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.

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.

Routine Outcome Monitoring (ROM) in Belgian and Dutch forensic patients

2011 ◽  
Vol 26 (S2) ◽  
pp. 2063-2063
Author(s):  
K. Goethals
Keyword(s):  
Quality Of Life ◽  
Sex Offenders ◽  
Forensic Psychiatry ◽  
Psychiatric Treatment ◽  
Forensic Patients ◽  
Preliminary Results ◽  
Outcome Monitoring ◽  
Forensic Psychiatric ◽  
The University

IntroductionBy means of ROM, the efficacy of forensic psychiatric treatment can be measured in domains of risk of recidivism, level of psychopathology, and quality of life. Although, research of the efficacy of this treatment has several methodological pitfalls.ObjectivesTo review the literature of ROM in forensic psychiatry; to consider the way of implementing ROM; to present relevant instruments in the domains as mentioned above.AimsTo investigate whether forensic psychiatric treatment leads to less symptoms, and a decrease of reoffending; to investigate the correlation between degrees of psychopathology and quality of life.MethodsPatients are recruited from the University Forensic Center (UFC), Antwerp, Belgium, which is a outpatient facility for treatment of sex offenders. In the future patients from other facilities will be included. Several instruments are used to measure the degree of psychopathology, risk of recidivism, and quality of life.ResultsPreliminary results are presented and discussed in this paper.

Long-stay in high and medium secure forensic psychiatric care – Prevalence, patient characteristics and pathways in England

2016 ◽  
Vol 33 (S1) ◽  
pp. S180-S180 ◽  
Author(s):  
R. Edworthy ◽  
B. Vollm
Keyword(s):  
Patient Group ◽  
Service Provision ◽  
Psychiatric Care ◽  
Care Pathway ◽  
Patient Characteristics ◽  
Care Pathways ◽  
Cross Sectional ◽  
Case File ◽  
Secure Care ◽  
Forensic Psychiatric

IntroductionForensic psychiatric services are costly and highly restrictive for patients. Clinical experience and the limited research available indicate some patients stay for too long in these settings. A proportion of patients may, however, require long-term (potentially life-long) secure forensic psychiatric care but their needs may not be met by existing service provision designed for faster throughput.ObjectivesWe conducted a national, multi-centre, cross sectional study exploring the prevalence of long-stay and characteristics of long-stayers in high and medium secure forensic psychiatric care in England.Aims(1) Estimate the prevalence of long-stay in secure settings in England (length of stay over 5 years in medium secure care or 10 years in high secure care); (2) describe the characteristics, needs and care pathways of long-stay patients. Develop recommendations following the exploration of international models for this patient group.MethodsWe employed a mixed-methods approach including the analysis of administrative data, case file reviews, patient interviews, consultant questionnaires, interviews with clinicians and commissioners and a Delphi survey.ResultsTwenty-five percent (n = 401) of our sample were experiencing long-stay. This patient group has a heterogeneous set of characteristics and needs relating to their diagnosis, offending history, risk and therapeutic need and have experienced a variety of care pathways through secure care.ConclusionsWe found a greater number of long-stay patients than originally estimated with a set of characteristics and needs that are arguably different to that of the general forensic population, therefore calling for a specific care pathway and service provision for this patient group with a greater focus on autonomy and quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Polish Experiences of Safety Measures Involving Forensic Psychiatric Inpatients Implemented During the SARS-CoV-2 Pandemic

2021 ◽  
Vol 11 ◽  
Author(s):  
Janusz Heitzman ◽  
Paweł Gosek
Keyword(s):  
Forensic Psychiatry ◽  
Psychiatric Care ◽  
Psychiatric Treatment ◽  
Inpatient Service ◽  
Safety Measures ◽  
Social Distancing ◽  
Forensic Psychiatric ◽  
Treatment Safety ◽  
Therapeutic Activities ◽  
Safety Procedures

The SARS-CoV-2 pandemic has made it necessary for us to adapt our healthcare systems to a very different sort of reality. This clearly also applies to psychiatric services. The restrictions and safeguards associated with the pandemic particularly concern adherence to social distancing and medical treatment safety procedures. The implementation of these procedures is generally complicated by conditions of forensic psychiatry where, in line with demands made by courts, the treatment and isolation of mentally unwell offenders must be carefully managed. In most countries, forensic psychiatric treatment is an inpatient service where patients are kept in restricted and cramped spaces, making social distancing difficult to implement as patients participate in compulsory group therapeutic activities. As a result, it is necessary to introduce unique recommendations relating to patient safety and treatment adapted to the realities of forensic psychiatry. All this requires the implementation of additional restrictions, over and above those arising from the essential aspects of forensic psychiatry. In this paper, we present and discuss the Polish guidelines for forensic psychiatric care during the SARS-CoV-2 pandemic, developed as a result of discussions on essential measures introduced to reduce the spread of the virus and the unique needs of the forensic patient population.

