Professor George Szmukler  MD, FRCPsych, Fellow of King's College
Professor of Psychiatry and Society

biography

Professor Szmukler is a psychiatrist who has had major research interests in the past in eating disorders and family carers of people suffering from a psychotic illness. His major research now concerns methods of reducing compulsion and ’coercion’ in psychiatric care, for example, through the use of ’advance statements’. A related interest is mental health law, particularly the possibility of generic legislation centred on impaired decision-making capacity which would apply to all persons, regardless of the cause of the underlying disturbance of mental functioning.

Professor Szmukler is also an Associate Director of the NIHR Mental Health Research Network, with lead responsibility for Patient and Public Involvement (PPI). A major aim is to increase the involvement in mental health research of service users and carers as partners in the conduct of research, as well as to engage the interest and support of the general public.

Professor Szmukler is a Visiting Professor in the Department of Sociology at the London School of Economics.

Past posts have included Dean of the Institute of Psychiatry (2001-2006), and Medical Director of the Bethlem and Maudsley NHS Trust (1997-1999) then joint Medical Director of the South London and Maudsley NHS Trust (1999-2001).

publications

Selected publications in current areas of interest:

Mental health legislation, compulsion, ‘coercion’, capacity, advance statements, service users in research:


Szmukler GI, Bird AS, Button EJ (1981). Compulsory admissions in a London Borough I: Social and clinical features and a follow up. Psychological Medicine 11, 617 635

Szmukler GI (1981) Compulsory admissions in a London Borough II: Circumstances surrounding admission; service implications. Psychological Medicine 11, 825 838

Halpern, A., & Szmukler, G. (1997) Psychiatric Advance Directives: Reconciling Automony and non-Consensual Treatment. Psychiatric Bulletin 21: 323-327.

Sutherby, K. & Szmukler, G. (1998) Crisis cards and self-help crisis initiatives. Psychiatric Bulletin 22: 4-7.

Szmukler G, Holloway F. (1998) Mental health legislation is now a harmful anachronism. Psychiatric Bulletin 22: 662-665.

Sutherby K, Szmukler GI, Halpern A, Alexander M, Thornicroft G, Johnson C, Wright S (1999) A study of ’crisis cards’ in a community psychiatric service. Acta Psychiatrica Scandinavica, 100 (1): 56-61.

Szmukler G (1999) Ethics in community psychiatry Australian & New Zealand Journal of Psychiatry 33: 328-338

Bindman J, Beck A, Glover G, Thornicroft G, Knapp M, Leese M, Szmukler G (1999) Evaluating mental health policy in England: Care Programme Approach and supervision registers. British Journal of Psychiatry, 175: 327 -330.

Szmukler G (2000) Homicide Inquiries: What sense do they make? Psychiatric Bulletin 24: 6-10.

Holloway F, Szmukler G, Sullivan D (2000) Involuntary outpatient treatment. Current Opinion in Psychiatry 13: 689-692

Szmukler G, Holloway F. (2000) Reform of the Mental Health Act. Health or safety? British Journal of Psychiatry, 177: 196-200.

Bindman J, Beck A, Thornicroft G, Knapp M, Szmukler G. (2000) Psychiatric patients at greatest risk and in greatest need. Impact of the Supervision Register Policy. British Journal of Psychiatry, 177: 33-37

McClelland R, Szmukler G (2000) Consent and Capacity in Psychiatric Practice Revisited. European Journal of Health Law, 7: 47-55

Szmukler G. (2001) A new mental health (and public protection) act. British Medical Journal 322: 2-3.

Szmukler G, Appelbaum P (2001) Treatment pressures, coercion and compulsion In: A Textbook of Community Psychiatry (2001) (Ed Thornicroft G, Szmukler G.) Oxford, Oxford University Press

Bindman J, Maingay S, Szmukler G. (2003) The Human Rights Act and mental health legislation. British Journal of Psychiatry: 182:91-4.

