Forensic care in Germany

2017 ◽  
Vol 41 (S1) ◽  
pp. S61-S61
Author(s):  
H. Dressing ◽  
H.J. Salize
Keyword(s):  
Psychiatric Hospital ◽  
Psychiatric Hospitals ◽  
Epidemiological Data ◽  
Mentally Ill Offenders ◽  
Legal Regulations ◽  
Forensic Patients ◽  
Penal Law ◽  
Forensic Psychiatric ◽  
Competing Interest ◽  
Legal Frameworks

Although the idea that offenders suffering from a mental disorder must primarily be considered as ill and should therefore be exempted from punishment is of considerable antiquity legal frameworks and key concepts, which are applied in this field, differ widely in European Union member States. The respective legal regulations and epidemiological data of Germany will be presented.In German penal law the question of the guilt of an offender is of central significance. Legal regulations on the placement and treatment of mentally ill offenders in a forensic psychiatric hospital are subsumed under the section “Measures on improvement and safety”. Section 63 of the German penal law provides for the temporally unlimited commitment to a forensic- psychiatric hospital.In accordance with section 64 of the German penal law addicted offenders can be committed to a detoxification center for a period of up to two years. The available epidemiological data show a clear increase in the admissions to forensic psychiatric hospitals and to detoxification centers since beginnings of the 1990s. Recently the German parliament passed a new law. The aim of the new law is to strengthen patients’ rights and to diminish the number of forensic patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Substance use among male forensic patients

2017 ◽  
Vol 41 (S1) ◽  
pp. S588-S588
Author(s):  
M. Mezghani ◽  
F. Fkih-Romdhane ◽  
F. Ghali ◽  
G. Jmii ◽  
M. Zghal ◽  
...  
Keyword(s):  
Substance Use ◽  
Treatment Needs ◽  
Psychiatric Symptomatology ◽  
Addictive Disorders ◽  
Forensic Patients ◽  
History Of ◽  
Forensic Psychiatric ◽  
Competing Interest ◽  
Psychopathological Disorders ◽  
Record Review

There is a widespread use of substances abuse which might cause violence, suicide, interpersonal conflicts, lawsuits, psychiatric commitment, and even crimes. Psychiatrists are under increasing pressure to develop strategies to address the problem of coexisting criminal behaviour, addiction, and mental illness. The aim of this study was to examine the association between demographic profile, psychiatric symptomatology and substance use in forensic psychiatric inpatients, and to consider the treatment needs and opportunities for intervention among the same sample.MethodologyA retrospective study was done on patients admitted to the department for Forensic Psychiatry at the Razi Hospital from 1996 to 2016, initially jailed for detention and drug consumption and judged irresponsible by reason of insanity. Data were collected by record review.ResultsThirty-two patients were included in the study. Mean age was 27.81 years. Thirty-six percent of the participants were illiterate and 45% were single. More than half of the subjects (54%) had personal psychiatric history and 27, 27% had family history of psychiatric problems. About one third (31.81%) of participants had judicial background: 33% were arrested for public drunkenness, 44% were arrested for violence, and 22% were arrested for theft. Concerning the diagnosis, 45% were suffering from schizophrenia, 22.77% were diagnosed with personality disorder and 27.27% of them would not have any mental trouble. About 50% of the patients did not follow up with treatment.ConclusionAddictive disorders are authentic psychopathological disorders. Effective treatment is hindered by the paucity of research on clinical application of treatment models for addictive disorders in this population.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Architecture as change-agent? Looking for innovation in contemporary forensic psychiatric hospital design

2020 ◽  
pp. medhum-2020-011887
Author(s):  
Rebecca Mclaughlan ◽  
Codey Lyon ◽  
Dagmara Jaskolska
Keyword(s):  
Psychiatric Hospital ◽  
Mental Healthcare ◽  
Psychiatric Hospitals ◽  
Advisory Panel ◽  
Design Practice ◽  
Hospital Design ◽  
Hospitalised Patients ◽  
The Usa ◽  
Forensic Psychiatric ◽  
The Uk

History suggests that departures from accepted design practice can contribute to positive change in the delivery of mental healthcare, the daily experience of hospitalised patients and public perceptions of mental illness. Yet the question of how architecture can support the therapeutic journey of patients remains a critical one. The availability of evidence-based design literature to guide architects cannot keep pace with growing global demand for new forensic psychiatric hospital facilities. This article reports a global survey of current design practice to speculate on the potential of three new hospitals to positively improve patient experience. A desktop survey was conducted of 31 psychiatric hospitals (24 forensic, 7 non-forensic) constructed or scheduled for completion between 2006 and 2022. This was supplemented by advisory panel sessions with clinical/facilities staff, alongside architectural knowledge obtained through workshops with architects from the UK and the USA, and the inclusion of Australian architects on the research team. Data analysis draws on knowledge from architectural practice, architectural history and environmental psychology, arguing that there is a responsibility to integrate knowledge from across these disciplines in respect of such a pressing and important problem.

scholarly journals Immigrant Patients Adapt to the Culture of Admission and Experience Less Safety in Forensic Psychiatric Care

