scholarly journals Profile of forensic psychiatric inpatients referred to the Free State Psychiatric Complex, 2004–2008

2011 ◽  
Vol 17 (2) ◽  
pp. 4
Author(s):  
C Pienaar ◽  
A Dreyer ◽  
L Van der Merwe ◽  
B Jansen van Rensburg ◽  
F J W Calitz ◽  
...  

<p><strong>Introduction:</strong> An accused found unfit to stand trial and/or not responsible for his/her actions because of mental illness, is declared a state patient by the court. <strong></strong></p><p><strong>Aim:</strong> The aim of the study was to analyse the biographical data and relevant particulars of forensic psychiatric inpatients who were admitted to the Free State Psychiatric Complex (FSPC) according to section 42 of the Mental Health Care Act (no. 17 of 2002), from 2004 to 2008. Study design A descriptive, retrospective study was conducted. Method One hundred and twenty forensic psychiatric inpatients admitted to the FSCP in the terms of section 42 of the Mental Health Care Act in the period 2004–2008, were included in the study.</p><p><strong>Results:</strong> The majority (95.8%) of the offenders were male, unmarried (83.8%) and unemployed (81.5%). The median age was 32.5 years. Most of the offenses against persons were of a sexual nature (45.8%). More than half (55.5%) of the forensic inpatients were diagnosed with schizophrenia, followed by mental retardation (10%) and bipolar mood disorder. Eighty percent (80%) of these patients were found not competent to stand trial and unaccountable. Fifty percent (50%) of the participants received treatment for a mental illness prior to the crime, and were also known to have poor compliance and defaulted from treatment in the past.</p><p><strong>Conclusion:</strong> The findings of this study can contribute to implement effective management and training programmes for the benefit of state patients.</p>

Author(s):  
Shonisani Raphalalani ◽  
Piet J. Becker ◽  
Manfred W. Böhmer ◽  
Christa Krüger

Background: Globally interest has grown in promoting the rights of patients, especially psychiatric patients. Two core elements of patients’ rights are the rights to be treated in a dignified manner and to give feedback about services. Psychiatric patients may feel treated in an undignified manner, especially during involuntary hospital admissions.Aim: We explored the relationship between Mental Health Care Act 17 of 2002 (MHCA) status and dignity-related complaints.Setting: The study was conducted at a specialist state psychiatric hospital.Methods: We reviewed 120 registered complaints by psychiatric inpatients, retrieved the clinical files, and analysed 70 complaints. Fisher’s exact tests described the relationship between patients’ MHCA status and the frequency of dignity-related or other categories of complaints. Logistic regression analyses were adjusted for potential covariates.Results: Most complaints were from single, literate male patients, aged 30–39 years, with mood disorders. Most complainants were admitted involuntarily (60%). Dignity-related complaints (n = 41; 58%) outnumbered nondignity-related complaints (n = 29; 41%). The proportion of dignity-related complaints was higher in involuntary (64%) and assisted (60%) patients than in voluntary patients (44%). Dignity-related complaints were not significantly associated with MHCA status (χ2 = 2.03 and p = 0.36). Involuntary patients were more than twice as likely as assisted and voluntary patients to complain about dignity-related matters (Odds ratio [OR]: 2.25; 95% confidence interval [CI] [0.71; 7.13]; p = 0.16).Conclusion: Involuntary patients are more likely to complain about dignity-related matters. Qualitative research is recommended for a deeper understanding of patients’ experiences during admission.


1996 ◽  
Vol 24 (3) ◽  
pp. 274-275
Author(s):  
O. Lawrence ◽  
J.D. Gostin

In the summer of 1979, a group of experts on law, medicine, and ethics assembled in Siracusa, Sicily, under the auspices of the International Commission of Jurists and the International Institute of Higher Studies in Criminal Science, to draft guidelines on the rights of persons with mental illness. Sitting across the table from me was a quiet, proud man of distinctive intelligence, William J. Curran, Frances Glessner Lee Professor of Legal Medicine at Harvard University. Professor Curran was one of the principal drafters of those guidelines. Many years later in 1991, after several subsequent re-drafts by United Nations (U.N.) Rapporteur Erica-Irene Daes, the text was adopted by the U.N. General Assembly as the Principles for the Protection of Persons with Mental Illness and for the Improvement of Mental Health Care. This was the kind of remarkable achievement in the field of law and medicine that Professor Curran repeated throughout his distinguished career.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Vivienne de Vogel ◽  
Nienke Verstegen

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.


2009 ◽  
Vol 16 (3) ◽  
pp. 283-291 ◽  
Author(s):  
Irena Trobec ◽  
Majda Herbst ◽  
Boštjan Žvanut

When forced treatment in mental health care is under consideration, two approaches guide clinicians in their actions: the dominant rights-based approach and the relational ethical approach. We hypothesized that nurses with bachelor's degrees differentiate better between the two approaches than nurses without a degree. To test this hypothesis a survey was performed in major Slovenian health institutions. We found that nurses emphasize the importance of ethics and personal values, but 55.4% of all the nurse participants confused the two approaches. The results confirmed our hypothesis and indicate the importance of nurses' formal education, especially when caring for patients with mental illness.


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