scholarly journals Forensic-Psychiatric Risk Evaluations: Perspectives of Forensic Psychiatric Experts and Older Incarcerated Persons From Switzerland

2021 ◽  
Vol 12 ◽  
Author(s):  
Tenzin Wangmo ◽  
Helene Seaward ◽  
Felix Pageau ◽  
Lutz-Peter Hiersemenzel ◽  
Bernice S. Elger
Keyword(s):  
Mental Health ◽  
Psychiatric Treatment ◽  
Negative Evaluation ◽  
Risk Assessments ◽  
Court Order ◽  
Forensic Institutions ◽  
Forensic Psychiatric ◽  
Predictive Risk ◽  
Study Participants ◽  
Purposive Sample

Background: Forensic-psychiatric risk assessments of persons in prisons aim to provide treatment for their mental health disorders to prevent risk of recidivism. Based on the outcomes of such evaluations, it is decided, for instance, whether the person can be released or be assigned to further treatment with or without privileges. A negative evaluation would mean that the assessed person must remain in prison or in a forensic institution until his or her mental health has improved to live safely in the community. This paper highlights the process of forensic-psychiatric evaluations and the challenges faced by the two parties directly involved in this process in Switzerland.Methods: Data for this manuscript are gathered using semi-structured one-to-one interviews. The study participants included a purposive sample of 41 older incarcerated persons under measures (i.e., mandated by court order to psychotherapeutic and psychiatric treatment), and 23 expert participants working in Swiss prisons or forensic institutions. We analyzed data using thematic analysis.Results: Study findings within four themes are reported. First we describe the standards and procedures that expert participants use to carry out adequate risk assessments and conditions under which they refuse to perform such assessments. Thereafter, we present expert participants' concerns associated with predictive risk assessments and highlight the need to be cautious in drawing conclusion from them. We then reveal older incarcerated participants' reports on the inconsistencies with the forensic expertise and their belief that these reports tend to be negative toward them. The final theme concerns older participants' experiences of how these evaluations negatively impact their lives and their perspectives of a different future.Conclusion: The study findings about forensic-psychiatric risk assessments point to the need for a clearer communication on how these evaluations take place and how decisions are taken based on them. As incarceration under measures denotes the necessity to continue therapy and reduce dangerousness, it is important that accused person understands his or her real progress, feel that the decisions are objective and justified, and are aware of the progress needed to achieve the goal of eventual release. Such clarity will not only be valuable for those under measures, but also the justice system.

scholarly journals Legal status of persons with mental illness in Serbia

2004 ◽  
Vol 132 (11-12) ◽  
pp. 448-452 ◽  
Author(s):  
Aleksandar Jovanovic
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mentally Ill ◽  
Legal Status ◽  
Psychiatric Treatment ◽  
Security Measures ◽  
Moral Integrity ◽  
General Law ◽  
Legal Competence ◽  
Forensic Psychiatric

In this study, legal status of the mentally ill has been discussed in the context of Serbian legislation. The topics covered are the following: 1) the admission of persons with mental illness to psychiatric institution, 2) general (legal) competence, 3) marital relations of persons with mental illness, 4) legal definitions of sanity and security measures of medical character. Serbia still has no general law on mental health which would be in accordance with European standards, and the existing legislation which deals with the rights of persons with mental illness is, to a large extent, incomplete and obsolete. The author appeals for passing the law on mental health which should: a) follow modern trends in psychiatry concerning the protection of human rights with the basic goal to protect society and mentally ill persons, b) to protect the professional and moral integrity of psychiatrists, c) to provide ethically and professionally acceptable authorization for the use of force, if necessary, in order to prevent criminal acts and/or self-injuries in patients suffering from severe psychical disorders, d) to conceptualize forensic psychiatric treatment (the security measures, corrective psychiatry) and the programs of rehabilitation as an integral part of the community mental health protection system.

Effects of Differences in Numeric Ability on the Perception of Adversity Risk to Others and Self

2013 ◽  
Vol 25 (2) ◽  
pp. 95-104 ◽  
Author(s):  
Coy Callison ◽  
Rhonda Gibson ◽  
Dolf Zillmann
Keyword(s):  
Risk Assessments ◽  
High Ability ◽  
News Report ◽  
Bodily Injury ◽  
Adolescent Groups ◽  
Study Participants

This study used an experimental news report about confrontational robberies by adolescent groups in Mexican resorts that presented statistics with or without personalized cases of victimization. Study participants estimated the risk of harm to victims and the extent of their suffering. They also indicated their own risk and concern for their own safety. The readers’ numeric ability was ascertained thereafter. A trisection of this ability showed that persons of high ability comparatively overestimated others’ risk but underestimated their own; this despite indicating greater concerns for their own safety. These results were not altered by consideration of the readers’ empathic, experiential, and rational traits. The incorporation of personalized cases of victimization in the news report did not appreciably influence risk assessments. The involvement of cases resulting in major bodily injury, however, increased estimates of the incidence of such robberies.