2021 ◽  
Vol 12 ◽  
Author(s):  
Larissa Titze ◽  
Julia Gros ◽  
Michael Büsselmann ◽  
Maximilian Lutz ◽  
Judith Streb ◽  
...  
Keyword(s):  
Country Of Origin ◽  
Reference Sample ◽  
Psychiatric Hospitals ◽  
Well Being ◽  
Migration Background ◽  
Daily Work ◽  
Forensic Patients ◽  
Immigrant Background ◽  
Forensic Psychiatric ◽  
Special Patient Population

Patients with an immigrant background are overrepresented in forensic psychiatric hospitals. As a result, daily work is impeded by language barriers and cultural differences. Furthermore, general therapy processes have not yet been adapted to this special patient population, and little reliable knowledge is available. All immigrants go through an acculturation process, which is related to their mental well-being. Four acculturation strategies exist: integration, separation, assimilation, and marginalization. The strategy chosen depends on the extent of someone’s orientation toward their country of origin and the country of admission. The current study aimed to expand knowledge of forensic patients with a migration background in Germany by evaluating their self-reported acculturation processes and associated individual and social factors, e.g., the ward climate. Therefore, we studied forensic patients with a migration background from 11 forensic hospitals in Bavaria, Germany. Besides completing the Frankfurter Acculturation Scale (FRACC) and Essen Climate Evaluation Schema (EssenCES), the participants provided information on their clinical and biographical history. We recruited 235 patients with a migration background and found that the participants oriented themselves more toward the culture of admission and less toward the country of origin than the reference sample did. Moreover, the patients experienced significantly less safety on the ward than the forensic reference sample did. A possible explanation for the patients’ orientation is the lack of possibilities to adhere to their cultural traditions. Patients may feel less safe because of their limited knowledge of German and cultural misunderstandings.

Loss of motivation and frustration for visitor surgeons in provincial health centers or psychiatric hospitals in Greece

2017 ◽  
Vol 41 (S1) ◽  
pp. S378-S379
Author(s):  
I. Christodoulou ◽  
E. Pogonidou ◽  
C. Pogonidis ◽  
C. Charalambous
Keyword(s):  
Health Center ◽  
Psychiatric Hospital ◽  
National Health System ◽  
Psychiatric Hospitals ◽  
Health Centers ◽  
Surgical Patients ◽  
The Core ◽  
Long Period ◽  
Competing Interest ◽  
To Receive

IntroductionThe core workplace for a surgeon is the operating theatre. Secondary duties may include visits to small health centers for outpatient examinations and visitor work to psychiatric hospitals.ObjectiveThe objective of our study is to highlight the mistakes of management that lead to half-empty provincial health centers and psychiatric hospitals.MethodsPresentation of the 2-year-experience of a surgeon visitor in provincial health centers and in a large psychiatric hospital in Greece.ResultsThe provincial health center of Lagada needs at least 4 surgeons to serve; too many patients to be examined or/and operated in 2–3 hours only. Subsequently problems arise, as simultaneously in the emergencies department a surgical eye for an abdominal pain or a bad looking leg is needed every 15 minutes. The health center of Koufalia needs 3 hours of driving per day for 3–8 surgical patients only. The psychiatric hospital offered work for 3 surgeons 5 days a week for a long period of time. During 2012–2014, only one surgeon visited the hospital once a week. The work needed to be done may kill the surgeon or force him to receive antidepressants in order to keep his functions alive.ConclusionsNot a hint of scientific motivation for two years is a strong reason for a surgeon to avoid the duty to provincial health centers and psychiatric hospitals which is obligatory according to our national health system Laws until two years are completed for newly appointed surgeons. Managers might encourage surgeons if some balancing convenience was offered.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The Relationships Of Clinical, Socio-demographic and Criminal Factors in a Sample of Forensic Psychiatric Patients

2016 ◽  
Vol 33 (S1) ◽  
pp. S464-S464
Author(s):  
A. Sileikaite ◽  
A. Germanavičius ◽  
I. Česnienė
Keyword(s):  
Substance Abuse ◽  
Psychiatric Patients ◽  
Criminal History ◽  
Substance Abuse Problem ◽  
Forensic Patients ◽  
Violent Offending ◽  
Violent Criminal ◽  
Forensic Psychiatric Patients ◽  
Forensic Psychiatric ◽  
Competing Interest

IntroductionThe relationship between clinical factors and both psychosocial and criminal history characteristics among forensic psychiatric patients entering treatment in Lithuania has not been well explored.AimsThe aims and objectives of this presentation are:– to overview the clinical, socio-demographic and criminal factors in a Lithuanian sample of forensic psychiatric patients;– to demonstrate which factors were significant to violent criminal behaviour;– to address some main concerns and issues of risk assessment processes.MethodsData were collected from 325 forensic psychiatric patients’ files in one forensic psychiatric hospital in Lithuania. A sample consisted of 36 (11%) females and 289 (89%) males. The average age of patients was 41.7 years (SD = 14.0).ResultsPsychosis was the most common psychiatric diagnosis. The substance abuse problem was common in this population as well. The results of the logistic regression show that increase in patients’ substance abuse and their age was significantly associated with violent offending.ConclusionsThe study stressed an urgent need for further research of forensic patients in Lithuania.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Matricide Versus Patricide in One Croatian Psychiatric Forensic Inpatient Unit

