Forensic Psychiatry and Occupational Therapy

1983 ◽  
Vol 46 (12) ◽  
pp. 348-350 ◽  
Author(s):  
Chris Lloyd
Keyword(s):  
Social Learning ◽  
Occupational Therapy ◽  
Forensic Psychiatry ◽  
Therapeutic Community ◽  
Psychiatric Unit ◽  
Alberta Hospital ◽  
Major Mode ◽  
Forensic Psychiatric ◽  
Goal Planning ◽  
Traditional Roles

At the Alberta Hospital Edmonton, one ward employs social learning as the major mode of treatment of character disorders. To meet the demands of working in a therapeutic community all disciplines have had to extend their traditional roles. Occupational therapy role extension has been in the area of assessment and goal planning. This article discusses the occupational therapist's involvement in the forensic psychiatric unit.

scholarly journals Peripheral recovery: ‘Keeping safe’ and ‘keep progressing’ as contradictory modes of ordering in a forensic psychiatric unit

2021 ◽  
pp. 026377582110130
Author(s):  
Laura McGrath ◽  
Steven D Brown ◽  
Ava Kanyeredzi ◽  
Paula Reavey ◽  
Ian Tucker
Keyword(s):  
Psychiatric Unit ◽  
Therapeutic Landscape ◽  
Criminal Justice Systems ◽  
Psychiatric Units ◽  
Carceral Geography ◽  
Forensic Psychiatric ◽  
The Uk ◽  
Institutional Space ◽  
Photo Production ◽  
Modes Of Ordering

Sitting between the psychiatric and criminal justice systems, and yet fully located in neither, forensic psychiatric units are complex spaces. Both a therapeutic landscape and a carceral space, forensic services must try to balance the demands of therapy and security, or recovery and risk, within the confines of a strictly controlled institutional space. This article draws on qualitative material collected in a large forensic psychiatric unit in the UK, comprising 20 staff interviews and 20 photo production interviews with patients. We use John Law’s ‘modes of ordering’ to explore how the materials, relations and spaces are mobilised in everyday processes of living and working on the unit. We identify two ‘modes of ordering’: ‘keeping safe’, which we argue tends towards empty, stultified and static spaces; and ‘keep progressing’ which instead requires filling, enriching and ingraining spaces. We discuss ways in which tensions between these modes of ordering are resolved in the unit, noting a spatial hierarchy which prioritises ‘keeping safe’, thus limiting the institutional capacity for engendering progress and change. The empirical material is discussed in relation to the institutional and carceral geography literatures with a particular focus on mobilities.

Self-Harm Among Forensic Psychiatric Inpatients With Schizophrenia Spectrum Disorders: An Explorative Analysis

2021 ◽  
pp. 0306624X2110621
Author(s):  
Johannes René Kappes ◽  
David Alen Huber ◽  
Johannes Kirchebner ◽  
Martina Sonnweber ◽  
Moritz Philipp Günther ◽  
...  
Keyword(s):  
Machine Learning ◽  
Forensic Psychiatry ◽  
Supervised Machine Learning ◽  
Depression And Anxiety ◽  
Schizophrenia Spectrum Disorders ◽  
Forensic Patients ◽  
Self Injury ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Forensic Psychiatric

The burden of self-injury among offenders undergoing inpatient treatment in forensic psychiatry is substantial. This exploratory study aims to add to the previously sparse literature on the correlates of self-injury in inpatient forensic patients with schizophrenia spectrum disorders (SSD). Employing a sample of 356 inpatients with SSD treated in a Swiss forensic psychiatry hospital, patient data on 512 potential predictor variables were retrospectively collected via file analysis. The dataset was examined using supervised machine learning to distinguish between patients who had engaged in self-injurious behavior during forensic hospitalization and those who had not. Based on a combination of ten variables, including psychiatric history, criminal history, psychopathology, and pharmacotherapy, the final machine learning model was able to discriminate between self-injury and no self-injury with a balanced accuracy of 68% and a predictive power of AUC = 71%. Results suggest that forensic psychiatric patients with SSD who self-injured were younger both at the time of onset and at the time of first entry into the federal criminal record. They exhibited more severe psychopathological symptoms at the time of admission, including higher levels of depression and anxiety and greater difficulty with abstract reasoning. Of all the predictors identified, symptoms of depression and anxiety may be the most promising treatment targets for the prevention of self-injury in inpatient forensic patients with SSD due to their modifiability and should be further substantiated in future studies.

scholarly journals A plea against over specialisation in forensic psychiatry

1992 ◽  
Vol 16 (7) ◽  
pp. 439-442 ◽  
Author(s):  
Eric F. Mendelson
Keyword(s):  
Forensic Psychiatry ◽  
Psychiatric Care ◽  
Early Stage ◽  
Integrated Approach ◽  
Integrated System ◽  
Forensic Patients ◽  
Secure Care ◽  
Regional Service ◽  
Forensic Psychiatric ◽  
Special Responsibility

The optimal system for delivering forensic psychiatric care has yet to be established. At an early stage, Gunn (1977) drew attention to the differing models of a ‘parallel’ service and an ‘integrated’ approach. Only with the integrated system do forensic patients pass to ordinary NHS facilities when they no longer require security or other specialist expertise. The debate can be extended into whether forensic services should be provided by regional units, by district services, or by a mixture of both. Indeed, the Royal College of Psychiatrists (1988) recognised that in addition to a regional service led by a fully trained forensic psychiatrist, secure care can be provided at a district level by consultants who have sufficient training to hold posts with a special responsibility. Furthermore, managers are understandably keen for as much as possible to be provided by their own district services.