Szmukler G (2004) Mental health legislation is discriminating and stigmatising In: Every Family in the Land (Ed Crisp A) The Royal Society of Medicine Press

Gudjonsson GH, Rabe-Hesketh S, Szmukler G. (2004) Management of psychiatric in-patient violence: patient ethnicity and use of medication, restraint and seclusion. British Journal of Psychiatry 184:258-62.

Henderson C, Flood C, Leese M, Thornicroft G, Sutherby K, Szmukler G. (2004) Effect of joint crisis plans on use of compulsory treatment in psychiatry: single blind randomised controlled trial. British Medical Journal 329: 136-140

Bindman J, Reid Y, Szmukler G, Tiller J, Thornicroft G, Leese M (2005) Perceived coercion at admission to psychiatric hospital and engagement with follow-up. Social Psychiatry & Psychiatric Epidemiology. 40:160-166

Cairns R, Maddock C, Buchanan A, David AS, Hayward P, Richardson G, Szmukler G, Hotopf M. (2005) Prevalence and predictors of mental incapacity in psychiatric in-patients. Br J Psychiatry 187:379-85.

Cairns R, Maddock C, Buchanan A, David AS, Hayward P, Richardson G, Szmukler G, Hotopf M. (2005) Reliability of mental capacity assessments in psychiatric in-patients. Br J Psychiatry 187:372-8

Szmukler, G. & Dawson, J. (2006). Commentary: toward resolving some dilemmas concerning psychiatric advance directives. J Am Acad Psychiatry Law, 34, 398-401.

Burgess P, Bindman J, Leese M, Henderson C, Szmukler G. (2006) Do community treatment orders for mental illness reduce readmission to hospital? : An epidemiological study. Soc Psychiatry Psychiatr Epidemiol. 41(7):574-9

Dawson J, Szmukler G. (2006) Fusion of mental health and incapacity legislation. Br J Psychiatry 188:504-9.

Flood C, Byford S, Henderson C, Leese M, Thornicroft G, Sutherby K, Szmukler G. (2006) Joint crisis plans for people with psychosis: economic evaluation of a randomised controlled trial. British Medical Journal 333: 729

Lewison, G., Thornicroft, G., Szmukler, G. & Tansella, M. (2007). Fair assessment of the merits of psychiatric research. British Journal of Psychiatry, 190, 314-318.

Henderson, C, Swanson, JW, Szmukler, G, Thornicroft, G, Zinkler, M (2008) A typology of advance statements in mental health care. Psychiatric Services, 59:63–71.

Owen GS, Richardson G, David A, Szmukler G et al (2008) Mental capacity to make decisions on treatment in people admitted to psychiatric hospitals: a cross sectional study. British Medical Journal 337: 448-451

Szmukler G, Appelbaum P (2008) Treatment pressures, leverage, coercion and compulsion in mental health care Journal of Mental Health 17:233-244

Hotopf M, Laird B, Singh I, Churchill R, David A, Richardson G, Szmukler G. (2008) Capacity, consent and electroconvulsive therapy. Journal of Mental Health 17:315-325

Szmukler G. (2008) Treatment pressures, coercion and compulsion in mental health care (Editorial) Journal of Mental Health 17: 229-231

Owen GS, David AS, Richardson G, Szmukler G, Hayward P, Hotopf M. (2008) Mental capacity, diagnosis and insight in psychiatric in-patients: a cross-sectional study. Psychol Med 22:1-10.

Henderson C, Flood C, Leese M, Thornicroft G, Sutherby K, Szmukler G. (2009) Views of service users and providers on joint crisis plans : Single blind randomized controlled trial. Soc Psychiatry Psychiatr Epidemiol. 44(5):369-76.

Szmukler G. (2009) Financial incentives for patients in the treatment of psychosis. J Med Ethics. 35(4):224-8.

Szmukler G (2009) Ethics in community psychiatry. In ’Psychiatric Ethics’ 4th Edition (Ed Bloch S & Green S) Oxford: Oxford University Press

Szmukler G (2009) Service users in research and a ’well ordered science’. Editorial. Journal of Mental Health 18: 87-90

Owen GS, David AS, Hayward P, Richardson G, Szmukler G, Hotopf M. (2009) Retrospective views of psychiatric in-patients regaining mental capacity. Br J
Psychiatry. 2009 Nov;195(5):403-7.

