首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 15 毫秒
1.
    
The number of older offenders is rapidly increasing in the United Kingdom and some older adults with mental health issues are referred to secure care services. It is therefore important to understand their unique characteristics in order to develop services based on their individual needs rather than chronological age. This study explored wellbeing and security needs of younger and older patients admitted to a secure psychiatric hospital. HoNOS-secure assessment at admission and discharge was extracted and used to build an anonymous data-set. Group comparison and score change during admission were conducted for six age groups: 18–24, 25–34, 35–44, 45–54, 55–64 and 65+. Younger patients improved on most measures whereas older patients aged 55–65+ showed little improvement or deterioration over time. This finding suggests that the subscales are sensitive to age difference although the needs measured by HoNOS-secure are less likely to inform the decision to discharge.  相似文献   

2.
    
‘Electronic Monitoring’ (EM) uses devices to monitor individuals’ whereabouts. In 2010, South London and Maudsley medium secure unit introduced EM to monitor individuals on leave. Analysis after two years revealed EM was associated with increased unescorted leave and reduced leave violation; however, comparative costs were not established. This study aims to compare costs of EM for patients on leave by comparing average total cost per patient with and without EM. Costs were compared before and after implementation of EM. Total cost of leave for each group was divided by number of patients to generate average total cost per patient. The average total cost per patient without EM was £1702; £1617 with EM. Although cost decreased, this was not statistically significant. The results showed no significant difference between average total costs per patient before and after EM. The finding of EM being cost-neutral is cautiously optimistic. Further trials are recommended.  相似文献   

3.
This study reports on the feasibility and impact of running a choir for forensic psychiatric inpatients, staff and members of the local community, within the confines of a medium secure psychiatric unit. The choir ran between October and December 2013. Eight weekly workshops and a final concert performance were evaluated through participant observation and focus groups held with the participants. Between 12 and 16 male and female patients attended each workshop and the final concert. All participating patients had received a diagnosis of schizophrenia, schizo-affective disorder or personality disorder, all had committed serious violent or sexual offences and all were legally detained and receiving treatment in a forensic medium or low secure ward, under the Mental Health Act (England and Wales). Considerable benefits were reported by patients, as well as by the participating community choir members and staff. Primary benefits reported by patients included the following: improved happiness and well-being; increased confidence and self-esteem; greater emotional connectedness and reduced sense of stigma. Participating staff also reported increased feelings of well-being and happiness, greater tolerance and more positive perceptions of the functioning and capabilities of forensic psychiatric patients. The longer term benefits of music participation on the mental health and social functioning of forensic psychiatric patients require further investigation.  相似文献   

4.
    
Traumatic brain injury (TBI) screening in forensic populations has been recommended, due to a high prevalence, links to specific offence profiles and poorer outcomes, such as higher rates of psychiatric disturbance, longer stays in prison, and reoffending. Research focusing on TBI among offenders with intellectual disability (ID) is lacking. This study therefore describes the implementation of TBI screening using the Brain Injury Screening Index (BISI©), TBI prevalence and correlates in a forensic ID service. TBI appeared under recorded in case notes, with considerably more patients self-reporting TBI. Reported causes of TBI differed somewhat to the general population, including childhood physical abuse, self-harming behaviour, and assault. Approximately one-third of injuries did not receive any treatment. Though further adaptations may be required on current screening measures for TBI in offenders with ID, screening can provide valuable information, contributing positively to individual patient therapeutic and risk formulations.  相似文献   

5.
    
The role of the forensic mental health nurse has led to many debates due to the conflicts between security and therapeutic aspects of their role. Physical restraint is a security element of the role which may have an impact on their ability to work therapeutically with patients. This study examined the impact of physical restraint on the nursing staff–patient therapeutic relationship. This was investigated in a secure unit in the North of England. Eight semi-structured interviews were conducted with patients across the service, and thematic analysis was undertaken. Five themes were identified from the data which highlighted the impact of the physical restraint as a power imbalance, the experience as traumatic, the importance of justification, the negative attributes and motives of some staff and the impact of coping with powerlessness. Clinical implications and research recommendations are discussed further in this article.  相似文献   

6.
To examine the ability of two forensic units, one high secure and one medium secure, to meet the NICE (National Institute for Health and Care Excellence) standards of care for diabetes. We applied the National Diabetes Audit programme, which uses as standards the NICE guidelines, to assess the quality of care provided for patients in two forensic units. Of the 500 patients, 200 in high secure and 300 in medium secure, 88 (17.6%) had type 2 diabetes. None had Type 1 diabetes. Of those with Type 2 diabetes, the care of 74 (84%) met all 8 NICE recommended standards. Glucose levels were lower in the medium/low secure unit compared to the higher security environment. Whilst achievement of process-based outcomes was higher than those reported nationally, achieving clinical outcomes was more challenging. High-quality diabetic care can be provided for patients in forensic units. Benchmarking physical health outcomes against national criteria in mental health inpatients is a potential method of improving outcomes.  相似文献   

