Siân Oram

Siân Oram
King's College London | KCL · Institute of Psychiatry

PhD

About

115
Publications
20,940
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3,556
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Introduction
Dr Sian Oram conducts research on the health needs of people who have experienced violence (including domestic violence and human trafficking) and on policy and service responses to these needs. She is currently working on research funded by the Department of Health Policy Research Programme to inform the NHS response to human trafficking.
Additional affiliations
January 2011 - December 2012
King's College London
January 2009 - present
London School of Hygiene and Tropical Medicine

Publications

Publications (115)
Article
Full-text available
Introduction The need to improve the quality of community mental health services for people with Complex Emotional Needs (CEN) (who may have a diagnosis of ‘personality disorder’) is recognised internationally and has become a renewed policy priority in England. Such improvement requires positive engagement from clinicians across the service system...
Article
Full-text available
Introduction This study aimed to identify research priorities for future research on screen use and adolescent mental health, from the perspectives of young people, parents/carers, and teachers. Methods The study design was informed by the James Lind Alliance Priority Setting Partnership approach. A three-stage consensus-based process of consultat...
Article
Full-text available
Background Intimate partner violence (IPV) is highly prevalent and is associated with a range of mental health problems. A broad range of psychosocial interventions have been developed to support the recovery of women survivors of IPV, but their mechanisms of action remain unclear. Methods Realist review following a prospectively published protoco...
Article
Full-text available
Background Individuals with Complex Emotional Needs (CEN) services, a working description to refer to the needs experienced by people who may have been diagnosed with a “personality disorder”, face premature mortality, high rates of co-morbidity, service user and treatment costs. Service provision for this population is recurrently identified as ne...
Article
Full-text available
Background There is consensus that services supporting people with complex emotional needs are part of a mental health care system in which change is needed. To date, service users’ views and co-production initiatives have had little impact on the development of interventions and care. This needs to change, and our paper evidences the experiences a...
Preprint
Full-text available
Background: Improving the quality of care in community settings for people with "Complex Emotional Needs"(CEN - our preferred working term for services for people with a "personality disorder" diagnosis or comparable needs) is recognised internationally as a priority. Plans to improve care should be rooted as far as possible in evidence. We aimed t...
Article
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Purpose To investigate whether (1) depression is associated with increased risk of past-year intimate partner violence (IPV) perpetration, disaggregated by sex, after controlling for potential confounders; (2) observed associations are mediated by alcohol misuse or past-year IPV victimisation. Methods Systematic review and individual participant d...
Article
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Background Low- and middle-income countries (LMICs) host the majority of the world’s refugees. Evidence suggests that refugees and asylum seekers have high mental health needs compared to the host country population. However, they face many social, economic and culture barriers to receiving mental health care and benefitting from mental health inte...
Article
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Background Armed conflict has significant impacts on individuals and families living in conflict-affected settings globally. Scholars working to prevent violence within families have hypothesised that experiencing armed conflict leads to an increase in family violence and mental health problems. In this review, we assessed the prevalence of family...
Article
Full-text available
The aim of this study was to explore staff perceptions of the impact of the COVID-19 pandemic on mental health service delivery and outcomes for women who were pregnant or in the first year after birth (‘perinatal’ women). Secondary analysis was undertaken of an online mixed-methods survey open to all mental health care staff in the UK involving 36...
Article
Objectives The Covid-19 pandemic has had a significant impact on older adults mental health care. Our study aimed to explore staff perspectives on key challenges and innovations in order to help inform the delivery of older adults mental health care in subsequent waves of the pandemic. Methods A mixed methods online questionnaire developed by NIHR...
Preprint
Full-text available
Background There is consensus that services supporting people with complex emotional needs are part of a mental health care system in which change is needed. To date, service users views and co-production exercises have had little impact on the development of treatment and care. This needs to change, and our paper evidences the experiences and pers...
Preprint
Full-text available
Background Service provision for people with complex emotional needs (CEN) is recurrently identified as needing to be transformed: there are serious concerns about quality, accessibility, fragmentation of the service system and the stigma and therapeutic pessimism service users say they encounter. We use the term CEN as a working description to ref...
Preprint
Full-text available
Background: This study aimed to identify research priorities for future research on screen use and adolescent mental health, from the perspectives of young people, parents/carers, and teachers. Methods: The study design was informed by the James Lind Alliance Priority Setting Partnership approach. A three-stage consensus-based process of consultati...
Article
Full-text available
Purpose Experiences of reported trauma are common and are associated with a range of mental health problems. Sex differences in how reported traumas are experienced over the life course in relation to mental health require further exploration. Methods 157,358 participants contributed data for the UK Biobank Mental Health Questionnaire (MHQ). Strat...
Article
Full-text available
Objectives Domestic violence and abuse (DVA) is highly prevalent, with severe adverse consequences to the health and well-being of survivors. There is a smaller evidence base on the health of DVA perpetrators and their engagement with healthcare services. This review examines the experiences of perpetrators of DVA of accessing healthcare services a...
