The interface between general and forensic psychiatry: a historical perspective

2014 ◽  
Vol 20 (5) ◽  
pp. 350-358 ◽  
Author(s):  
Harvey Gordon ◽  
Vivek Khosla
Keyword(s):  
Mental Disorder ◽  
Mentally Ill ◽  
Forensic Psychiatry ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
The Past ◽  
The Uk

SummaryMental disorder and criminality are separate entities but some people with a mental disorder commit criminal offences and some criminals have a mental disorder. Before 1800 there was no separate category of mentally disordered offenders (referred to as criminal lunatics until 1948) in UK legislation. The provision of facilities for mentally disordered offenders in Britain and Ireland overlapped with, but was also separate from, provision for the mentally ill generally. The interface between general and forensic psychiatry is an area of tension and of collaboration. To understand how contemporary general and forensic psychiatry interact, it is useful to have an understanding of how factors have evolved overtime.Learning Objectives•Have an understanding of the evolution of general and forensic psychiatry in the UK over the past 200 years.•Comprehend the similarities and differences between general and forensic psychiatry.•Be aware of some of the roots of conflict between general and forensic psychiatry.

scholarly journals The interface between general and forensic psychiatry: the present day

2014 ◽  
Vol 20 (5) ◽  
pp. 359-365 ◽  
Author(s):  
Vivek Khosla ◽  
Phil Davison ◽  
Harvey Gordon ◽  
Verghese Joseph
Keyword(s):  
Forensic Psychiatry ◽  
Clinical Care ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
England And Wales ◽  
Adult Psychiatry ◽  
The Republic ◽  
Definition Of ◽  
The Uk

SummaryWith the subspecialisation of psychiatry in the UK, clinicians encounter problems at the interfaces between specialties. These can lead to tension between clinicians, which can be unhelpful to the clinical care of the patient. This article focuses on the interface between general and forensic psychiatry in England and Wales. The pattern of mental health services in England and Wales differs to an extent from those in Scotland, Northern Ireland and in the Republic of Ireland. Consequently, the interface between general and forensic psychiatry is subject to varying influences. Important interface issues include: the definition of a ‘forensic patient’; the remit and organisation of services; resources; clinical responsibility; and care pathways. This article also discusses a general overview of how to improve collaboration between forensic and general adult psychiatric services.Learning Objectives•Develop an understanding of important issues at the forensic/general adult psychiatry interface.•Be aware of areas of conflict that may arise at the forensic/general adult psychiatry interface.•Be aware of options for optimum cooperation at the interface.

scholarly journals Mental Health Guardianship—a Change for the Better?

1982 ◽  
Vol 6 (10) ◽  
pp. 176-177
Author(s):  
Gareth W. Hughes
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Legal Framework ◽  
Psychiatric Practice ◽  
Mentally Disordered ◽  
The Past ◽  
Mental Health Act ◽  
Compulsory Care ◽  
The Uk ◽  
As If

The 1959 Mental Health Act has provided the legal framework for psychiatric practice in the UK for the past two decades. The Mental Health (Amendment) Bill (DHSS, 1981) currently before Parliament proposes to update the Act by improving the safeguards for detained patients, clarifying the position of staff looking after them, and by the removal of uncertainties in the law. The Bill incorporates changes relating to the compulsory care of Mentally Disordered patients in the community whereby a person may be accepted into Guardianship on the grounds that he or she is suffering from a Mental Disorder. Once accepted into Guardianship, the person or body named as Guardian has the power to exercise control over the person as if he or they were the father of the patient, and the patient was under 14 years of age.

scholarly journals Assisted dying – the debate: Videtur… sed contra

2014 ◽  
Vol 20 (4) ◽  
pp. 250-257
Author(s):  
Philip Graham ◽  
Julian C. Hughes
Keyword(s):  
Health Professionals ◽  
Empirical Data ◽  
Terminally Ill ◽  
Learning Objectives ◽  
List Type ◽  
Assisted Dying ◽  
Type Number ◽  
The Law ◽  
The Uk

SummaryShould the law be changed to allow health professionals to assist mentally competent, terminally ill people to end their own lives? In this article Philip Graham (P.G.) puts the arguments in favour of such a change in the law and Julian Hughes (J.H.) opposes these arguments. J.H. then sets out why he believes such a law should not be passed and P.G., in turn, sets out counterarguments. Before concluding comments, both P.G. and J.H. independently make brief closing statements supporting their own positions.LEARNING OBJECTIVESUnderstand the differences between various types of ‘assisted dying’.Appreciate some of the ethical arguments in favour of and against changes in the law on assisted dying in the UK.Understand some of the empirical data involved in arguments about assisted dying.