16Up: Outline of a Study Investigating Wellbeing and Information and Communication Technology Use in Adolescent Twins

2020 ◽  
Vol 23 (6) ◽  
pp. 345-357
Author(s):  
Brittany L. Mitchell ◽  
Katherine M. Kirk ◽  
Kerrie McAloney ◽  
Margaret J. Wright ◽  
Tracey A. Davenport ◽  
...  
Keyword(s):  
Mental Health ◽  
Information And Communication Technology ◽  
Communication Technology ◽  
Technology Use ◽  
Health Resources ◽  
Physical And Mental Health ◽  
Ict Use ◽  
Hair Samples ◽  
Information And Communication ◽  
Study Participants

AbstractThe ‘16Up’ study conducted at the QIMR Berghofer Medical Research Institute from January 2014 to December 2018 aimed to examine the physical and mental health of young Australian twins aged 16−18 years (N = 876; 371 twin pairs and 18 triplet sets). Measurements included online questionnaires covering physical and mental health as well as information and communication technology (ICT) use, actigraphy, sleep diaries and hair samples to determine cortisol concentrations. Study participants generally rated themselves as being in good physical (79%) and mental (73%) health and reported lower rates of psychological distress and exposure to alcohol, tobacco products or other substances than previously reported for this age group in the Australian population. Daily or near-daily online activity was almost universal among study participants, with no differences noted between males and females in terms of frequency or duration of internet access. Patterns of ICT use in this sample indicated that the respondents were more likely to use online information sources for researching physical health issues than for mental health or substance use issues, and that they generally reported partial levels of satisfaction with the mental health information they found online. This suggests that internet-based mental health resources can be readily accessed by adolescent Australians, and their computer literacy augurs well for future access to online health resources. In combination with other data collected as part of the ongoing Brisbane Longitudinal Twin Study, the 16Up project provides a valuable resource for the longitudinal investigation of genetic and environmental contributions to phenotypic variation in a variety of human traits.

scholarly journals Effects of Pregnancy Loss on Subsequent Postpartum Mental Health: A Prospective Longitudinal Cohort Study

2021 ◽  
Vol 18 (4) ◽  
pp. 2179
Author(s):  
David C. Reardon ◽  
Christopher Craver
Keyword(s):  
Mental Health ◽  
Risk Factor ◽  
Live Birth ◽  
Pregnancy Loss ◽  
Mental Health Problems ◽  
Psychiatric Treatment ◽  
Reproductive Services ◽  
History Of ◽  
Mental Health Treatments ◽  
Prospective Longitudinal

Pregnancy loss, natural or induced, is linked to higher rates of mental health problems, but little is known about its effects during the postpartum period. This study identifies the percentages of women receiving at least one postpartum psychiatric treatment (PPT), defined as any psychiatric treatment (ICD-9 290-316) within six months of their first live birth, relative to their history of pregnancy loss, history of prior mental health treatments, age, and race. The population consists of young women eligible for Medicaid in states that covered all reproductive services between 1999–2012. Of 1,939,078 Medicaid beneficiaries with a first live birth, 207,654 (10.7%) experienced at least one PPT, and 216,828 (11.2%) had at least one prior pregnancy loss. A history of prior mental health treatments (MHTs) was the strongest predictor of PPT, but a history of pregnancy loss is also another important risk factor. Overall, women with a prior pregnancy loss were 35% more likely to require a PPT. When the interactions of prior mental health and prior pregnancy loss are examined in greater detail, important effects of these combinations were revealed. About 58% of those whose first MHT was after a pregnancy loss required PPT. In addition, over 99% of women with a history of MHT one year prior to their first pregnancy loss required PPT after their first live births. These findings reveal that pregnancy loss (natural or induced) is a risk factor for PPT, and that the timing of events and the time span for considering prior mental health in research on pregnancy loss can significantly change observed effects. Clinicians should screen for a convergence of a history of MHT and prior pregnancy loss when evaluating pregnant women, in order to make appropriate referrals for counseling.

scholarly journals Effectiveness and cost effectiveness of interpersonal community psychiatric treatment (ICPT) for people with long-term severe non-psychotic mental disorders: a multi-Centre randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mark van Veen ◽  
Bauke Koekkoek ◽  
Steven Teerenstra ◽  
Eddy Adang ◽  
Cornelis L. Mulder
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Cost Effectiveness ◽  
Community Mental Health ◽  
Mental Health Treatment ◽  
Psychiatric Treatment ◽  
Illness Management ◽  
Illness Management And Recovery ◽  
Perceived Difficulty

