Search results for ‘Subject term:"mentally disordered offenders"’ Sort:
Results 1 - 10 of 23
Back from the abyss
- Author:
- APPLETON Philip
- Journal article citation:
- Professional Social Work, February 2012, pp.12-13.
- Publisher:
- British Association of Social Workers
Using the case of one man who was admitted to a high secure hospital and the support given to him, the author explores the role of the forensic social worker. The man was referred for an assessment by a high secure hospital whilst in prison for robbery, after he assaulted a prison officer with a razor blade. The case highlights the importance of the social workers assessment, the information and support given to the family, and the role of the supervision social worker when discharged.
Perceptions, experiences and meanings of recovery in forensic psychiatric patients
- Authors:
- MEZEY Gillian C., et al
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 21(5), October 2010, pp.683-696.
- Publisher:
- Taylor and Francis
The 'Recovery Approach' is widely regarded as the guiding principle for mental health service delivery in the UK. However, it is not clear whether this approach has any relevance or is applicable to mentally disordered offender patients, who are almost invariably detained against their will and whose capacity to exert choice and control over their treatment must therefore be severely restricted. This study set out to explore forensic psychiatric patients’ experiences and perceptions of recovery. Ten patients with schizophrenia or schizoaffective disorder who were detained in medium secure psychiatric provision underwent face-to-face interviews. Most patients defined recovery as getting rid of symptoms and feeling better about themselves. Medication and psychological work, relationships with staff and patients and being in a secure setting were all cited as being important in bringing about recovery. The stigma associated with being an offender, as well as having a serious mental illness, was perceived as a factor holding back recovery, particularly in relation to discharge and independent living in the community. Core recovery concepts of hope, self-acceptance, and autonomy are more problematic and appear to be less meaningful to individuals, who are detained for serious and violent offences. The article concludes that the recovery approach may need to be modified for use in forensic psychiatric services.
The development of the Medium Security Recidivism Assessment Guide (MSRAG): an actuarial risk prediction instrument
- Authors:
- HICKEY Nicole, YANG Min, COID Jeremy
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 20(2), April 2009, pp.202-224.
- Publisher:
- Taylor and Francis
The majority of patients in medium secure services in the UK have a primary diagnosis of major psychosis. Currently available actuarial risk prediction instruments have limited application, having been developed in different jurisdictions on samples with different characteristics. The Medium Security Recidivism Assessment Guide (MSRAG) was developed to assess risk of acquisitive and serious offending in patients with schizophrenia and delusional disorder. It assesses static predictor variables and is designed for use at the pre-discharge stage of rehabilitation. Results indicate the MSRAG has good predictive accuracy, and acquisitive and serious offending scales were cross-validated. Dynamic risk factors occurring post-discharge interact with four levels of ascribed risk, impacting especially on those at high risk. The MSRAG can be easily scored from case file information, does not require extensive training, and can be used to screen patients routinely prior to discharge. Observed interactions with dynamic factors after discharge can guide clinical risk management.
Relationship between adherence, symptoms, treatment attitudes, satisfaction, and side effects in prisoners taking antipsychotic medication
- Authors:
- GRAY Richard, et al
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 19(3), September 2008, pp.335-351.
- Publisher:
- Taylor and Francis
This study aims to examine the nature and clinical correlates of adherence in prisoners prescribed antipsychotic medication, and how these differ from findings in people taking antipsychotic medication who are not in prison. Treatment adherence, satisfaction with antipsychotic medication, drug attitudes, symptoms, medication side effects, and insight (and insight dimensions) were assessed in 44 prisoners taking antipsychotic medication. In a regression model, 52% of prisoners' adherence to antipsychotic medication was predicted by three explanatory variables: 'I feel motivated to take my antipsychotic medication'; 'My antipsychotic medication makes me feel better'; and putting on weight. Adherence interventions for prisoners taking antipsychotic medication may benefit from focusing on increasing personal relevance/benefit from medication and on enhancing motivation to stick with treatment.
Psychophysiological and behavioural characteristics of individuals comorbid for antisocial personality disorder and schizophrenia-spectrum personality disorder
- Authors:
- SCHUG Robert A., RAINE Adrian, WILCOX Rand R.
- Journal article citation:
- British Journal of Psychiatry, 191(11), November 2007, pp.408-414.