2016 ◽  
Vol 33 (S1) ◽  
pp. S463-S463 ◽  
Author(s):  
I. Pedisic ◽  
K. Radic ◽  
N. Buzina ◽  
V. Jukic
Keyword(s):  
Psychiatric Hospital ◽  
Forensic Psychiatry ◽  
Psychotic Disorders ◽  
Rare Event ◽  
Point Of View ◽  
Different Types ◽  
Forensic Inpatient ◽  
Forensic Psychiatric ◽  
Competing Interest ◽  
The University

IntroductionParricide (referring as parental homicide) is a rare event among homicides, yet challenging and intriguing from psychiatric point of view. Still, literature concerning parricide is sparse and most studies concern small or heterogenous samples or anecdotal cases.ObjectiveTo analyze differences in parricide offenders among forensic psychiatric inpatients at the university psychiatric hospital Vrapče's centre for forensic psychiatry.AimsTo test some differences between parricide offenders with regard to specific type of parricide.MethodsAvailable retrograde data of 50 years forensic inpatients (n = 430). We identified parricide cases of matricide and patricide included.ResultsThe analysis included a total of 22 parricide offenders. All parricide offenders were male adults. Matricide was more prevalent then patricide (13 vs. 9). Matricide offenders were in average younger when committed crime, had more prevalence of psychotic disorders and earlier onset of symptoms in comparison with patricide group.ConclusionWe identified differences and similarities between these two parricide offenders groups. It is important to expand research further including different types of motives and family dynamics regarding the type of parricide victim.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Therapeutic alliance in forensic psychiatric hospitals: An empirical study

1997 ◽  
Vol 8 (3) ◽  
pp. 528-545 ◽  
Author(s):  
Martin Krupinski ◽  
Claudia Schöchlin ◽  
Alfred Fischer ◽  
Norbert Nedopil
Keyword(s):  
Empirical Study ◽  
Therapeutic Alliance ◽  
Psychiatric Hospitals ◽  
Forensic Psychiatric

scholarly journals Family involvement and patient-experienced improvement and satisfaction with care: a nationwide cross-sectional study in Danish psychiatric hospitals

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Marie Louise Svendsen ◽  
Trine Ellegaard ◽  
Karoline Agerbo Jeppesen ◽  
Erik Riiskjær ◽  
Berit Kjærside Nielsen
Keyword(s):  
Psychiatric Hospital ◽  
Hospital Care ◽  
Psychiatric Hospitals ◽  
Cross Sectional Study ◽  
Satisfaction With Care ◽  
Sectional Study ◽  
Cross Sectional ◽  
Caregiver Relationship ◽  
Patient Reported ◽  
Caregiver Involvement

Abstract Background Randomised controlled trials suggest that family therapy has a positive effect on the course of depression, schizophrenia and anorexia nervosa. However, it is largely unknown whether a positive link also exists between caregiver involvement and patient outcome in everyday psychiatric hospital care, using information reported directly from patients, i.e. patient-reported experience measures (PREM), and their caregivers. The objective of this study is to examine whether caregiver-reported involvement is associated with PREM regarding patient improvement and overall satisfaction with care. Methods Using data from the National Survey of Psychiatric Patient Experiences 2018, we conducted a nationwide cross-sectional study in Danish psychiatric hospitals including patients and their caregivers who had been in contact with the hospital (n = 940 patients, n = 1008 caregivers). A unique patient identifier on the two distinct questionnaires for the patient and their caregiver enabled unambiguous linkage of data. In relation to PREM, five aspects of caregiver involvement were analysed using logistic regression with adjustment for patient age, sex and diagnosis. Results We consistently find that high caregiver-reported involvement is statistically significantly associated with high patient-reported improvement and overall satisfaction with care with odds ratios (OR) ranging from 1.69 (95% confidence interval (CI) 0.95–2.99) to 4.09 (95% CI 2.48–6.76). This applies to the following aspects of caregiver-reported involvement: support for the patient-caregiver relationship, caregiver information, consideration for caregiver experiences and the involvement of caregivers in decision making. No statistically significant association is observed regarding whether caregivers talk to the staff about their expectations for the hospital contact. Conclusion This nationwide study implies that caregiver involvement focusing on the patient-caregiver relationship is positively associated with patient improvement and overall satisfaction with care in everyday psychiatric hospital care.

Predictors of Weight Gain and Metabolic Indexes among Men Admitted to Forensic Psychiatric Hospital

2021 ◽  
pp. 1-11
Author(s):  
N. Zoe Hilton ◽  
Elke Ham ◽  
Stephanie Hill ◽  
Talia Emmanuel ◽  
Barna Konkolÿ Thege
Keyword(s):  
Weight Gain ◽  
Psychiatric Hospital ◽  
Forensic Psychiatric
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