Professor Lindsay Thomson (MB,ChB; MPhil, MD, FRCPsych)

Personal Chair of Forensic Psychiatry; Director of the Forensic Mental Health Managed Care Network; Medical Director, The State Hospitals Board for Scotland

Centre for Clinical Brain Sciences
Forensic Mental Health Services Managed Care Network
The State Hospitals Board for Scotland

Tel: 07949220250
Email: L.D.G.Thomson@ed.ac.uk

Street: Department of Psychiatry
Kennedy Tower
Morningside Park
Edinburgh
City
Post code: EH10 5HF

Street: The State Hospital
City: Lanark
Post code: ML11 8RP

Biography

Background

Lindsay Thomson is Professor of Forensic Psychiatry at the University of Edinburgh, Director of the Forensic Mental Health Services Managed Care Network and Medical Director of the State Hospitals Board for Scotland. She is an honorary consultant forensic psychiatrist working clinically in a high security setting.

Professor Thomson graduated in Medicine from the University of Edinburgh in 1987 and completed basic Psychiatry training at the Royal Edinburgh Hospital. She was a research fellow in the Division of Psychiatry for 2 years and then completed her higher psychiatric training in general adult psychiatry and forensic psychiatry.

She became senior lecturer in forensic psychiatry in 1997 and subsequently reader in forensic psychiatry. She had a sabbatical to the Victorian Institute of Forensic Mental Health (Forensicare) in Melbourne, Australia 2003-4.

She was the psychiatry undergraduate course organiser from 1998 - 2015.

She has been Executive Medical Director for the State Hospitals Board for Scotland since 2007 and Director of the Forensic Mental Health Services Managed Care Network since 2014 (Medical Director 2007-14). She established the School of Forensic Mental Health in 2008. The School was awarded the Scottish Public Service Award for Employee Engagement and Skills Award at the Scottish Parliament in 2014.

She was awarded a life-time achievement award for teaching by NHS Education Scotland in 2015.

She has over 125 publications including the first textbook on Scots Law and Mental Health in Practice.

Forensic Mental Health Services assess and treat mentally disordered offenders and patients with major behavioural and mental health problems, in a range of secure health facilities and the community, police stations, courts and prisons. As individuals, these patients are often subject to rejection by non-specialist services, whilst forensic services have an ignominious history of scandal and abuse. Professor Thomson since her appointment to the University of Edinburgh in 1997, has utilised the processes of research, education, clinical and managerial work, through her varying roles, to radically change forensic mental health services, particularly in Scotland but with influence internationally. This has contributed to new mental health legislation, new facilities, and new treatment and management initiatives, including a systematic approach to risk assessment and management. Such developments bring with them a substantial educational agenda to ensure improved patient care and public safety, and a School of Forensic Mental Health was established to meet this need.

Qualifications

University Education

M.B.;Ch.B University of Edinburgh Medical School (1987)
Master of Philosophy, University of Edinburgh (1994)
Doctorate of Medicine, University of Edinburgh (2000)

Professional Qualifications

Membership of Royal College of Psychiatrists (1991)
UK Certificate of Completion of Specialist Training (1998)
Fellowship Royal College of Psychiatrists (2008)

Responsibilities & affiliations

Clinical research impact markers include:

Editorial Boards: Psychiatry, Psychology and Law, Journal of Criminal Behaviour and Mental Health and Journal of Forensic Psychiatry and Psychology since 2008, 2001 and 2000 respectively.
International Association of Forensic Mental Health Services – Board Member and Chair of Advisory Group (since 2021)
Healthcare in Custody Board (2022-current)
Forensic Executive, Scottish Division, Royal College of Psychiatrists (since 1998)
Forensic Psychiatry Research Society, UK (President, 2004 – 2009)
Chair, National Oversight Stakeholder Group for Development of Forensic Child and Adolescent National Medium Secure Unit Chair (since 2018)
Scottish Government Mental Disorder Definition Review Group 2023-34
Scottish Government Short life working group on Barron Review of Forensic Mental Health Services (2021-22)
Chief Medical Officer Taskforce for Improvement of Services for Victims of Rape and Sexual Assault 2017-2021
Scottish Government Mental Health Act Implementation Reference Group 2016 - 2018
National Prisoner Healthcare Network Mental Health Implementation Subgroup, 2014 - 2016 (Chair)
Scottish Government Justice Strategy and Mental Health reference Group January 2017 – 2019
Chief Scientist Office Mental Health Portfolio Group 2007 – 2014.
HM Chief Inspector of Prisons: Severe and enduring mental health problems in Scotland’s Prisons: A Thematic Inspection, Member of Mental Health of Reference Group 2007-08.
NHS Education Scotland: member of Psychiatry Board (previously Transitional Board for Run Through Training in Mental Health), 2006-2009.
SACRO (Safeguarding Communities, Resettling Offenders) Board member December 2006 - 2014.
International Inquiry into the Care and Treatment of XX, Australia

