Is There a Need for Elderly Forensic Psychiatric Services?

2005 ◽  
Vol 45 (2) ◽  
pp. 154-160 ◽  
Author(s):  
I O Nnatu ◽  
F Mahomed ◽  
A Shah
Keyword(s):  
Mental Illness ◽  
Old Age ◽  
The Elderly ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
Court Diversion ◽  
Mental Health Difficulties ◽  
Old Age Psychiatry ◽  
Forensic Psychiatric ◽  
Developed Nations

The population of the elderly in most developed nations is on the increase. Furthermore, the prevalence of mental disorder amongst elderly offenders is high. The true extent of `elderly' crime is unknown because much of it goes undetected and unreported. This leads to a failure to detect mental illness in such offenders. Court diversion schemes may improve recognition of mental illness but these schemes usually tend to deal with the more severe crimes. This may result in an overestimation of the amount of serious crime committed by the elderly and a failure to detect mental illness amongst those who commit less serious crimes. Efforts to service this hidden morbidity call for multi-agency collaboration. Improved detection and reporting of crimes is essential if mental health difficulties in the elderly are not to go unnoticed. The needs of elderly mentally-disordered offenders are complex and fall within the expertise of old age and forensic psychiatry, without being adequately met by either one. Therefore, consideration should be given to the development of a tertiary specialist forensic old-age psychiatry service.

Old and new reasons for specialization

2016 ◽  
Vol 33 (S1) ◽  
pp. S64-S65
Author(s):  
G. Stoppe
Keyword(s):  
Mental Illness ◽  
Health Service ◽  
Old Age ◽  
Service System ◽  
Psychiatric Patients ◽  
The Elderly ◽  
Current Evidence ◽  
Ageing Population ◽  
Old Age Psychiatry ◽  
Competing Interest

Mental illness is one of the largest areas of activity in the health service, with mental disorders of the elderly an important part of it. This substantial ageing of the population is a new phenomenon, occurring over the last century. It has given prominence to mental illness in old age. There is a growing interest in making decisions about how many and which services to provide to the older community.The expertise of old age psychiatry services lies in the care and treatment of people with complex mixtures of psychological, cognitive, functional, behavioral, physical and social problems usually relating to ageing. Current evidence suggests specialist old age services are best equipped to diagnose and treat mental illness in our ageing population. However, the specialists should be integrated optimally into a service system to the benefit of the elderly. It will be crucial to improve access of older patients to the services. The service system and the partners in the system differ to those for younger adult psychiatric patients. Thus, not only knowledge and skills underline the necessity of specialization but also the increasingly complex health service structures of modern societies.Disclosure of interestThe author has not supplied his declaration of competing interest.

Motivational Influences and Trajectories to Violence in the Context of Major Mental Illness

2019 ◽  
pp. 088626051987671
Author(s):  
Stephanie R. Penney ◽  
Andrew Morgan ◽  
Alexander I. F. Simpson
Keyword(s):  
Mental Illness ◽  
Developmental Trajectories ◽  
Psychiatric Patients ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
New Information ◽  
Forensic Psychiatric Patients ◽  
Not Criminally Responsible ◽  
Forensic Psychiatric ◽  
Motivational Influences

Developmental trajectories regarding the age onset of violence and offending have not routinely considered the role of major mental illness (MMI). In parallel, despite several studies investigating the relationship between MMI, violence and offending, fewer have identified motivational processes that may link illness to these outcomes in a more direct and proximal manner. This study investigates whether subtypes of forensic psychiatric patients deemed Not Criminally Responsible on account of Mental Disorder ( N = 91) can be identified based on the age onset of mental illness and offending behavior, and whether information on motivational influences for offending—elicited both from the patient directly and detailed collateral information—contributes to the clinical utility of this typology. Results indicated that most patients reported engaging in violence (51%) or antisocial behaviors (72%) prior to the onset of MMI, but that the index offense(s) resulting in forensic admission were predominantly psychotically motivated. In contrast to patients for whom the onset of MMI occurred prior to offending, patients exhibiting premorbid violence had higher levels of risk and criminogenic need; they were more likely to be diagnosed with personality and substance use disorders, and to have conventional (i.e., non-illness-related) motivations ascribed to their index offense. Findings are consistent with the existing literature regarding subgroups of mentally disordered offenders, but provide new information regarding proximal risk factors for violence through better identification of motivational processes.

scholarly journals Comparision of how old age psychiatry and general adult psychiatry services meet the needs of elderly people with functional mental illness: Cross-sectional survey

2015 ◽  
Vol 207 (5) ◽  
pp. 440-443 ◽  
Author(s):  
Walid Khalid Abdul-Hamid ◽  
Kelly Lewis-Cole ◽  
Frank Holloway ◽  
Ann Marisa Silverman
Keyword(s):  
Mental Illness ◽  
Elderly People ◽  
Old Age ◽  
The Elderly ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Urban Catchment ◽  
People With Mental Illness ◽  
Adult Psychiatry ◽  
Old Age Psychiatry

