Civil and forensic patients in secure psychiatric settings: A comparison

Abstract

Aims and method To evaluate differences between male patients in secure psychiatric settings in the UK based on whether they are detained under civil or forensic sections of the Mental Health Act 1983. A cohort of patients discharged from a secure psychiatric hospital were evaluated for length of stay and frequency of risk-related incidents.Results Overall, 84 patients were included in the study: 52 in the forensic group and 32 in the civil group. Civil patients had more frequent incidents of aggression, sex offending, fire-setting and vulnerability, whereas forensic patients had more frequent episodes of self-harm.Clinical implications Secure hospitals should ensure treatment programmes are tailored to each patient's needs. Civil patients require greater emphasis on treatment of their mental illness, whereas forensic patients have additional offence-related treatment needs. Regular liaison between forensic and general adult services is essential to help ensure patients can return to appropriate settings at the earliest opportunity in their recovery.

Staff perspectives on barriers to and facilitators of quality of life, health, wellbeing, recovery and reduced risk for older forensic mental-health patients: A qualitative interview study

“…8 Services offer psychiatric assessment, treatment and rehabilitation to enable patients to progress towards living independently. 9 Interventions include a wide range of services to improve mental health and reduce risk, through for example psychoeducation, cognitive behavioural therapy, violence prevention, sexual offending treatment programmes, along with occupational, vocational and recreational opportunities as well as physical health support through assessment, monitoring and care planning and management. 10,11 The overarching aim is to improve quality of life, recovery and mental health, and reduce risk and offending behaviours.…”

Agression en milieu psychiatrique fermé : identification des déclencheurs qui précèdent les agressions contre les intervenants

“…Le personnel des hôpitaux psychiatriques est particulièrement victime de ces agressions, tant au Canada, aux États-Unis qu'en Europe (Gerberich et al, 2005;Martinez, 2016;Schuwey-Hayoz et Needham, 2006;Van Leeuwen et Harte, 2017). Le risque de se faire agresser est similaire pour les intervenants qui pratiquent en milieu psychiatrique général que pour ceux qui travaillent en psychiatrie légale, soit dans les hôpitaux à sécurité maximum (Galappathie, Khan et Hussain, 2017;Linhorst et Scott, 2004;Tengström et Hodgins, 2002).…”

Reforming fitness to plead and stand trial legislation in England and Wales

“…We suggest that this approach would be helpful, as it would help courts to fast-track appropriate cases, especially where there is little doubt that streamlined determination of finding and disposal would be in the best interests of the defendant and other parties. Criminal procedures are known to be stressful for defendants and are associated with an increased risk of self-harm (Galappathie 2017).…”