7.
《精神卫生法(草案)》征求意见是我国卫生法治的一大进步,其有关精神障碍司法鉴定的内容还存在与鉴定规律、证据制度、诉讼制度相矛盾、冲突的地方,需要在立法中进一步完善与调整,保障其与现有的司法鉴定制度相衔接。  相似文献   

8.
以司法鉴定为视角,对精神疾病司法鉴定的规定是否应纳入精神卫生法等问题进行探讨,并详细分析精神卫生法草案的立法精神,肯定了将司法鉴定作为重要协助手段是此次立法的亮点之一,提出了明确关于危险精神病人有关规定的立法建议。  相似文献   

9.
Adshead's recognition that only when taken together can the many different conceptions of justice accommodate what is called for in the particularly demanding setting of forensic mental health care, is to be applauded. Each must be honoured and built into the systems of assessment and treatment that are the tasks of the forensic psychiatrist, she demonstrates. Adshead's far‐reaching revisions could resolve much that is troubling about the present practice of forensic psychiatry. Yet how much these revisions can overcome the moral dilemmas associated with dual roles in forensic psychiatry, is not so clear.  相似文献   

10.
Hope is an important factor in psychological resilience and change, and recovery from mental health difficulties. Recently, there has been an increased focus on recovery-oriented practice within forensic mental health settings. Several policies include calls for mental health practitioners to inspire hope for recovery in the individuals they work with. However, there is little suggestion of how to implement such recommendations in practice or research exploring how staff foster hope in forensic settings. This study used grounded theory to explore nurses’ perspectives and experiences of hope within a medium secure setting. A model was developed from the data that integrated nurses’ beliefs about hope, practices to develop service users’ hope and the emotional impact of this work. The nurses’ values played a significant role in their work to develop hope. Recommendations are made to help manage the emotional impact and address challenges unique to fostering hope within forensic settings.  相似文献   

11.
Aim: We sought to ascertain the current nature of specialist community mental health provision for young people presenting with risk of harm to others or involvement with the youth justice system in England, Wales and Scotland. Methods: Questionnaire-based survey. Results: Fifty-five services were contacted, 48 responded and 35 of these were found to be providing some form of community mental health provision to high-risk young people. Thirteen services provided comprehensive community forensic child and adolescent mental health (FCAMH) services, whilst the remainder offered more ad hoc clinical input. Amongst the comprehensive FCAMH services, staffing, function, commissioning arrangements and population served varied widely. Conclusions: There is patchy geographical provision of comprehensive community FCAMH services across England, Scotland and Wales with heterogeneous commissioning arrangements, staffing and function. Development of a national commissioning strategy for community FCAMH services is required to ensure that the complex needs of high-risk young people are adequately addressed.  相似文献   

12.
    
Using data from the National Trajectory Project, we compared 50 individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD) for sexual offences with 50 age- and gender-matched individuals found NCRMD for nonsexually violent offences. We also described the concurrent offenses, the symptoms at the time of the offense and the characteristics of the victims of offenders found NCRMD for sexual offences. Persons found NCRMD for sexual offences were less likely to be employed and were significantly younger at time of first psychiatric contact, but did not differ in other sociodemographic characteristics, other aspects of their psychiatric histories or in criminal history. Despite no differences in recidivism and no differences in behaviours between Review Board hearings when adjusting for unequal time at risk, persons found NCRMD for sexual offences had longer tenures under a Review Board mandate than persons found NCRMD for nonsexually violent offences. Given the many similarities between the two groups, this finding suggests that Review Boards may be unnecessarily conservative in how they manage sexual offenders.  相似文献   

13.
14.
国务院法制办公布了《精神卫生法(草案)》征求社会意见,必要而及时。反复修改后的草案在结构和内容上基本合理,但也存在不足之处:对非自愿住院和强制住院产生异议的有关救济程序不完善;未涉及在监狱等特殊场所设立精神卫生医疗机构;“监护人”等名词使用欠周全;部分条款的结构及用语值得商榷。  相似文献   

