A standardised tool for assessing needs in forensic psychiatric population: clinical validation of the Italian CANFOR, staff version

Castelletti, Luca; Lasalvia, Antonio; Molinari, Elena; Thomas, Stuart; Straticò, Ettore; Bonetto, Chiara

doi:10.1017/s2045796014000602

Cited by 11 publications

(12 citation statements)

References 18 publications

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“…Psychological distress, accommodation, daytime activities, psychotic symptoms, and company were the most common needs whereas accommodation, intimate relationships and company were most often considered as unmet. These results were largely in line with other studies (15,19,20,49,66). The practice of violence risk assessment and management has recently been introduced in Italy, concurrently with the reformed system (3).…”

Section: Main Findingssupporting

confidence: 89%

“…The CANFOR is designed to identify the needs of forensic psychiatric patients. It is considered to be a valid and reliable needs assessment instrument (20,48) and has been translated and validated for use in forensic psychiatric services in Spain, Portugal and Italy (19,36,49). Through a partially structured interview, the CANFOR integrates the patient's and clinician's perspective on 25 domains of frequent or important problem areas for forensic patients.…”

Section: Needsmentioning

confidence: 99%

“…Furthermore, needs and QoL can vary significantly among forensic psychiatric patients, reflecting the wide heterogeneity of this specific psychiatric population (32)(33)(34). For instance, lower levels of global functioning were associated with higher numbers of unmet needs (35,36) and patients with severe mental illness were significantly more satisfied with their QoL than patients with a personality-disorder admitted at the same clinic (37).…”

Section: Introductionmentioning

confidence: 99%

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Exploring Needs and Quality of Life of Forensic Psychiatric Inpatients in the Reformed Italian System, Implications for Care and Safety

Vorstenbosch

Castelletti

2020

Front. Psychiatry

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The Italian forensic psychiatric system underwent drastic reforms. The newly developed facilities are inspired by psychiatric community services, embracing a recovery-oriented approach. Needs and quality of life are broader concepts that consider the more rehabilitative and humanitarian aspects of treatment. In one of the new Italian forensic psychiatric services, this cross-sectional study aimed to investigate the needs and quality of life of forensic psychiatric patients. A second aim was to validate the Italian version of the Forensic inpatient Quality of Life questionnaire Short Version (FQL-SV). Overall, 42 forensic psychiatric patients were assessed using the Forensic version of the Camberwell Assessment of Need (CANFOR), the Historical-Clinical-Risk-Management-20 (HCR-20), the FQL-SV, and the World Health Organization Quality of Life (WHOQoL-Bref). Patients reported significantly fewer needs, whether met or unmet, than their treating clinicians. The general level of agreement between patients and clinicians on specific needs was low Kappa values were < .40 for 64% of the total needs and 46% of the unmet needs. Risk factors according to the HCR-20 mean scores were 13.1, 4.6, and 6.4 for the historical, clinical and risk management subscale. Quality of life was moderate to high for 74% of the patients. Our results showed that lower numbers of needs, whether reported by patients or clinicians, were associated with a better quality of life. The Italian FQL-SV had a Cronbach's alpha of 0.86 and correlated as expected with the WHOQoL-Bref. The FQL-SV is a valid and reliable tool, justifying its use for routinely assessing QoL in Italian forensic psychiatric services. This study enhances our understanding of needs and quality of life of forensic psychiatric patients and how their assessment could have an additional value for recoveryoriented treatment in forensic psychiatry. Although the detained status of forensic patients imposes real limits on the capacity for autonomy and choice, incorporating the patient's perspective on decision-making processes, in relation to aspects of treatment, care, and daily life, may have benefits such as a better treatment adherence or therapeutic alliance. Future research should clarify how routinely assessing needs and quality of life can contribute to the recovery of these forensic psychiatric patients.

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Section: Main Findingssupporting

confidence: 89%

Section: Needsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Exploring Needs and Quality of Life of Forensic Psychiatric Inpatients in the Reformed Italian System, Implications for Care and Safety

Vorstenbosch

Castelletti

2020

Front. Psychiatry

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“…Previous studies have administered the CANFOR-S with samples of forensic psychiatric patients and gaol detainees (Baksheev et al 2010; Castelletti et al 2015; O’Hara et al 2016; Segal et al 2010). While rarely used in prison samples, the range of needs it assesses is clearly relevant to prisoners in addition to forensic patients (Thomas et al 2009).…”

Section: Methodsmentioning

confidence: 99%

Are Australian prisons meeting the needs of Indigenous offenders?

