Student or educator? Sign up with your school email and get 6 months of Pro free.
CoChat
Sign Up
Cited by 1Psychopathy, Forensic Psychiatry, Sexual OffendingStalking, Cyberstalking, and HarassmentCrime Patterns and Interventions

The DOI matches its Crossref record; 48 of the 48 references it cites were found in a registry or an index; none of the 51 sources its claims cite is checked for support yet.

Unmet needs: analysing the Fixated Threat Assessment Centre’s fulfilment of the public health approach, and its value for violence prevention

Open access
Seaward, Amber, Marchment, Zoe, Wilson, Simon, Elfituri, Sammi, Farnham, Frank, Plumb, Trevor, Rose, Keith, Taylor, Alice, Corner, Emily, Gill, Paul·2025·Psychology, Crime & Law
DOI 10.1080/1068316x.2025.2581795
Open this paper in CoChat — free accountOpen PDF

Abstract

The Fixated Threat Assessment Centre (FTAC) operates with a public health approach, through catalysing mental health treatment for those with mental health needs unidentified, untreated, or sub-optimally managed by mainstream services. While much literature examines mental illness’s role in fixated threats, unmet mental health needs garner less attention. This paper evaluates the value and fulfilment of safeguarding within FTAC, through analysing whether (1) FTAC identifies and successfully refers into treatment those with unmet needs, and (2) unmet needs are related to concerning behaviours. Two measures of unmet needs are analysed: disengagement from mental health services, and unidentified mental illness. Data comprise FTAC referrals from 2012 to 2016, and methods include chi-squared tests and logistic regressions. Results indicate FTAC does safeguard individuals referred. Over a quarter of referrals (where previous mental healthcare information is available) have unmet needs, predominantly psychotic illnesses. These are directed to (mental) health-based interventions, reducing concern levels. Safeguarding is useful for violence prevention, as unmet needs isolate a subgroup exhibiting disproportionately concerning behaviours (approach, problematic approach, breaching security barriers). Findings imply unmet mental health needs should be given more attention in research as a variable, and in threat assessment as a risk indicator for assessments of levels of concern.

Overview

CoChat Summary

TL;DR

This study analyses 1,914 FTAC referrals from 2012–2016 and finds that over a quarter had unmet mental health needs, predominantly psychotic illnesses, and that FTAC disproportionately directed them to mental-health interventions and reduced judged concern. Unmet needs also identified a subgroup with more concerning approach and security-breach behaviours, supporting their value as a risk indicator in fixated threat assessment.

Key findings

  • In the analysed sample, 26.70% had one of two unmet-needs forms: 21.42% were recorded as disengaged from mental health services and 5.28% had an unidentified mental illness; 84.06% had previous contact with services but only 52.25% were in contact at referral.
  • Unmet needs disproportionately involved psychotic illness: disengaged cases were more likely to have schizophrenia (OR = 1.57), while unidentified mental illness was less likely to be schizophrenia (OR = 0.49) and disproportionately involved delusional disorder (OR = 3.12).
  • FTAC disproportionately provided (mental) health-based interventions to disengaged individuals and was unlikely to take no action or police/criminal-justice action alone; both unmet-needs forms were related to a decrease in judged level of concern.
  • Disengaged individuals were more likely to approach (OR = 1.80), to both communicate and approach (OR = 1.75), and, among communicators, to approach (OR = 2.10); among approachers, unidentified mental illness was associated with successful security breaches (odds over 27 times higher than no breach and 11 times higher than a failed attempt).

Methods

  • Data were 1,914 FTAC referrals from 2012–2016, drawn from an original 2,866 referrals after removing cases with missing key mental-health information, international cases, and missing concerning-behaviour data.
  • Two unmet-needs variables were created: unidentified mental illness (no confirmed prior or current mental health service contact but FTAC clinicians judged a disorder/overt illness) and disengaged from mental health services (known to services but recorded as noncompliant).
  • Analysis used bivariate chi-squared tests and multivariate logistic regressions for approach and breach behaviours, with control variables drawn from prior fixated-threat literature where available.

Limitations

  • The paper states limitations including outdated data, missing data, unavailable interrater reliability, less information on low-concern cases, and selection effects from analysing only non-international referrals with mental-healthcare information.
  • It states there is no counterfactual, so it cannot determine what would have happened without FTAC; concern measures are professional judgements rather than objective outcomes and may be biased.
  • The paper states the causal link between unmet needs and concerning behaviours is unclear, and the findings are limited to fixated threats and FTAC; the observational design also cannot establish causality.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1080/1068316x.2025.2581795

Cites

48 of 48 references verified0 citation errors · 0 not checkable

Statistics

Figures

Image 1
CC-BY · From the PDF
Image 2
CC-BY · From the PDF
Image 3
CC-BY · From the PDF

Verification

Claims the paper makes

0 Valid · 2 Not valid · 32 Not checked · 140 Own results and interpretations

118 more claims

Create a free account to see all 174 claims and to verify the 42 references still open.

