Biomedical subjects
Publications and source records attributed to R L Symonds.
A previous survey of national rail fatalities and a sample of fatalities in southern England revealed many probable suicides and a small proportion of accidents. Epidemiological and clinical characteristics of this survey are reviewed in the light of general safety on British railways.
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National statistics for railway fatalities in England and Wales show a reduction of train crashes and a fluctuating level of deaths, of which an increasing proportion is from suicide. A closer examination of a two-year sample from the South of England revealed a large proportion of probable suicides and a small proportion of pure accidents. The remainder appeared to have medical, mainly psychiatric, contributions to their death, of which alcohol was an important factor in single young men. Rail suicides appear to be younger, the men less often married, the women more often married, and both sexes less often widowed than other suicides. They included more cases of major psychosis and neurosis, but fewer and less severe alcoholics. Characteristic patterns of this method of suicide are described with examples. Hypotheses to explain the choice of method suggest that it is not related to either volume of traffic, or residence in a rail-dense area or in an area with a high suicide rate, or the proximity of a psychiatric hospital.
The use of lithium-containing compounds has increased dramatically since their introduction into the pharmacopoeia in 1968. However, there is no evidence of more than transitory decreases in admissions to hospital with mania. Such admissions, particularly for female readmissions, have increased. Reasons for this are suggested.
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The seasonal variation of admissions to hospital with a diagnosis of mania (296.1) in England and Wales was examined. The results indicated that for females there was a significant seasonal trend, the peak being in August-September, while for males there was no significant seasonal pattern. The possible reasons for these findings are discussed.
This is a study of one mode of inception into psychiatric care in Birmingham. Mentally disturbed people coming to the attention of the police are referred to a mental welfare officer and assessed by him, usually in a police station. The mental welfare officer may then refer for a psychiatric decision with regard to further management, and the patient is examined by the doctor in the police station. The annual frequency of use of this referral system was studied from 1962-73 inclusive. It is shown that there was an increase in referral over the years and that such referral from the police became an increasing proportion of new referrals to the Mental Health Department (Social Services Department). The sample of referrals from the police for 12 months is studied in greater detail (252 cases), surveying social characteristics of individual patients, the relationships between such police intervention and areas of the city, the nature of situation requiring intervention and the management and treatment which these patients received. The referrals were traced from contact with the mental welfare officer to hospital where the case notes of those admitted were studied for details of legal status and mental state on admission, diagnosis, duration of stay and disposal. The effectiveness of this method of entering treatment is discussed and some recommendations are made.
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