Exploring core relationships between insight and communication and social skills in mentally disordered offenders

This paper reports collective data analysis for the Behavioural Status Index insight and communication and social skills subscales. This is an instrument designed specifically for health care practitioners to measure behavioural and social functioning among mental health clients, in particular those in forensic care. Data were collected, using a repeated measures method by primary nurses, from a sample of 503 patients in two high security mental health hospitals in the UK. Results are reported for interscalar item correlations and factor analysis. Data trends are indicative of clinically interesting relationships. A six-factor structure emerged suggesting groupings of intra- and interscalar behaviours. The first of these contained all the Behavioural Status Index insight items. Significant differences were found on a number of factors between independent groups. Generally, results indicate that patients on lower dependency wards scored more normatively on the factors, adding to instrument validity. Men were found to score more normatively than women. According to Mental Health Act 1983 classifications, psychopathically disordered patients scored more normatively than mentally ill patients, who in turn scored more normatively than patients with learning disability. Clinical practice implications and ongoing European studies examining the use of the instrument in clinical practice and its association to treatment planning are discussed.