Legal issues

2019 ◽  
pp. 931-976
Author(s):  
David Semple ◽  
Roger Smyth
Keyword(s):  
Mental Health ◽  
Mental Disorder ◽  
Criminal Law ◽  
Forensic Psychiatry ◽  
Common Law ◽  
Treatment Decisions ◽  
Legal Issues ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
Areas Of Interest

Practising psychiatrists must be familiar with the laws in their country relating to mental health. Five broad areas of interest include common law as it relates to medical treatment decisions, the law in relation to incapable adults, regulations around the treatment of patients with a mental disorder, confidentiality, and criminal law in relation to mentally disordered offenders. This chapter, in conjunction with the chapter on forensic psychiatry, provides the background of Mental Health Acts across the British Isles.

scholarly journals A comparison of DSM and ICD classifications of mental disorder

2014 ◽  
Vol 20 (4) ◽  
pp. 280-285 ◽  
Author(s):  
Peter Tyrer
Keyword(s):  
Mental Disorder ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Behavioural Disorders ◽  
Major Player ◽  
The Usa ◽  
History Of ◽  
Pros And Cons ◽  
Research Classification

SummaryMost disorders in medicine are classified using the ICD (initiated in Paris in 1900). Mental and behavioural disorders are classified using the DSM (DSM-I was published in the USA in 1952), but it was not until DSM-III in 1980 that it became a major player. Its success was largely influenced by Robert Spitzer, who welded its disparate elements, and Melvyn Shabsin, who facilitated its acceptance. Spitzer pointed out that most diagnostic conditions in psychiatry were poorly defined, showed poor reliability in test-retest situations, and were temporally unstable. The consequence was that the beliefs of the psychiatrist seemed to matter much more than the characteristics of the patient when it came to classification. Since DSM-III there has been a split between those who adhere to DSM because it is a better research classification and those who adhere to ICD because it allows more clinical discretion in making diagnoses. This article discusses the pros and cons of both systems, and the major criticisms that have been levelled against them.LEARNING OBJECTIVESUnderstand the principles and reasoning behind classification in medicine and psychiatry.Be able to describe the recent history of psychiatric classification.Be able to compare DSM and ICD classifications of mental disorder.

Law and Psychiatry: Scandinavia in the 1980s

1986 ◽  
Vol 484 (1) ◽  
pp. 144-154 ◽  
Author(s):  
LEIF ÖJESJÖ
Keyword(s):  
Mentally Ill ◽  
Outpatient Treatment ◽  
Forensic Psychiatry ◽  
Mental Health Treatment ◽  
Mentally Disordered Offenders ◽  
Health Treatment ◽  
Mentally Disordered ◽  
Severely Mentally Ill ◽  
Special Defense

The major policies and practices with regard to the civil and criminal commitment of the mentally ill in the Scandinavian countries during the 1970s and 1980s are described and discussed. Deinstitutionalization, community work, and outpatient treatment within geographically defined sectors have been introduced in all the Nordic countries. At the same time, criminally committed mental patients constitute an increasing proportion of the involuntarily hospitalized population. The special defense of insanity and tests such as McNaughtan are not used in the Scandinavian countries. The handling and disposition of severely mentally ill criminal defendants is closer to the notions of guilty but mentally ill in some U.S. jurisdictions, although in Scandinavia such persons are hospitalized and do not receive penal sentences. Even though forensic psychiatry has come under much criticism, there is still a need for psychiatric evaluations for courts and there is still a need for the provision of mental health treatment, rehabilitation, and follow-up for mentally disordered offenders.