Abstract Background Long-term community mental health treatment for non-psychotic disorder patients with severe mental illness (SMI) who are perceived as difficult by clinicians, is poorly developed and lacks a structured, goal-centred approach. This study compares (cost-)effectiveness of Interpersonal Community Psychiatric Treatment (ICPT) with Care As Usual (CAU) on quality of life and clinician perceived difficulty in the care for non-psychotic disorder SMI-patients. A multi-centre cluster-randomized clinical tria was conducted in which Community Mental Health Nurses (Clinicians) in three large community mental health services in the Netherlands were randomly allocated to providing either ICPT or CAU to included patients. A total of 56 clinicians were randomized, who treated a total of 93 patients (59 in ICPT-group and 34 in CAU-group). Methods Primary outcome measure is patient-perceived quality of life as measured by the Manchester Short Assessment of Quality of Life (MANSA). Secondary outcome measures include clinician-perceived difficulty, general mental health, treatment outcomes, illness management and recovery, therapeutic relationship, care needs and social network. Patients were assessed at baseline, during treatment (6 months), after treatment (12 months) and at 6 months follow-up (18 months). Linear mixed-effects models for repeated measurements were used to compare mean changes in primary and secondary outcomes between intervention and control group of patients over time on an intention to treat basis. Potential efficiency was investigated from a societal perspective. Economic evaluation was based on general principles of a cost-effectiveness analysis. Outcome measures for health economic evaluation, were costs, and Quality Adjusted Life Years (QALYs). Results Half of the intended number of patients were recruited. There was no statistically significant treatment effect found in the MANSA (0.17, 95%-CI [− 0.058,0.431], p = 0.191). Treatment effects showed significant improvement in the Different Doctor-Patient Relationship Questionnaire-scores and a significant increase in the Illness Management and Recovery–scale Client-version scores). No effects of ICPT on societal and medical costs nor QALYs were found. Conclusions This is the first RCT to investigate the (cost)-effectiveness of ICPT. Compared with CAU, ICPT did not improve quality of life, but significantly reduced clinician-perceived difficulty, and increased subjective illness management and recovery. No effects on costs or QALY’s were found. Trial registration NTR 3988, registered 13 May 2013.

IMPACT OF COVID-19 ON MENTAL HEALTH AND CONCERNS REGARDING CURRICULUM IN FINAL YEAR MBBS STUDENTS

2021 ◽  
pp. 11-13
Author(s):  
Mruthyunjaya N ◽  
Vaibhavi PS ◽  
Vinod Kulkarni G
Keyword(s):  
Mental Health ◽  
Undergraduate Students ◽  
Sleep Disturbances ◽  
Online Survey ◽  
Clinical Skills ◽  
Psychiatric Morbidity ◽  
P Value ◽  
Medical Undergraduate ◽  
Spss Software ◽  
Study Participants

Background: The current SARS CoV-2 pandemic has affected the mental health of various sectors of the country while it has also jeopardised the education system. In this background the present study was done to explore the mental health of the nal year medical undergraduate students and their concerns regarding the curriculum. Materials and Methods:An online survey was conducted among the nal year MBBS students in India and psychiatric morbidity was measured by the Depression, Anxiety, and Stress Scale-21. A total of 83 complete responses out of 130 were received and the data was assessed using SPSS software. Results: Out of the 83 study participants, about 34.9% were depressed, about 39.5% and 32.9% were having anxiety and stress, respectively. Sleep disturbances were signicantly associated with depressive symptoms (p value - 0.0001) and those with stress (p value - 0.01) while change in appetite was also signicantly associated with stress (p value - 0.01). Conclusion: The current pandemic has led to growing concerns in the educational sector especially medical education where MBBS students are facing psychological distress along with newer challenges in their academics like distant education as against traditional bedside teaching for acquiring clinical skills.

Self-injurious behaviour in forensic mental health care: a study into the prevalence and characteristics of incidents of self-injury

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vivienne de Vogel ◽  
Nienke Verstegen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Suicide Attempts ◽  
Psychiatric Patients ◽  
Forensic Mental Health ◽  
Content Type ◽  
Self Injury ◽  
Forensic Psychiatric ◽  
The Impact

