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 forensic.medicine@fflm.ac.uk