Forensic Psychiatry and Older People - a UK Perspective

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
G. Yorston
Keyword(s):  
Older Adults ◽  
Older People ◽  
Prison Population ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
The Past ◽  
Older Prisoners ◽  
Forensic Psychiatric ◽  
The Uk ◽  
Psychiatric Beds

The number of older people in prison has quadrupled in the UK in recent years, such that older prisoners now make up 2.6% of the total prison population, despite the fact that the number of offences committed by older adults has remained static. Older prisoners have high levels of psychiatric and physical morbidity, and forensic psychiatric services are receiving increasing numbers of referrals of older adults. In the past, few of these referrals resulted in admissions to secure psychiatric beds, however, reflecting a reluctance by forensic psychiatrists to admit older adults, who were perceived as being at risk from younger patients. Over the past 10 years, however, specialist secure inpatient units have been established in the UK for the assessment and management of older mentally disordered offenders. This seminar will explore the research evidence and clinical experience relating to this group of patients.

scholarly journals Beyond year zero: getting the best out of revalidation

2014 ◽  
Vol 20 (4) ◽  
pp. 237-246
Author(s):  
Mary Jane Tacchi
Keyword(s):  
Medical Practice ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Good Medical Practice ◽  
The Uk

SummaryMedical revalidation was introduced in the UK in 2012 (‘year zero’) after years of discussion and debate. This article describes what it aims to achieve. The General Medical Council's Good Medical Practice is used as a framework on which to build to provide evidence of competencies. Practical aspects of appraisal and revalidation are discussed, with suggestions of how to get the most out of the process both for patients and doctors.LEARNING OBJECTIVES•Understand the purpose of revalidation.•Understand the role of the responsible officer.•Describe the types of supporting information necessary for revalidation.

Electric Propulsion Development. Part I. Ion Thrusters

1969 ◽  
Vol 73 (706) ◽  
pp. 916-922
Author(s):  
P. R. Openshaw
Keyword(s):  
Electric Propulsion ◽  
List Type ◽  
Type Number ◽  
Considerable Time ◽  
The Past ◽  
Ion Thrusters ◽  
The Uk ◽  
Systems Studies

Although an interest in electric propulsion has existed in the UK for a considerable time, it is only in the past few years that it has been considered worthwhile to undertake the development of hardware and produce detailed systems studies. The practical developments can be divided into two categories: — 1. The development of comparatively large thrusters (in the region of ½ kW power, giving 10-20 milli Newtons of thrust), for producing major movements in a satellite's position. 2. The development of micro-thruster systems for the maintenance of a satellite's attitude and position against the small disturbing forces and torques it normally experiences in orbit.

scholarly journals Metabolic syndrome in psychiatry: advances in understanding and management

2014 ◽  
Vol 20 (2) ◽  
pp. 101-112 ◽  
Author(s):  
Cyrus S. H. Ho ◽  
Melvyn W. B. Zhang ◽  
Anselm Mak ◽  
Roger C. M. Ho
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Psychiatric Disorders ◽  
Psychiatric Patients ◽  
Learning Objectives ◽  
List Type ◽  
Type Number ◽  
Unhealthy Lifestyle ◽  
Definition Of ◽  
The Relationship

SummaryMetabolic syndrome comprises a number of cardiovascular risk factors that increase morbidity and mortality. The increase in incidence of the syndrome among psychiatric patients has been unanimously demonstrated in recent studies and it has become one of the greatest challenges in psychiatric practice. Besides the use of psychotropic drugs, factors such as genetic polymorphisms, inflammation, endocrinopathies and unhealthy lifestyle contribute to the association between metabolic syndrome and a number of psychiatric disorders. In this article, we review the current diagnostic criteria for metabolic syndrome and propose clinically useful guidelines for psychiatrists to identify and monitor patients who may have the syndrome. We also outline the relationship between metabolic syndrome and individual psychiatric disorders, and discuss advances in pharmacological treatment for the syndrome, such as metformin.LEARNING OBJECTIVES•Be familiar with the definition of metabolic syndrome and its parameters of measurement.•Appreciate how individual psychiatric disorders contribute to metabolic syndrome and vice versa.•Develop a framework for the prevention, screening and management of metabolic syndrome in psychiatric patients.

Sign in / Sign up

Export Citation Format

Share Document