Consecutive series of individuals for whom psychiatric reports were requested by the courts in the context of criminal proceedings were studied in six countries: Brazil, Denmark, Egypt, Swaziland, Switzerland, Thailand. A total sample of 96 cases was obtained. Careful study of the court records and psychiatric reports revealed three types of situation which could trigger a request for such a report; an ‘offence-oriented’ response where the offence itself is seen as indicative of mental morbidity, a ‘patient-oriented’ response in which the patient's previous contact with the mental health system serves as trigger and a ‘behaviour-oriented’ response in which the patient's disturbed behaviour in detention or in court arouses concern. The majority of the individuals were first offenders (60 per cent), while a similar proportion had had previous psychiatric treatment.

Descriptive information on the social control network for deviants in 6 countries with diverse social, economic and cultural backgrounds has been collected and compared. In each country it was possible to identify a sequence by which deviant behaviour is controlled and managed, consisting of 5 stages: discovery, official screening, disposal, release and after-care. It was also possible to make a clear distinction between the mental health systems and the criminal justice systems in each country. Differences were apparent in the extent of community involvement in the discovery stage and in the role of the primary level of health services. In some instances, differences were also apparent between rural and urban areas and between the way in which rich and poor people were handled. In all countries community after-care services are insufficient, particularly for offenders released from the prison system. This report is based on the first phase of a WHO collaborative study. It forms the basis for further work currently in progress which includes: (a) a review of laws to identify situations in which dangerousness is used as a criterion; (b) a study of consecutive cases of patients admitted against their will to mental hospitals and of individuals on whom the courts request psychiatric reports; and (c) a study of the reliability and reasons for dangerousness assessment made by various professional groups and based on a standard set of case histories.

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Nordisk retspsykiatrisk symposium. Rungstedgaard 8.-10. november 1973. Afsluttende synspunkter Hans AdserballeUnder den afsluttende drnrftelse nAede man frem ti1 fnrlgende opregning af fremfnrrte synspunkter: 1) vedrmende behandlingsopgaver:Der var almindelig enighed om, at tyngdepunktet for den psykiatriske virksomhed inden for retsvaesenet b0r laegges PA det terapeutiske, dvs. at en vaesentlig indsats skal flyttes ti1 stadiet efter, at den juridiske sagsbehandling er tilendebragt (ved dom eller tiltalefrafald).De kriminelle psykotiske (og udtalt Andssvage) bsr behandles uden for retsvaesenet PA linie med og i samme institutioner som de ikke-kriminelle psykotiske og Andssvage.De kriminelle karakterafvigende, alkoholikere og narkomane er det vanskeligt at fA modtaget ti1 behandling uden for kriminalforsorgen. Hospitalerne er afvisende, fnrrst og fremmest fordi de terapeutiske muligheder i det hele er smA, og b1.a. fordi disse personer har en usikker motivation, og de opleves som besvaerlige og provokerende. Et forslag om at snrge oprettet en specie1 institutionel ))socialvArd)) for disse grupper (en 3. forsorg foruden 1) kriminalforsorgen, og 2) det institutionelle og ambulante hospitalsvaesen) mnrdte almindelig modstand.De kriminelle karakterafvigende, alkoholisterne og de narkomane, som det fnrles nnrdvendigt at reagere overfor, kommer derfor hovedsagelig ti1 at henhare under kriminalforsorgen. Det blev naevnt, at der var et betydeligt udaekket behov for psykiatrisk bistand ti1 disse og andre psykiatriske patientkategorier (f.eks. reaktive insufficienstilstande) inden for kriminalforsorgen, men det var vanskeligt at se, hvorledes dette behov kunne imnrdekommes som fnrlge af en svigtende rekruttering af psykiatere. Nogle fandt, at en oprustning af behandlingsfaciliteter for b1.a. akut medtagne narkomane og alkoholister, som faengselsvaesenet modtager, findes staerkt pakraevet. Andre var betaenkelige ved enhver tendens ti1 institutionalisering af saerbehandling for narkomane og alkoholikere inden for kriminalforsorgen PA grund af faren for etableringen af en permanent og utilstraekkelig specialbehandlingsservice inden for kriminalforsorgen. -Det fnrles snskeligt, at den almindelige alkoholist-og narkomanbehandling oprustes, og at en vaesentlig del af de kriminelle af disse kategorier kan behandles der. 377Nord J Psychiatry Downloaded from informahealthcare.com by Flinders University of South Australia on 01/05/15For personal use only.

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