Szmukler G. "Personality disorder" and capacity to make treatment decisions. (2009) J Med Ethics. 35(10):647-50.

Owen GS, Szmukler G, Richardson G, David AS, Hayward P, Rucker J, Harding D, Hotopf M. (2009) Mental capacity and psychiatric in-patients: implications for the new
mental health law in England and Wales. Br J Psychiatry. 195(3):257-63.

Szmukler, G., Daw, R., & Dawson, J. (2010). 1. A model law fusing incapacity and mental health legislation & outline of the Model Law. 2. Response to the commentaries. J Mental Health Law,. Journal of Mental Health Law, Special Issue Ed 20, 11-24; 101-128.

Brown P, Calnan M, Scrivener A, Szmukler G (2009) Trust in mental health services: a neglected concept. Journal of Mental Health 18:449-458

Owen G, Szmukler G, Richardson G, et al (2009) Mental capacity and psychiatric inpatients: some implications for the new mental health law for England and Wales British J Psychiatry 195:257-263

David A, Hotopf M, Owen G, Moran P, Szmukler G, Richardson G (2010) ) Mentally disordered or lacking capacity? Lessons for management of serious deliberate self harm. British Medical Journal 134 341:doi:10.1136/bmj.c4489

Owen GS, Ster IC, David AS, Szmukler G, Hayward P, Richardson G, Hotopf M (2011) Regaining mental capacity for treatment decisions following psychiatric admission: a clinico-ethical study. Psychological Medicine 41: 119-128

Cairns R, Brown P, Grant-Peterkin H, Owen G, Richardson G, Szmukler G, Hotopf M. (2011) Mired in confusion: making sense of the deprivation of liberty safeguards. Medicine, Science and the Law 5: 228-236

McKillop M, Dawson J, Szmukler G. (2011) The concept of objection under the DOLS regime. J Mental Health Law, Special Edition 61-67

Cairns R, Brown P, Grant-Peterkin H, Khoondoker M, Owen G, Richardson G, Szmukler G, Hotopf M. (2011) Comparing judgements about Deprivation of Liberty by lawyers, psychiatrists, best interests assessors and independent mental capacity assessors. The Psychiatrist 35: 344-349

Lewison G, Roe P, Wentworth A, Szmukler G (2012) The reporting of mental disorders research in British media Psychological Medicine 42: 435-441

Szmukler, G., Everitt, B., & Leese, M. (2012). Risk assessment and ROC curves. Psychological Medicine, 42, 895-898.

Staley, K., Kabir, T., & Szmukler, G. (2012). Service users as collaborators in mental health research: less stick, more carrot. Psychol Med, 1-5.

Szmukler G (2010) Use of ‘coercive’ measures. In Ethics in psychiatry: European contributions. (ed. Helmchen H, Sartorius N) Elsevier Press.

Szmukler G & Dawson J (2011) Reducing discrimination in mental health law: the ‘fusion’ of incapacity and mental health legislation. In: “Coercive treatment in psychiatry - Clinical, legal and ethical aspects” (Editors: Thomas Kallert, Juan Mezzich, John Monahan) Wiley-Blackwell

Szmukler G (2013) Fifty years of mental health legislation: Paternalism, bound and unbound. In Psychiatry: Past, Present and Prospects (Ed: Bloch S, Green S, Holmes J). Oxford, Oxford University Press

Szmukler G & Rose, N (2013) Risk assessment in mental health care: values and costs. Behavioral Sciences and the Law (in press)

Szmukler G and Rose D. (2013) Strengthening self-determination of persons with mental illness. In Handbook of Neuroethics (Ed Clausen JC & Levy N) Heidelberg, Springer (in press)