Teaching & PhD supervision

Undergraduate teaching

Course Organiser of Undergraduate Teaching, Division of Psychiatry (1999 – 2015) including major course restructuring in response to GMC changes.
Lecturer
- Mental Health Legislation
- Forensic Psychiatry
- Personality Disorder and Psychopathy
Undergraduate Course Developments
- Introduced new psychiatry curriculum (2000-2002)
- Videos on psychosis (2000) and suicide (2003)
- Outpatient funding system for tutorial groups (2005)
- Teaching the Teachers' Course (2004 and thereafter annual)
- Study Guides in Psychiatry for Year 3 and Year 4 (2005)
- Computerised feedback system (EeMec) for Year 3 (2005)
- Computerised assisted learning module in alcohol problems (2005 - current)
- Pilot of use of simulated patients in teaching undergraduates (2006)
- Subspecialty placements of medical students at the State Hospital (July 2006)
- Development of a computer lab for medical students in the Division of Psychiatry (2007)
- Roll out of the use of simulated patients to all tutorial groups (2007)
- Introduction of standardized Oral Examination on Clinical Issues (2008-09)
- Examining the Examiners Course (2009 and 2011)
- Major review of undergraduate psychiatry course (2010-11)
- Implementation of Review 2011-12
- Thomson, L.D.G. and Dave, S. (2011) The Organisation of Undergraduate Teaching, Chapter in Teaching Psychiatry, Recruiting Psychiatrists. Eds. Royle, J. and Brown, T., Royal College of Psychiatrists
- Annual Teaching Skills Course, S-DARG, Royal College of Psychiatrists, Edinburgh (2009-2012)
- Established Scottish Psychiatry Summer School 31/8/12-1/9/12. Annual
Institute of Psychiatry and South London and Maudsley Trust – invited participant of 5 member international review team to review undergraduate and postgraduate psychiatry 18-19/3/10

Postgraduate teaching

Established the School of Forensic Mental Health in 2007 in response to demonstrable need for improved educational provision for individuals working in health, social and criminal justice services. Current activities include:
New to Forensic Suite of Programmes
Short course programme
Academic Courses including MSc in Forensic Mental Health
Approved Medical Practitioner Training materials for NHS Education Scotland
Research Special Interest Group with quarterly research publication bulletins
Developed the first national medical specialist training scheme in Scotland, the National Training Scheme in Forensic Psychiatry (2009).
Edited Scottish textbook on Mental Health and Scots Law in Practice - 2nd edition 2014
Lecturer to psychiatrists, psychologists, criminal justice social workers, lawyers, sheriffs and criminologists
External examiner; PhD Supervisor and Examiner internationally.
PhD and MPhil supervisor - 14 completed

Open to PhD supervision enquiries?

Yes

Research

Research summary

Professor Thomson’s research interests are in the improvement of the mental health of offenders and public safety, in particular:

risk of harm to others
mental health of prisoners
impact of legislative change
specific mental disorders and effects of co-morbidity
outcome factors for mentally disordered offenders
treatment interventions for mentally disordered offenders

Current research interests

• Improving the health and well-being of people with dementia and cognitive frailty in prison • Progression through services: data linkage and analysis of transitions and overall pathway of the 2013 Scottish forensic inpatient population • Outcomes of Appeals Against Excessive Security in High and Medium Security • Understanding Needs, Securing Public Safety: The Forensic Network Census and Database – annual • Evaluation of the implementation and utility of the new State Hospital Clinical Model • Comparing models of care in forensic mental health systems: an international realist evaluation