BackgroundThere is little research evidence as to whether general adult psychiatry or old age psychiatry should look after old people with enduring mental illness.AimsTo compare the extent to which general adult and old age psychiatric services meet the needs of older people with enduring mental illness.MethodA total of 74 elderly patients with functional psychiatric disorders were identified by reviewing the notes of patients over the age of 60 living in a defined inner urban catchment area. Data were collected on the morbidity and needs of the sample. Needs were assessed using the Elderly Psychiatric Needs Schedule (EPNS).ResultsThe participants in contact with old age psychiatry had significantly fewer unmet needs compared with those in contact with general adult psychiatry (2.8 v. 5.6, t = 2.2, P<0.03). Total needs were not significantly different between those managed by old age and general adult services (8.0 v. 6.5 respectively, t = 1.2, P = 0.2).ConclusionsThis study found that old age psychiatry services were better placed to meet the needs of elderly people with mental illness. This finding supports the need for a separate old age psychiatry service.

Offenders with Mental Illness in Prison

2016 ◽  
Author(s):  
Sarah M. Manchak ◽  
Robert D. Morgan
Keyword(s):  
Mental Illness ◽  
Mentally Ill ◽  
Justice System ◽  
Mental Illnesses ◽  
Future Research ◽  
Mentally Disordered Offenders ◽  
Prison Management ◽  
Mentally Disordered ◽  
Prison Environment ◽  
Offenders With Mental Illness

This essay describes trends in the number of mentally disordered offenders in prison and the unique challenges posed by them in terms of prison management and service delivery. The essay first explores why persons with mental illnesses are overrepresented in the criminal justice system, then discusses efforts to rehabilitate this population should not take place within the prison environment (and, if they do, what changes in current practices are necessary to adapt to the prison setting). How the challenges posed by mentally ill inmates are managed is also covered, with critical discussions of these strategies. Finally, an analysis of the changes that are needed to improve conditions for inmates with mental illness in prisons is presented, with a description of one promising program for treating these offenders. Suggestions for future research with this population that will help inform and improve prison conditions for offenders with mental illness are also provided.

scholarly journals The interface between old age psychiatry and the law

2002 ◽  
Vol 8 (4) ◽  
pp. 271-278 ◽  
Author(s):  
Brian Murray ◽  
Robin Jacoby
Keyword(s):  
Old Age ◽  
Psychiatric Care ◽  
Common Law ◽  
Civil Law ◽  
The Elderly ◽  
Legal Aspects ◽  
Northern Irish ◽  
Care For The Elderly ◽  
Old Age Psychiatry ◽  
The Uk

This article aims to provide a practical overview concentrating on civil legal aspects of psychiatric care for the elderly. We limit ourselves to English law (which also has jurisdiction in Wales; Scottish and Northern Irish law may be similar, but not identical). Civil law can, in turn, be divided into statute law (legislation provided by Parliament) and common law (the UK, unlike some European countries, has a strong tradition of law based on previous rulings by judges).

Community forensic psychiatric services in England and Wales

CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 604-617
Author(s):  
Richard Latham ◽  
Hannah Kate Williams
Keyword(s):  
Research Evidence ◽  
Medical Specialty ◽  
Community Services ◽  
Mentally Disordered Offenders ◽  
Late 20Th Century ◽  
England And Wales ◽  
Mentally Disordered ◽  
Forensic Psychiatric ◽  
Criminal Legislation ◽  
The 19Th Century

Forensic psychiatry is an established medical specialty in England and Wales. Although its origins lie in the 19th century, the development of secure hospitals accelerated in the late 20th century. Services for mentally disordered offenders in the community have developed most recently and it is these services, which are the focus of this article. We have looked broadly at community services and have included criminal justice liaison and diversion services in our remit. We have also considered partnerships between health and justice agencies as well as mental health and criminal legislation. We consider the limited research evidence in relation to community forensic services and the discussion this has provoked.

scholarly journals Physical illness associated with depression in the elderly in community based and hospital patients

1992 ◽  
Vol 16 (10) ◽  
pp. 612-613
Author(s):  
Stephen Dover ◽  
Christopher McWilliam
Keyword(s):  
Old Age ◽  
Psychiatric Illness ◽  
Geriatric Medicine ◽  
The Elderly ◽  
Physical Illness ◽  
Community Based ◽  
Senior Registrar ◽  
Hospital Patients ◽  
Old Age Psychiatry ◽  
Registrar Training

The co-existence of physical and psychiatric illness in so much of the elderly population poses diagnostic and therapeutic problems for psychiatrists, geriatricians and general practitioners alike, with the presence of physical illness strongly influencing and sometimes limiting the options for treatment of the psychiatric illness. Recognition of this has resulted in the Section of Old Age Psychiatry of the Royal College of Psychiatrists recommending that senior registrar training in old age psychiatry should include a one month attachment to an approved geriatric medicine unit.

scholarly journals 3. Old age psychiatry

1991 ◽  
Vol 15 (1) ◽  
pp. 15-16
Author(s):  
Dawn Black ◽  
Elspeth Guthrie ◽  
David Jolley
Keyword(s):  
Old Age ◽  
The Elderly ◽  
Old Age Psychiatry

The old age psychiatrist's role has been evocatively described as “physician to the soul of the elderly”. A more practical definition is psychiatrist to patients over the age of 65 with both functional and organic illnesses.

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