See all claims — free account
  • It may state two separate claims as one. 45
  • Probably not a substantial claim. 10

Create a free account to see these claims.

Create a free account to see these assumptions.

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Consistentχ²(8) = 24.491reported p = .002 · recomputed p = .002

    “χ 2 (8, N = 1132) = 24.491,p = .002”

1 of 1

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Self-check results appear here once an independent check has confirmed them.

Citations

Cites

Research works printed but not linked: 7

  1. Cornell, D., Sheras, P., Kaplan, S., Levy-Elkon, A., McConville, D., McKnight, L., & Posey, J. (2004). Guidelines for responding to student threats of violence: Field test of a threat assessment approach. In M. J. Furlong, P. M. Bates, D. C. Smith, P. M. Kingery, & P. M (Eds.), Appraisal and prediction of school violence: Methods, issues and contents (pp. 11–36). Nova Science Publishers.
  2. James, D. V., Farnham, F. R., & Wilson, S. P. (2013). The fixated threat assessment centre: Implementing a joint policing and psychiatric approach to risk assessment and management in public figure threat cases. In J. R. Meloy, & J. Hoffman (Eds.), International handbook of threat assessment (1st ed., pp. 299–320). Oxford University Press.
  3. James, D. V., Meloy, J. R., Mullen, P. E., Pathé, M. T., Farnham, F. R., Preston, L. F., & Darnley, B. J. (2010). Abnormal attentions toward the British royal family: Factors associated with approach and escalation. The Journal of the American Academy of Psychiatry and the Law, 38(3), 329–340. https://repository.tavistockandportman.ac.uk/471/1/Darnley_Abnml_attn.pdf.
  4. James, D. V., Mullen, P. E., Pathé, M. T., Meloy, J. R., Farnham, F. R., Preston, L., & Darnley, B. (2008). Attacks on the British royal family: The role of psychotic illness. The Journal of the American Academy of Psychiatry and the Law, 36(1), 59–67. https://fixatedthreat.com/perch/resources/attacks-on-the-british-royal-family.pdf.
  5. McEwan, T. E., & Darjee, R. (2021). The problem behaviour program: Threat assessment and management in a community forensic mental health context. In J. R. Meloy, & J. Hoffman (Eds.), International handbook of threat assessment (2nd ed., pp. 536–553). Oxford University Press.
  6. McEwan, T. E., MacKenzie, R. D., & McCarthy, J. (2013). The problem behavior program: Threat assessment and management in community forensic mental health. In J. R. Meloy, & J. Hoffman (Eds.), International handbook of threat assessment (1st ed., pp. 360–374). Oxford University Press.
  7. Wilson, S. P., Pathé, M. T., Farnham, F. R., & James, D. V. (2021). The fixated threat assessment centers: The joint policing and psychiatric approach to risk assessment and management in cases of public figure threat and lone actor grievance-fueled violence. In J. R. Meloy, & J. Hoffmann (Eds.), International handbook of threat assessment (2nd ed., pp. 471–487). Oxford University Press.

Cited by

See all 1

Related

See all

Metadata

Authors
Seaward, A., Marchment, Z., Wilson, S., Elfituri, S., Farnham, F., Plumb, T., Rose, K., Taylor, A., Corner, E., & Gill, P.
Affiliations
  • University College London (GB)
  • North London NHS Foundation Trust (GB)
  • Metropolitan Police Service (GB)
  • Australian National University (AU)
Corresponding author
Seaward, Amber
ORCID
Venue
Psychology, Crime & Law
Publisher
Informa UK Limited
Published
2025-11-03
Pages
1-24
ISSN
  • 1068-316X (ISSN-L)
  • 1477-2744
DOI
10.1080/1068316x.2025.2581795
OpenAlex
W4415841687
Cited by
1
References
48
Citations by year
2026: 1
FWCI
0.78
Type
journal article
Language
en
Open access
Licence
Locations
  • Psychology Crime and Law (publishedVersion, cc-by)
  • UCL Discovery (University College London) (submittedVersion)
Funders
  • European Research Council
  • Horizon 2020 (758834)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
  • Social Sciences › Sociology and Political Science › Stalking, Cyberstalking, and Harassment
  • Social Sciences › Sociology and Political Science › Crime Patterns and Interventions
Keywords
unmet mental health needs, public health approach, violence prevention, safeguarding, threat assessment, psychosis, risk indicators

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-11-13, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-11-13 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Data sources

Bibliographic data: Semantic Scholar, OpenAlex, Crossref.

Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.