physicians.
The FFLM has produced numerous publications to assist students
https://fflm.ac.uk/resources/publications/ and provides a wide range of learning
activities to support those studying in this field including eLearning, webinars,
face-to-face study days. See: https://fflm.ac.uk/e-learning/
Courses
Events
Faculty of Forensic & Legal Medicine
Correspondence address: Suite 507, 1 Alie Street, London, E1 8DE
http://fflm.ac.uk [email protected]