2016

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BackgroundThe over-representation of Indigenous Australians in custody is well documented, yet little is known about whether the health and social needs of Indigenous prisoners are met in correctional facilities. This study sought to identify common areas of need in a representative sample of Indigenous people in custody, and consider how well prison services were addressing these issues.MethodsThe sample comprised 122 Aboriginal and Torres Strait Islander people in custody in Victoria. Participants were administered the Camberwell Assessment of Need Forensic-Short Version to ascertain the presence or absence of needs in custody. Statistical analyses to determine associations with re-offence were conducted.ResultsFindings indicated that prisons were able to meet the non-criminogenic needs of many offenders; however there was a limited capacity to address specific criminogenic needs. Psychological distress, substance abuse, poor treatment adherence and threatening behaviours were considered ongoing needs regardless of supports/interventions being provided. Moreover, these four unaddressed needs were all associated with future recidivism.ConclusionsEffective prison treatment services focusing on these four areas of need are urgently required. Such initiatives require continuation post-release combined with additional assistance to uphold basic non-criminogenic needs acquired in prison.

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“…The accuracy and reliability of the CAN-FOR scale was also assessed for adaptation in Portugal [16], Spain [17] and Italy [18].…”

Section: Canformentioning

confidence: 99%

Assessment of the needs and clinical parameters in patients with mental disorders residing in forensic psychiatry wards with varying degrees of security.

Trizna¹,

Adamowski²

2016

Arch Psych Psych

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SummaryAims: The aim of the study was to compare patients treated in "court psychiatric wards" of low and medium security in terms of their needs, severity of psychopathological symptoms, subjective assessment of quality of life and satisfaction with treatment. Method:The study was conducted at the Regional Mental Hospital in Lubiąż, Poland. It involved patients interned at two low security forensic psychiatric wards and one medium security ward. 93 male patients were assessed. The following research tools were used: Camberwell Assessment of Need -Forensic Version (CAN-FOR), a sociodemographic and clinical data questionnaire, Brief Psychiatric Rating Scale (BPRS), Client's Assessment of Treatment (CAT) scale, and the Manchester Short Assessment of Quality of Life (MANSA) scale.Results: Patients at the medium security ward reported greater overall needs and a greater number of unmet needs. The overall severity of psychopathology, including deficits and positive symptoms, was higher among patients in low security wards. Discussion:Results indicate that medical care on wards with low and medium security is at a similar level. Individuals are committed to medium security wards based not on their mental disorder but rather on the nature of the offense they had committed, which in this case is more serious than that of individuals directed to low security wards. Conclusions:The services provided in forensic psychiatric wards, especially in medium security wards, do not sufficiently meet the needs of patients. forensic psychiatry, patients' needs, mental disordersMental disorders are associated with the greatest adverse effect on the social functioning and quality of life of patients. The patient's mental state as well as their needs is influenced not only by their mental condition, but also by factors they have to cope with at the hospital. As part of psychiatric hospital treatment in Poland, medical services may be provided in day hospitals, stationary or forensic wards. Daily and stationary psychiatric wards differ in many respects from forensic psychiatric wards. Wards which implement security measures are organized as psychiatric units with low, medium and high security.

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A standardised tool for assessing needs in forensic psychiatric population: clinical validation of the Italian CANFOR, staff version

Abstract: The Italian version of CANFOR has adequate psychometric properties. It can be considered a promising instrument for the assessment of needs of forensic psychiatric patients.

Cited by 11 publications

References 18 publications

Exploring Needs and Quality of Life of Forensic Psychiatric Inpatients in the Reformed Italian System, Implications for Care and Safety

Exploring Needs and Quality of Life of Forensic Psychiatric Inpatients in the Reformed Italian System, Implications for Care and Safety

Are Australian prisons meeting the needs of Indigenous offenders?

Assessment of the needs and clinical parameters in patients with mental disorders residing in forensic psychiatry wards with varying degrees of security.

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