Music Therapy and Forensic Psychiatry — Choice, Denial and the Law

1994 ◽  
Vol 8 (2) ◽  
pp. 10-18 ◽  
Author(s):  
Helen Loth
Keyword(s):  
Music Therapy ◽  
Psychiatric Hospital ◽  
Forensic Psychiatry ◽  
Therapy Group ◽  
Psychiatric Setting ◽  
Secure Unit ◽  
The Law ◽  
Forensic Psychiatric

This paper looks at aspects of work in the forensic psychiatric setting. It is based on music therapy work in a Medium Secure Unit, situated within a general psychiatric hospital. It was felt that there were several important differences in working in this unit of the hospital which often seemed to question the feasability and existence of a music therapy group. This paper concerns itself with these differences. A brief introduction to forensic psychiatry and secure units is given first. This is followed by a short case study of an eight-week music therapy group from which material is used to look at the themes identified. These are summarized into the headings of choice, denial and the law. Their effect on the patients is discussed and the ways in which the music therapy group can address the issues involved are highlighted.

scholarly journals Registration of aggressive incidents in an adolescent forensic psychiatric unit and implications for further practice

2014 ◽  
Vol 23 (9) ◽  
pp. 823-833 ◽  
Author(s):  
S. Tremmery ◽  
M. Danckaerts ◽  
L. Bruckers ◽  
G. Molenberghs ◽  
M. De Hert ◽  
...  
Keyword(s):  
Psychiatric Unit ◽  
Forensic Psychiatric

Ethical Issues in the Practice of Forensic Psychiatry

1982 ◽  
Vol 10 (1) ◽  
pp. 7-43 ◽  
Keyword(s):  
New York ◽  
Forensic Psychiatry ◽  
Ethical Issues ◽  
Rapid Development ◽  
Panel Discussion ◽  
Special Interests ◽  
Philosophical Perspective ◽  
Psychiatric Setting ◽  
Forensic Psychiatric ◽  
Hospital Center

The recent, rapid development of the practice of forensic psychiatry has led to an increasing awareness of and a growing concern about the ethical issues that inhere in this subspecialty. While some such issues are similar to those found in the general practice of psychiatry (confidentiality, informed consent, etc.), there are aspects of these and other ethical issues which are unique to the practice of forensic psychiatry. On October 16 and 17, 1980, at the annual meeting of the American Academy of Psychiatry and Law held in Chicago, Illinois, a panel discussion concerning ethical issues in forensic psychiatry took place. The chairman was Henry C. Weinstein, M.D., Director, Forensic Psychiatry Services, Bellevue Hospital Center, New York. This panel, made up of two forensic psychiatrists and two philosophers (with special interests in medical ethics), discussed the ethical issues in the practice of forensic psychiatry from a variety of perspectives. A general statement in regard to ethics and forensic psychiatry opened the panel, followed by a series of presentations relating to specific ethical issues, including those which face the forensic psychiatrist practicing in a secure forensic unit, those which arise in the practice of forensic psychiatry with children and adolescents, as well as ethical issues relating to research in forensic psychiatry. A special program for the exploration and teaching of ethical issues, in a clinical forensic psychiatric setting, utilizing a philosopher-in-residence, was described and discussed. The panel presentation was concluded by a commentary from the philosophical perspective.

scholarly journals “I would prefer not to”: Assessing competence to consent in a case of refusal of cancer treatment

2019 ◽  
Vol 14 (1) ◽  
pp. 42-45
Author(s):  
Gustavo B Castellana ◽  
Lilia B Schraiber ◽  
Talita R de Oliveira ◽  
Daniel M de Barros
Keyword(s):  
Decision Making ◽  
Forensic Psychiatry ◽  
Patient Relationship ◽  
Ethical Conflict ◽  
Actual Case ◽  
Clinical Issue ◽  
Case Presentation ◽  
Decision Making Capacity ◽  
Forensic Psychiatric

Background Based on an actual case in which a psychiatrist was called in to assess a patient’s capacity to refuse treatment, the aim of this study is to discuss how to manage this ethical and clinical issue and the dilemmas faced by the medical team. Case presentation: The case involved a 45-year-old female patient diagnosed with breast cancer who refused treatment. Since the mastology team had doubts about the patient’s mental state and given that she refused to consent to surgery, a forensic psychiatric consult was requested. Conclusion The forensic psychiatry team concluded that the patient’s decision-making capacity was preserved. The team suggested some actions to help the specialists deal with the ethical conflict. A reflection is proposed about the role of psychiatrists when an ethical dilemma involving decision-making capacity emerges in clinical situations, elucidating their work not only as physicians who determine diagnoses and conducts, but also as agents of transformation in the doctor–patient relationship.

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