scholarly journals Engaging with Families Is a Challenge: Beliefs among Healthcare Professionals in Forensic Psychiatric Care

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Ulrica Hörberg ◽  
Eva Benzein ◽  
Christen Erlingsson ◽  
Susanne Syrén
Keyword(s):  
Forensic Psychiatry ◽  
Healthcare Professionals ◽  
Psychiatric Care ◽  
Ethical Dilemmas ◽  
Complex Field ◽  
The Family ◽  
Forensic Psychiatric ◽  
Group Interviews ◽  
And Control ◽  
The Way

Being healthcare professionals in the complex field of forensic psychiatry care (FPC) seems particularly challenging. Historically, families have almost been invisible in FPC. The aim of this study was to uncover beliefs among healthcare professionals concerning families of patients admitted for FPC. Using a hermeneutical approach inspired by Gadamer’s philosophy, group interviews with healthcare professionals in four Swedish forensic psychiatric clinics were analyzed. Analysis resulted in seven key beliefs. There were three beliefs about families: family belongingness is a resource for the patient; most families are broken and not possible to trust; and most families get in the way of the patient’s care. Four beliefs concerned encounters with families: it is important to achieve a balance and control over the family; it is essential to set aside one’s own values and morals; family-oriented work is an impossible mission; and family oriented work requires welcoming the families. Despite ethical dilemmas of working with families in FPC, healthcare professionals showed a willingness and desire to work in a more family-oriented manner. More knowledge, understanding, and caring tools are needed in order to meet the needs of the family as well as support the family’s resources.

scholarly journals Opportunities and Challenges of Green-Lean: An Integrated System for Sustainable Construction

2020 ◽  
Vol 12 (11) ◽  
pp. 4460 ◽  
Author(s):  
Mohammadsoroush Tafazzoli ◽  
Ehsan Mousavi ◽  
Sharareh Kermanshachi
Keyword(s):  
Cost Savings ◽  
Integrated Approach ◽  
Integrated System ◽  
Waste Minimization ◽  
Sustainable Construction ◽  
Future Research ◽  
Safety Improvement ◽  
The Individual ◽  
High Level ◽  
Industry Professionals

Although the two concepts of lean and sustainable construction have been developed due to different incentives, and they do not pursue the same exact goals, there exists considerable commonality between them. This paper discusses the potentials for integrating the two approaches and their practices and how the resulting synergy from combining the two methods can potentially lead to higher levels of fulfilling the individual goals of each of them. Some limitations and challenges to implementing the integrated approach are also discussed. Based on a comprehensive review of existing papers related to sustainable and lean construction topics, the commonality between the two approaches is discussed and grouped in five categories of (1) cost savings, (2) waste minimization, (3) Jobsite safety improvement, (4) reduced energy consumption, and (5) customers’ satisfaction improvement. The challenges of this integration are similarly identified and discussed in the four main categories of (1) additional initial costs to the project, (2) difficulty of providing specialized expertise, (3) contractors’ unwillingness to adopt the additional requirements, and (4) challenges to establish a high level of teamwork. Industry professionals were then interviewed to rank the elements in each of the two categories of opportunities and challenges. The results of the study highlight how future research can pursue the development of a new Green-Lean approach by investing in the communalities and meeting the challenges of this integration.

scholarly journals The use of physical exercise in forensic psychiatric care in Sweden: a nationwide survey

2021 ◽  
pp. 1-9
Author(s):  
Henrik Bergman ◽  
Thomas Nilsson ◽  
Peter Andiné ◽  
Alessio Degl’Innocenti ◽  
Roland Thomeé ◽  
...  
Keyword(s):  
Physical Exercise ◽  
Psychiatric Care ◽  
Nationwide Survey ◽  
Forensic Psychiatric

A register-based comparison study of Swedish patients in forensic psychiatric care 2010 and 2018

2021 ◽  
Vol 77 ◽  
pp. 101715
Author(s):  
Alessio Degl’ Innocenti ◽  
Eirini Alexiou ◽  
Peter Andiné ◽  
Jolita Striskaite ◽  
Thomas Nilsson
Keyword(s):  
Psychiatric Care ◽  
Comparison Study ◽  
Forensic Psychiatric
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