Past research interests

• Mental health needs of Scotland’s prison population • Randomised controlled trial of the short-term effects of osmotic-release oral system methylphenidate on symptoms and behavioural outcomes in young male prisoners with attention deficit hyperactivity disorder: CIAO-II study • Risk assessment and management

Knowledge exchange

Professor Thomson's research team's:

studies of mentally disordered offenders, in particular on their security needs assessments, have resulted in major change in practice and services including a 44% reduction in the provision of high security beds and the development of a new high security hospital; the creation of 3 medium secure units; and introduction of excessive security appeals to the Mental Health Act. Our research has shown that this is working well. This legal provision was extended to medium security in 2015.
studies on risk of harm to others have highlighted the primacy of psychopathological as opposed to criminogenic factors in the assessment and management of forensic patients, contrary to some existing literature, and have led to a Scotland wide Forensic Network approach to risk management.
research findings on “Appropriate Adults” were implemented as Scottish Executive policy to Health Boards [HDL (2006) 56] and became statutory in 2019. Similarly, my research on “The Hospital Direction” (a disposal available to the courts combining a period in psychiatric hospital with a prison sentence) resulted in new guidelines from the Scottish Executive in 2005.
response to concerns of a high prevalence of Autistic Spectrum Disorder in prisons and the management of these individuals, studied over 2,000 prisoners and found major abnormalities in their social cognitions, but no elevated prevalence of Autistic Spectrum Disorder.
research with the Police Complaints Commission (PCCS) and Scottish Public Sector Ombudsman (SPSO) has generated an assessment tool and findings which will contribute to the better management of these individuals as vexatious and persistent complainants may experience distress and consume enormous resources within our society.
developed an annual forensic inpatient census, starting in 2013.
prevalence study of Attention Deficit Hyperactivity in Young Offenders led to a major randomised controlled treatment of treatment for the disorder which considered whether medication could reduce not only ADHD symptoms but antisocial behaviour as well, thereby reducing the chance of recidivism. This was the first UK RCT using medication in a prison setting.
research on recovery found major problems with the physical health of forensic patients with men and dying respectively 15 and 24 years earlier than expected. This led to the development of the Supporting Health Choices initiative and the State Hospitals Board becoming the first NHS Board to go smoke free. This remains in place despite a challenge at the Supreme Court.
research recommendations contained in its report for Scottish Government into the Mental Health Needs of Scotland’s Prison Population have been accepted.

Affiliated research centres

University of Aberdeen, UK
University of the West of Scotland, UK
University of Montreal, Canada
University of Cardiff, UK
Swinburne University, Melbourne, Australia

Publications

View all publications on Research Explorer

Conferences

Conference details

Since 2021:

20 June 2024 IAFMHS conference San Francisco Ten years on from the Forensic Network Inpatient Census: Who were these patients, what were their needs and what happened?
20 – 22 June 2023 – IAFMHS conference, Sydney Randomised controlled trial of the short-term effects of OROS-methylphenidate on ADHD symptoms and behavioural outcomes in young male prisoners with attention deficit hyperactivity disorder (CIAO-II)
20 – 22 June 2023 – IAFMHS conference, Sydney Understanding the Mental Health Needs of Scotland’s Prison Population – symposium: A national health needs analysis.
3 November 2022 – Forensic Network Research Special Interest Group Conference: Understanding the mental health needs of Scotland’s prison
16 June 2022 – International Association of Forensic Mental Health Services, Berlin Recovery in Forensic Mental Health Services: Issues in operationalization and measurement. Symposium
15 June 2022 – International Association of Forensic Mental Health Services, Berlin Covid-19: Response and Learning in Forensic Mental Health Services
3^rd March 2022 Independent Review into Delivery of Forensic Mental Health Services Symposium – a View from the Scottish Forensic Network, Royal College of Psychiatrists Forensic Faculty Conference
16 June 2021 – Models of care symposium International Association of Forensic Mental Health Services Online Conference
4 March 2021 Royal College of Psychiatrists Forensic Faculty Conference NHS Scotland Forensic Network Response to COVID-19
4 March 2021 Royal College of Psychiatrists Forensic Faculty Conference Exploration of morbidity, suicide and all-cause mortality in a Scottish forensic cohort over 20 years. Winner of the 2021 Royal College of Psychiatrists Forensic Faculty Research Prize

Invited speaker