PurposePeople with intellectual disability (ID) experience high rates of physical and mental health problems, while access to appropriate healthcare is often poor. This cohort was established to develop an epidemiological profile related to the health, health service use, disability services, mortality and corrective services records of people with ID.ParticipantsThe cohort contains 92 542 people with ID (40% females) with a median age of 23 years (IQR: 12–43 years) and 2 004 475 people with a neuropsychiatric or developmental disorder diagnosis (50% females) with a median age of 51 years (IQR: 29–73 years) from New South Wales, Australia. The whole sample contains records for 2 097 017 individuals with most data sets spanning financial years 1 July 2001 to 30 June 2016. A wide range of data from linked population data sets are included in the areas of disability, health, corrective services and targeted specialist support services in public schools, Public Guardian and Ombudsman services.Findings to dateThis study includes one of the largest cohorts of people with ID internationally. Our data have shown that the presence of ID is significantly associated with emergency department presentations and psychiatric readmissions after the first psychiatric admission based on a subcohort of people with a psychiatric admission. Adults with ID experience premature mortality and over-representation of potentially avoidable deaths compared with the general population.Future plansWithin the health service system, we will examine different components, that is, inpatient, emergency adult services, children and younger people services and costs associated with healthcare as well as mortality, cause and predictors of death. The neuropsychiatric and developmental disorders comparison cohort allows comparisons of the physical health, mental health and service use profiles of people with ID and those with other neuropsychiatric disorders.

This paper addresses the air emissions of grid supply versus grid‐connected and off‐grid photovoltaic power generation, using the framework of life‐cycle assessment, in the context of rural household energy supply in Australia. Emissions of carbon dioxide, sulphur dioxide and nitrous oxides are calculated for the three life‐cycle stages of manufacture, use and disposal. Sensitivities to materials and data inputs, as well as to component efficiencies, lifetimes and sizing are discussed. For each supply option, demand management options, including insulation and appliance choice, and the substitution of solar heating or bottled gas for electricity, are considered. The best option in all cases, in terms of life‐cycle air emissions, is a grid‐connected photovoltaic system used to supply an energy‐efficient household with a mix of solar, gas and electric appliances. However, in financial terms, with current Australian energy prices, this option represents a high capital and life‐cycle cost. Additionally, for the grid options, electricity costs do not significantly disadvantage the high demand scenarios. Both results provide a clear illustration of current Australian energy‐pricing policies being in conflict with long‐term environmental sustainability. © 1998 John Wiley & Sons, Ltd.

In a 25-year Australian cohort of men and women found Not Guilty by reason of Mental Illness (NGMI forensic patients; N ¼ 477), we aimed to: establish the sociodemographic, clinical and forensic characteristics of the sample, comparing men and women; to establish rates of post-release reoffending, including for men and women separately; and to test associations between individual characteristics and post-release re-offending in the full sample. Post-release re-offending was considered in terms of officially-recorded charges, proven offenses, violent offenses, and any offending within the first 12 months of release. Women (13.8%) were found to differ significantly from men on a number of key characteristics but, although women had a higher rate of proven offending in the early post-release period, sex was not a predictor of post-release offending overall. Post-release re-offending rates were low (6.3% committed proven offenses in the first 12 months following release) and the only independent predictor of re-offending was a clinically-recorded diagnosis of co-morbid personality disorder (i.e. co-morbid with a primary psychosis diagnosis). The differences identified between male and female NGMI forensic patients, including the differences in reoffending in the early post-release period, have implications for the development of forensic services and interventions, in both inpatient and community settings.

Objective: To describe the characteristics of offenders found not guilty on the grounds of mental illness (NGMI) in New South Wales and rates of NGMI and other homicide verdicts. Method: Demographic, legal and clinical data after referral to the NSW Mental Health Review Tribunal following an NGMI verdict for homicide matched with results from the National Homicide Monitoring Program. Results: Between 1993 and 2016, a total of 2159 homicide offenders were dealt with by the NSW courts, including 169 (7.8%) who were found NGMI. Over this period, the rate of non-NGMI homicide convictions fell from 1.83 per 100,000 per annum to 0.65 per 100,000 per annum (Kendall’s tau = −0.79, p ⩽ 0.001) while the rate of NGMI homicide fluctuated, with an average annual rate of about 0.1 per 100,000 per annum (Kendall’s tau = 0.17, p = 0.23). There was no association between the annual rates of NGMI and non-NGMI homicides (Pearson r = −0.3, p = 0.16) but falling rate of non-NGMI homicide meant that the proportion of NGMI offences doubled from 5.5% in the first 12 years to 11% in the second 12 years. Nearly all (88.7%) of those found NGMI had a schizophrenia-related psychosis. However, there were high rates of psychiatric comorbidity including substance use disorder (60.7%) and a history of a prior head injury (41.1%). Most (83.4%) of the NGMI offenders had previous contact with mental health services, but only half of these had received treatment with antipsychotic medication. Conclusion: The fall in conviction for homicide offences in the last 24 years has not been matched by a reduction in NGMI homicide verdicts. More assertive treatment of emerging psychosis and comorbid substance use disorders, and improved continuity of care of chronic psychosis might prevent some homicides.

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