Thornicroft G, Farrelly S, Szmukler G, Birchwood M, Waheed W, Flach C, Barrett B, Byford S, Henderson C et al. Randomised controlled trial of joint crisis plans to reduce compulsory treatment for people with psychosis: clinical outcomes. Lancet (in press)


Families and caregivers:


Eisler I, Szmukler GI, Dare C (1985) Systematic observation and clinical insight: Are they compatible? An experiment in the recognition of family interactions. Psychological Medicine 15, 173 188

Szmukler GI, Eisler I, Russell GFM, Dare C (1985) Anorexia nervosa, parental "Expressed Emotion" and dropping out of treatment. British Journal of Psychiatry 147, 265 271

Russell GFM, Szmukler GI, Eisler I, Dare, C (1987) An evaluation of family therapy in anorexia nervosa and bulimia nervosa. Archives General Psychiatry 44, 1047 1056.

Eisler I, Dare C, Szmukler GI (1988) What’s happened to family interaction research? An historical account and a family systems viewpoint. Journal of Marital and Family Therapy, 14, 45 65.

Dare C, Eisler I, Russell GFM, Szmukler GI. (1990) The clinical and theoretical impact of a controlled trial of family therapy in anorexia nervosa. Journal of Marital & Family Therapy, 16, 39 57

Bloch S, Szmukler GI, Herrman H, Benson A, Colusa, S. (1995) Counselling caregivers of relatives with schizophrenia: Themes, interventions and caveats. Family Process 34: 413-425.

Szmukler G. (1996) From family ‘burden’ to caregiving. Psychiatric Bulletin 20: 449-451.

Szmukler, G.I., Burgess, P., Herrman, H., Benson, A., Colusa, S., & Bloch S. (1996) Caring for relatives with serious mental illness: The development of the ‘Experience of Caregiving Inventory’. Social Psychiatry & Psychiatric Epidemiology 31: 137-148

Szmukler, G.I., Herrman, H., Colusa, S., Benson, A., & Bloch S. (1996) A controlled trial of a counselling intervention for caregivers of relatives with schizophrenia. Social Psychiatry & Psychiatric Epidemiology 31: 149-155.

Szmukler GI, Bloch S. (1997) Family involvement in the care of people with psychoses. An ethical argument. British Journal of Psychiatry 171:401-5.

Eisler-I; Dare-C; Russell-GF; Szmukler-G; le-Grange-D; Dodge-E (1997) Family and individual therapy in anorexia nervosa. A 5-year follow-up. Archives General Psychiatry. 54(11): 1025-30

Szmukler G, Wykes T, Parkman S. (1998) Care-giving and the impact on carers of a community mental health service. PriSM Psychosis Study 6 British Journal of Psychiatry 173: 399-403.

Stern S, Doolan M, Staples E, Szmukler GI, Eisler I (1999) Disruption and reconstruction: narrative insights into the experience of family members caring for a relative diagnosed with serious mental illness Family Process 38: 353-369

Joyce J, Leese M, Szmukler G. (2000) The Experience of Caregiving Inventory: further evidence. Social Psychiatry & Psychiatric Epidemiology, 35: 185-189

Treasure J, Murphy T, Szmukler G, Todd G, Gavan K, Joyce J (2001) The experience of caregiving for severe mental illness: a comparison between anorexia nervosa and psychosis. Social Psychiatry & Psychiatric Epidemiology, 36: 343-347

Joyce J, Leese M, Kuipers E, Szmukler G, Harris T, Staples E. (2003) Evaluating a model of caregiving for people with psychosis. Social Psychiatry & Psychiatric Epidemiology. 38(4):189-95.

Szmukler G, Kuipers E, Joyce J, Harris T, Leese M, Maphosa W, Staples E. (2003) An exploratory randomised controlled trial of a support programme for carers of patients with a psychosis. Social Psychiatry & Psychiatric Epidemiology. 38(8):411-8.

McCrone P, Szmukler G, Kuipers E (2005) Service use and cost associated with caring for people with serious mental illness. Journal of Mental Health 14(1): 37-47

last updated: Monday, January 21, 2013