Article
Full-text available
Background There is a recognised need to develop clear service models and pathways to provide high quality care in the community for people with complex emotional needs, who may have been given a “personality disorder” diagnosis. Services should be informed by the views of people with these experiences. Aims To identify and synthesise qualitative...
Article
Full-text available
PurposeThe COVID-19 pandemic has many potential impacts on people with mental health conditions and on mental health care, including direct consequences of infection, effects of infection control measures and subsequent societal changes. We aimed to map early impacts of the pandemic on people with pre-existing mental health conditions and services...
Article
Full-text available
PurposeThe COVID-19 pandemic has potential to disrupt and burden the mental health care system, and to magnify inequalities experienced by mental health service users.Methods We investigated staff reports regarding the impact of the COVID-19 pandemic in its early weeks on mental health care and mental health service users in the UK using a mixed me...
Preprint
Full-text available
Introduction The need to improve the quality of community mental health services for people with Complex Emotional Needs (CEN) is recognised internationally and has become a renewed policy priority in England. Such improvement requires positive engagement from clinicians across the service system, and their perspectives on achieving good practice n...
Preprint
Purpose The Covid-19 pandemic is likely to have a significant impact on older adults mental health care. Our study aimed to explore staff perspectives on key challenges and innovations, to help inform the delivery of older adults mental health care in subsequent waves of the pandemic. Methods A mixed methods online questionnaire developed by NIHR...
Preprint
Full-text available
Research aim: To systematically review and synthesise qualitative studies on service user experiences of community mental health care for Complex Emotional Needs. Personality Disorder, Community Mental Health Services, UK.
Preprint
Full-text available
There is a recognised need to develop clear service models and pathways to provide high quality care in the community for people with complex emotional needs, who may have been given a “personality disorder” diagnosis. Services should be informed by the views of people with these experiences. Aims To systematically review and synthesise qualitativ...
Preprint
Full-text available
Background Diagnoses of “personality disorder” are prevalent among people using community secondary mental health services. Whilst the effectiveness of a range of community-based treatments have been considered, as the NHS budget is finite, it is also important to consider the cost-effectiveness of those interventions. Aims To assess the cost-effe...
Article
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Mental Health Treatment Requirements (MHTRs) have been available in England and Wales since 2005 but are rarely used, despite high rates of mental health problems amongst offenders. In 2018, a new protocol to facilitate the use of MHTRs was piloted in five sites in England. Aims: Understanding the experiences of professional stakeholders and identi...
Preprint
Full-text available
Purpose: the aim of this study was to explore staff perceptions of the impact of the COVID-19 pandemic on mental health service delivery and outcomes for women who were pregnant or in the first year after birth (perinatal women). Methods: secondary analysis of an online mixed-methods survey open to all mental health care staff in the UK involving 3...
Preprint
Full-text available
Purpose The COVID-19 pandemic has many potential impacts on people with mental health conditions and on mental health care, including direct consequences of infection, effects of infection control measures and subsequent societal changes. We aimed to map early impacts of the pandemic on people with pre-existing mental health conditions and services...
Preprint
Full-text available
Purpose: The COVID-19 pandemic has potential to disrupt and burden the mental health care system, and to magnify inequalities experienced by mental health service users. Methods: We investigated staff reports regarding the impact of the COVID-19 pandemic in its early weeks on mental health care and mental health service users in the UK using a mixe...
Article
Full-text available
Background Carers are key providers of care and support to mental health patients and mental health policies consistently mandate carer involvement. Understanding carers' experiences of and views about assessment for involuntary admission and subsequent detention is crucial to efforts to improve policy and practice. Aims We aimed to synthesise qua...
Article
The experiences and needs of trafficking victims have received increasing attention. However, variation in the experiences and needs of people trafficked for different types of labor have been poorly explored. People trafficked for domestic servitude may represent a particularly vulnerable group but are typically subsumed within labor exploitation....
Chapter
Intimate partner violence is one of the most prevalent forms of violence against women worldwide and is associated with a wide variety of mental disorders, including depression, anxiety, post-traumatic stress disorder, eating disorders, and psychosis. This chapter reviews the evidence for an association between intimate partner violence and mental...
Article
Trends in detention under the Mental Health Act 1983 in two major London secondary mental healthcare providers were explored using patient-level data in a historical cohort study between 2007–2008 and 2016–2017. An increase in the number of detention episodes initiated per fiscal year was observed at both sites. The rise was accompanied by an incre...
Article
Full-text available
Trends in detention under the Mental Health Act 1983 in two major London secondary mental healthcare providers were explored using patient-level data in a historical cohort study between 2007–2008 and 2016–2017. An increase in the number of detention episodes initiated per fiscal year was observed at both sites. The rise was accompanied by an incre...
Article
Trafficked people require timely and ongoing access to healthcare services. Yet, many encounter difficulties accessing and utilising healthcare services, both while in situations of exploitation and after their escape. This research investigated barriers that hinder healthcare providers from identifying, providing care and making necessary referral...
Article
Full-text available
Background: Little is known about the health of GMS commercial fishers and seafarers, many of whom are migrants and some trafficked. This systematic review summarizes evidence on occupational, physical, sexual and mental health and violence among GMS commercial fishers/seafarers. Methods: We searched 5 electronic databases and purposively searche...