Purpose Incidents of self-injury by forensic psychiatric patients often have a deleterious impact on all those involved. Moreover, self-injurious behaviour is an important predictor for violence towards others during treatment. The aim of this study is to analyse methods and severity of incidents of self-injury of patients admitted to forensic psychiatry, as well as the diagnoses of self-injuring patients. Design/methodology/approach All incidents of self-injury during treatment in a forensic psychiatric centre recorded between 2008 and 2019 were analysed and the severity was coded with the modified observed aggression scale+ (MOAS+). Findings In this period, 299 incidents of self-injury were recorded, displayed by 106 patients. Most of these incidents (87.6%) were classified as non-suicidal. Methods most often used were skin cutting with glass, broken plates, a razor or knife and swallowing dangerous objects or liquids. Ten patients died by suicide, almost all by suffocation with a rope or belt. The majority of the incidents was coded as severe or extreme with the MOAS+. Female patients were overrepresented and they caused on average three times more incidents than male patients. Practical implications More attention is warranted for self-injurious behaviour during forensic treatment considering the distressing consequences for both patients themselves, supervisors and witnesses. Adequate screening for risk of self-injurious behaviour could help to prevent this behaviour. Further research is needed in different forensic settings into predictors of self-injurious behaviour, more specifically, if there are distinct predictors for aggression to others versus to the self. Originality/value Incidents of self-injury occur with some regularity in forensic mental health care and are usually classified as severe. The impact of suicide (attempts) and incidents of self-injurious behaviour on all those involved can be enormous. More research is needed into the impact on all those involved, motivations, precipitants and functions of self-injurious behaviour and effective treatment of it.

UTILIZATION OF A PEDIATRICIAN IN A MENTAL HEALTH CLINIC

PEDIATRICS ◽  
1970 ◽  
Vol 46 (5) ◽  
pp. 807-809
Author(s):  
William E. Stone
Keyword(s):  
Mental Health ◽  
Community Mental Health ◽  
Health Center ◽  
Psychiatric Treatment ◽  
Mental Health Center ◽  
Mental Health Program ◽  
Health Clinic ◽  
Select Group ◽  
Accurate Picture ◽  
Community Mental Health Program

The field of psychiatry, and certainly the subspecialty of child psychiatry, is currently involved in an identity crisis which has particular relevance to the relationship between the pediatrician and the psychiatrist in the delivery of mental health services to children. This crisis is related to the move from patient-oriented psychiatric treatment to the newer methods of community mental health. A good community mental health program is founded on the knowledge and skills learned from careful work with individual patients, but the techniques and goals of treatment require modification. While individual psychotherapy is still an essential part of patient care, it is frequently impractical in the light of the demands and needs of our current culture. In the community mental health center which I am serving, we are currently involved in a major reassessment of our techniques in order to meet the needs of the community rather than the demands of a small group. Ours is a relatively affluent community, generally considered to be sophisticated, well-educated, and knowledgeable about psychiatry. An easy pitfall in developing a mental health center would be to assume that this is an accurate picture of the entire community and base the whole program on the model of private psychiatric care. However, the city has its pockets of poverty and has large numbers of people who would not respond to insight therapy if it were available to them. Psychiatrists have been, until very recently, poorly trained for work in the community. Their work has been principally in mental hospitals and in outpatient clinics that offered treatment to a very select group of patients.

scholarly journals Factors associated with psychiatric treatment dropout in a mental health reference center, Belo Horizonte

2005 ◽  
Vol 27 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Ana Paula Souto Melo ◽  
Mark Drew Crosland Guimarães
Keyword(s):  
Mental Health ◽  
Cox Regression ◽  
Psychiatric Treatment ◽  
Treatment Interruption ◽  
Treatment Dropout ◽  
Factors Associated ◽  
Psychiatric Hospitalizations ◽  
History Of ◽  
Belo Horizonte ◽  
Social Demographic

OBJECTIVE: To characterize an outpatient public referral center for mental health and to assess factors associated with treatment dropout. METHODS: A non-concurrent prospective study was undertaken to review 295 patient files. Patients, whose first consultation took place between January and December 1997, were followed-up for at least four months until April 1998. Patients were considered as having abandoned their treatment when, following a recommendation for at least a second visit, they did not return within four months after the first consultation. Social, demographic and clinical variables were compared to verify possible factors associated with dropout of treatment. Statistical analysis was performed using relative hazard (RR) with 95% confidence interval (CI) estimated by the Cox Regression Model. RESULTS: Cumulative incidence of treatment dropout was 39.2% while multivariate analysis indicated that the following characteristics were statistically associated with treatment interruption: to live outside the referral area (RR = 1.95), no history of previous psychiatric hospitalizations (RR = 1.88), alcohol or drug use at admission (RR = 1.72), spontaneous demand to the service (RR = 2.12), lack of bus-passes (RR = 3.68) and to have less than four clinical appointments (RR = 7.31). CONCLUSIONS: Our findings suggest that services should be aware of the high incidence of treatment interruption, especially among those with no history of previous psychiatric hospitalizations and with less institutional bonds. This may indicate that mental health services should develop and implement public policies targeted at this population.

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