Patient profiles in high-security forensic psychiatry in Flanders

Verschueren, Sophie; Jeandarme, Inge; Ameele, Ruben van den; Buysschaert, Bert; Bogaerts, Stefan

doi:10.1080/13218719.2022.2124549

Cited by 6 publications

(4 citation statements)

References 40 publications

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“…The majority of patients had been assessed as presenting an elevated risk for violence, unauthorized leave, substance abuse, self-neglect, or victimization during the year in which they attended SSCOs. This profile of forensic psychiatric inpatients is generally consistent with the broader literature ( 28 – 30 ), suggesting that our findings are likely generalizable to other forensic psychiatric cohorts.…”

Section: Discussionsupporting

confidence: 89%

Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes

Farrell,

Petersen,

Hanzouli

et al. 2024

Front. Psychiatry

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Mental health professionals are tasked with making difficult clinical decisions in treatment settings. In the forensic system, decision making regarding staff supervised community outings (SSCOs) provides a significant challenge due to the need to balance patient liberties, mental health recovery, and public safety. This study explored the characteristics and rehabilitative nature of SSCOs, characteristics of patients attending SSCOs, and any adverse events that occurred during the outings. Employing a cross-sectional design, 110 patients who participated in SSCOs over a one-year period from a Canadian Forensic Psychiatric Hospital were included. Clinical records were reviewed to capture patient and SSCO variables. Descriptive analyses were used to calculate participant, risk, SSCO, and adverse event characteristics. Qualitative analysis was used to explore the purpose of SSCOs and rehabilitative progress that occurred during the outings. Patients attending SSCOs were comprised of long-stay patients with over half having committed a violent index offence. Almost 75% of patients had a moderate/high risk for violence and 50% of the patients had a moderate/high risk of absconding. During the study period, 463 SSCOs were completed. Most outings focused on developing skills for daily living and staff comments suggested many patients developed skills in these areas. Despite considerable risk profiles and public concern regarding forensic patients having community access, there was a single occurrence of unauthorized leave and no instances of violence or substance use. This research can disrupt stigma, demonstrating that SSCOs support a specific rehabilitative intent, promote community reintegration, and maintain public safety.

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Section: Discussionsupporting

confidence: 89%

Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes

Farrell,

Petersen,

Hanzouli

et al. 2024

Front. Psychiatry

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“…Patients in forensic psychiatry often suffer from various (mental) health conditions that severely affect functioning. Examples include, but are not limited to, substance use disorders, depression, bipolar disorder, and schizophrenia ( 6 ).…”

Section: Introductionmentioning

confidence: 99%

Putting the usability of wearable technology in forensic psychiatry to the test: a randomized crossover trial

de Looff,

Noordzij,

Nijman

et al. 2024

Front. Psychiatry

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IntroductionForensic psychiatric patients receive treatment to address their violent and aggressive behavior with the aim of facilitating their safe reintegration into society. On average, these treatments are effective, but the magnitude of effect sizes tends to be small, even when considering more recent advancements in digital mental health innovations. Recent research indicates that wearable technology has positive effects on the physical and mental health of the general population, and may thus also be of use in forensic psychiatry, both for patients and staff members. Several applications and use cases of wearable technology hold promise, particularly for patients with mild intellectual disability or borderline intellectual functioning, as these devices are thought to be user-friendly and provide continuous daily feedback.MethodIn the current randomized crossover trial, we addressed several limitations from previous research and compared the (continuous) usability and acceptance of four selected wearable devices. Each device was worn for one week by staff members and patients, amounting to a total of four weeks. Two of the devices were general purpose fitness trackers, while the other two devices used custom made applications designed for bio-cueing and for providing insights into physiological reactivity to daily stressors and events.ResultsOur findings indicated significant differences in usability, acceptance and continuous use between devices. The highest usability scores were obtained for the two fitness trackers (Fitbit and Garmin) compared to the two devices employing custom made applications (Sense-IT and E4 dashboard). The results showed similar outcomes for patients and staff members.DiscussionNone of the devices obtained usability scores that would justify recommendation for future use considering international standards; a finding that raises concerns about the adaptation and uptake of wearable technology in the context of forensic psychiatry. We suggest that improvements in gamification and motivational aspects of wearable technology might be helpful to tackle several challenges related to wearable technology.

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“…Nurses are also exposed to the aversive details related to patient forensic histories (Newman et al, 2021). Violent and sexual-related index offenses account for 60%–70% and 10%–22%, respectively, of forensic mental health patients (Chaimowitz et al, 2022; Verschueren et al, 2022). Forensic mental health nurses are required to obtain knowledge about the patients' offending behavior as part of the nursing process (Martin et al, 2013; Newman et al, 2016).…”

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confidence: 99%

Vicarious Trauma and Health Outcomes in Forensic Mental Health Nurses

Newman,

Roche,

Elliott

2023

Journal of Forensic Nursing

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Background Nurses working in forensic mental health settings are at risk of vicarious trauma because of their exposure to traumatized patients and distressing material such as the aversive details of patient crimes. Aim The aim of this study was to determine the incidence of vicarious trauma and explore its impact on health and absence from work. Methods A cross-sectional descriptive correlational study was undertaken. All 205 forensic mental health nurses working in a high-security inpatient facility were invited to participate. An online survey included the Vicarious Trauma Scale and the SF-36v2 to measure mental and physical health. Absence from work was also explored. Results Sixty-seven respondents completed the survey. Almost half of respondents had a moderate level of vicarious trauma, and only over one-quarter experienced high levels. Higher levels of vicarious trauma were associated with poorer mental health (r = −0.59, p < 0.000) and absence from work (r = 0.27, p < 0.010). Conclusions Forensic mental health nurses are at a greater risk of vicarious trauma than nurses working in mainstream mental health services, given their exposure to aversive details of patients' violent crimes. Adverse mental health consequences of vicarious trauma, and other forms of workplace trauma experienced by forensic mental health nurses, are likely to include trauma-related symptoms, depression, and anxiety. Forensic mental health nurses experiencing vicarious trauma may use sick leave as time away from work to care for their own mental health or a coping mechanism for workplace-induced psychological distress.

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Patient profiles in high-security forensic psychiatry in Flanders

Cited by 6 publications

References 40 publications

Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes

Staff supported community outings among forensic mental health patients: patient characteristics, rehabilitative goals, and (the absence of) adverse outcomes

Putting the usability of wearable technology in forensic psychiatry to the test: a randomized crossover trial

Vicarious Trauma and Health Outcomes in Forensic Mental Health Nurses

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