Article
Trafficked children are frequently exposed to multiple traumatic events, including during their recruitment, transit, and exploitation. It has been hypothesized that such exposures can lead to the development of Complex Posttraumatic Stress Disorder (PTSD). Complex PTSD includes (in addition to the core PTSD symptoms of re-experiencing, avoidance,...
Article
Full-text available
Background Child trafficking is the recruitment and movement of people aged younger than 18 for the purposes of exploitation. Research on the mental health of trafficked children is limited, and little is known about the use of mental health services by this group. This study aimed to investigate the mental health and service use characteristics of...
Data
List of trafficking search terms to generate trafficked sample. (DOCX)
Article
Full-text available
Background Although trafficked women and adolescents are at risk of unprotected or forced sex, there is little research on maternity care among trafficking survivors. We explored health care needs, service use and challenges among women who became pregnant while in the trafficking situation in the United Kingdom (UK) and clinicians’ perspectives of...
Data
Framework analysis example. (DOCX)
Article
Mental health professionals have opportunities to intervene and provide care for trafficked people. Research shows that mental health problems – including depression, anxiety and post-traumatic stress disorder – are prevalent among trafficked people, and that at least some trafficked people come into contact with secondary mental health services in...
Article
Full-text available
Abstract: Background Trafficked people experience high levels of physical and psychological morbidity, but little is known about trafficked people’s experiences of accessing and using healthcare services during or after their trafficking experiences. Aim To explore trafficked people’s access to and use of healthcare during and after trafficking...
Article
Full-text available
Background: Men comprise nearly two-thirds of trafficked and forced labourers in common low-skilled labour sectors including fishing, agriculture and factory work. Yet, most evidence on human trafficking has focused on women and girls trafficked for sex work, with scant research on trafficked men and boys. Methods: We analyse survey data from the...
Article
Aim Currently, there is no research available on the experiences of spouses providing informal care to wounded, injured or sick (WIS) UK military personnel. The aim of this study was to fill this gap by investigating the relationship experiences of non-military partners caring for WIS UK military personnel. Methods Spouses of WIS military personne...
Article
Violence against women is widely recognised as a violation of human rights and a public health problem. In this Series paper, we argue that violence against women is also a prominent public mental health problem, and that mental health professionals should be identifying, preventing, and responding to violence against women more effectively. The mo...
Article
Objective: This study estimated the prevalence and correlates of self-harm among adult victims of human trafficking who accessed secondary mental health services, and it estimated the responses of mental health services to these individuals. Methods: A clinical records database was searched for self-harm, sociodemographic, clinical, and service...
Article
Full-text available
People with severe mental illness (SMI) have high prevalence of lifetime victimization, but little is known about the extent and risk of recent domestic/sexual violence. The objective was to synthesize evidence on prevalence, odds, and risk factors for recent violence against people with SMI, with a focus on domestic and sexual violence. Relevant s...
Article
Full-text available
Young people who have been trafficked may have experienced significant trauma and violence but little is known about their health and healthcare needs. This UK study aimed to address that gap. It included a health survey and qualitative interviews with 29 young people aged 16-21 trafficked into the UK from other countries who were recruited through...
Article
Full-text available
Background: Despite the multiple physical and psychological health consequences associated with human trafficking, there is little evidence-based guidance available for health providers on assessing and meeting the health needs of trafficked people. We aimed to review literature that provided guidance or research on care provision for people who h...
Article
Full-text available
Background Previous studies have found a high prevalence of depression and post-traumatic stress disorder (PTSD) among survivors of human trafficking. European countries are required to assist trafficked people in their psychological recovery, but there are no rigorous data on the costs of doing so. The objectives of this study were to quantify the...
Article
Domestic violence and abuse is a considerable international public health problem, which is associated with mental disorders in both women and men. Nevertheless, victimization and perpetration remain undetected by mental health services. This paper reviews the evidence on mental health service responses to domestic violence, including identifying,...
Article
Trafficking is a global human rights violation with multiple and complex mental health consequences. Valid and reliable mental health assessment tools are needed to inform health-care provision. We reviewed mental health assessment tools used in research with men and women trafficked for sexual and labour exploitation. We searched nine electronic d...
Article
Full-text available
Objectives: To investigate physical and mental health and experiences of violence among male and female trafficking survivors in a high-income country. Methods: Our data were derived from a cross-sectional survey of 150 men and women in England who were in contact with posttrafficking support services. Interviews took place over 18 months, from...
Article
To update and expand on a 2012 systematic review of the prevalence and risk of violence and the prevalence and risk of physical, mental and sexual health problems among trafficked people. Systematic review and meta-analysis. Searches of 15 electronic databases of peer-reviewed articles and doctoral theses were supplemented by reference screening,...
Article
Full-text available
Background: Human trafficking is a global crime and human rights violation. Although research has demonstrated a high prevalence of mental disorder among trafficked people and that trafficked people are in contact with mental health services, little is known about mental health professionals' experiences of identifying and providing care for traff...