15.
This service evaluation project explored service users’ experiences of positive behavioural support (PBS) within a medium secure mental health service. Interpretative phenomenological analysis (IPA) was used to analyse interviews with ten service users. Four main themes emerged from the data: My plan; How I understand PBS; How PBS has helped me, the benefits; and Making the plan work. Overall, service users viewed their experience of having a PBS plan positively. They reflected that the plans offered staff greater understanding of their behaviours and needs, enabling them to receive appropriate support. Service users valued the experience of being involved in the process, offering important insights into their experiences. They also expressed frustrations about staff not following the plan and not understanding why they had a plan whilst others did not. Limitations of the study, clinical implications and ideas for future research have been discussed.  相似文献   

16.
This study explored change in dynamic risk for violence using the Clinical and Risk Management subscales of the Historical Clinical and Risk Management-20 version 3 (HCR-20 v3) and sought to determine whether change was associated with violent recidivism. The association between the magnitude of change and psychopathy was also assessed. Participants were 40 male (n = 32) and female (n = 8) forensic psychiatric inpatients discharged from a secure forensic mental health service. Results showed that participants significantly improved on the HCR-20v3 Clinical subscale but significantly worsened on the Risk Management subscale. Psychopathy was unrelated to change in Clinical and Risk Management subscales. The hypothesis that changes in dynamic risk would predict recidivism over and above total pre-treatment risk (HCR-20v3 Total score) and psychopathy was not supported. These results suggest that improvements in mental state risk factors alone are insufficient with regard to lowering violence risk.  相似文献   

17.
This article introduces a special issue of Law and Human Behavior, including five articles describing the limits of forensic mental health assessments of (a) risk of violence in female adolescents, (b) sexually violent predators, (c) dangerousness in capital murder cases, (d) child sexual abuse, and (e) PTSD litigants. Knowing the limits of forensic mental health assessment methods is essential in order to recognize their strengths, increase the credibility of forensic mental health assessment, and drive research that will enhance the value of assessments for the courts.  相似文献   

18.
Abstract

In this stick we compare legal arrangements dealing with mentally disordered offenders in the criminal law systems ct Belgium, Canada, Germany, the Netherlands, Norway, Sweden, and the United Kingdom. To describe relevant diffesenoes and similarities in the arrangemeats, we used a checklist containing antral aspects of adjudication, assessment and treatment of mentally ill offenders. These aspects concern: (1) the legal classifications of mental illnesses that can lead to exclusion of criminal responsibility: (2) the acceptance of diminished capacity as a partial excuse; (3) the possibilities for imposing security measures of compulsory treatment instead of or next to criminal punishment; (4) the conditions for their imposition in terms of seriousness of crimes committed and dangerousness of offenders; (5) the available hospitals or special clinics for executing security measures; (6) the role and task of forensic mental health professionals in assessing the offender's state of mind and in advising compulsory treatment; (7) the rules for duration, prolongation and termination of the measures. The findings of this comparative analysis are evaluated in light of legal protection for mentally disordered offenders.  相似文献   

19.
    
The Health of the Nation Outcome Scale (HoNOS) is a widely used tool for monitoring consumer outcomes within mental health services. However, concern about its suitability in forensic mental health settings led to the development of a forensic version of this tool (HoNOS-Secure). To date, no direct comparison of these versions has appeared in the empirical literature. In the present study, a cohort of forensic mental health consumers was rated using the HoNOS and HoNOS-Secure. Pearson correlations were generated to compare the tools at a total score and item level. Logistic regression was employed to evaluate how well these tools categorise patients on a range of measurable outcomes. HoNOS scores were also compared against civil mental health consumers to evaluate differences between these populations. The HoNOS/HoNOS-Secure correlated strongly at the total score level, but demonstrated variable correlations at the item level. Logistic regression suggested that the HoNOS-Secure ‘clinical and social functioning scale’ adds little to the HoNOS in a forensic setting; however, the HoNOS-Secure ‘security scale’ added significant benefit to both versions. Results remained stable when re-evaluated over time. Forensic and civil mental health patients were found to demonstrate the same degree of psychopathology at the point of admission; however, they differed at review and discharge collection occasions. Implications for clinical practice and policy are explored.  相似文献   

20.
    
Introduction: Liaison and Diversion (L&D) currently serves 50% of the population of England. L&D relies on modified working practices with key delivery partners, especially the police. Service evaluation data is thus presented from both police and health services. Method: A before and after intervention review of 3 months of operational data of L&D in Cornwall focusing on health, criminal and economic outcomes. Results: After L&D intervention individuals’ contact with the police as either victim or perpetrator reduced significantly. Implications: Preliminary findings suggest that L&D enabled reduced use of police and criminal justice resources. National reporting procedures may be unable to demonstrate the multi-agency impact if criminal justice data are not considered within the outcome data-set. Recommendations echo international observations that specifying outcome measures and the consistent definition of L&D services would enable generalisation of findings.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号