- Publisher:
- Cambridge University Press
Studies have examined people with comorbid schizophrenia-spectrum personality disorder and antisocial personality disorder, a subgroup who may differ psychophysiologically and behaviourally from those with either condition alone. The aim was to test whether individuals with both types of personality disorder are particularly characterised by reduced orienting and arousal and by increased criminal offending. In a community adult sample, self-reported crime and skin conductance orienting were collected on four diagnostic groups: schizophrenia-spectrum personality disorder only; antisocial personality disorder only; comorbidity of the two disorders; and a control group. The comorbid group showed significantly higher levels of criminal behaviour than the other three groups. They also showed reduced skin conductance orienting to neutral tones compared with the other groups, and significantly reduced arousal and orienting to significant stimuli compared with the control group. Reduced orienting may reflect a neurocognitive attentional risk factor for both antisocial and schizotypal personality disorders that indirectly reflects a common neural substrate to these disorders.
Comorbidity of post traumatic stress disorder and paranoid schizophrenia: a comparison of offender and non-offender patients
- Author:
- SARKAR Jaydip
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), December 2005, pp.660-670.
- Publisher:
- Taylor and Francis
This study describes rates of trauma and posttraumatic stress disorder (PTSD) in forensic and non-forensic psychiatric patients, with a primary diagnosis of paranoid schizophrenia. Twenty-seven disordered offender patients (forensic) were compared with 28 non-offender (general) psychiatric inpatients. Ninety-three percent of the entire group reported previous trauma, with the forensic group reporting higher rates of physical and sexual abuse. The forensic patients had also experienced more multiple traumas then the general psychiatric patients, although the result was non-significant. There was no difference between the groups with regard to the age of the earliest trauma experienced. PTSD was common, with rates of 27% for current, and 40% lifetime diagnosis in the whole group. Forensic patients had higher rates of both current (33% v 21%) and lifetime (52% v 29%) PTSD. Very few patients had received a working diagnosis of PTSD, or were receiving trauma focussed psychological therapy. Possible reasons for high rates of trauma and PTSD, and implications for treatment are discussed.
Preventing crime by people with schizophrenic disorders: the role of psychiatric services
- Authors:
- MULLER-ISBERNER R., HODGINS S.
- Journal article citation:
- British Journal of Psychiatry, 185(9), September 2004, pp.245-250.
- Publisher:
- Cambridge University Press
Knowledge of when and how to implement treatments to prevent criminal offending among people with schizophrenia is urgently needed. The aim was to identify opportunities for interventions to prevent offending among men with schizophrenic disorders by tracking their histories of offending and admissions to hospital. The authors examined 232 men with schizophrenic disorders discharged from forensic and general psychiatric hospitals. Data were collected from participants, family members and official records. More than three-quarters (77.8%) of the forensic patients had previously been admitted to general psychiatric services; 24.3% of the general psychiatric patients had a criminal record. Offences had been committed by 39.8% of the forensic patients and 10.8% of the general psychiatric patients before their first admission to general psychiatry, and after their first admission these 59 patients committed 195 non-violent and 59 violent offences. Subsequently, 49 of them committed serious violent offences that led to forensic hospital admission. The offenders were distinguished by a pervasive and stable pattern of antisocial behaviour evident from at least mid-adolescence. General psychiatry requires resources in order to prevent criminal offending among a subgroup of patients with schizophrenic disorders.
Discharges to prison from medium secure psychiatric units in England and Wales
- Authors:
- DOYLE M., et al
- Journal article citation:
- British Journal of Psychiatry, 205(3), 2014, pp.177-182.
- Publisher:
- Cambridge University Press
Background: Early findings from a national study of discharges from 32 National Health Service medium secure units revealed that nearly twice as many patients than expected were discharged back to prison. This study aims to compare the characteristics of those discharged back to prison with those discharged to the community, and consider the implications for ongoing care and risk. Method: Prospective cohort follow-up design. All forensic patients discharged from 32 medium secure units across England and Wales over a 12-month period were identified. Those discharged to prison were compared with those who were discharged to the community (including independent tenancies, supported accommodation, hostels and open rehabilitation wards. Results: Nearly half of the individuals discharged to prison were diagnosed with a serious mental illness and over a third with schizophrenia. They were a higher risk, more likely to have a personality disorder, more symptomatic and less motivated than those discharged to the community. Conclusions: Findings suggest that alternative models of prison mental healthcare should be considered to reduce risks to the patient and the public. (Edited publisher abstract)
A quasi-experimental pilot study of the Reasoning and Rehabilitation programme with mentally disordered offenders
- Authors:
- CLARKE Amory Y., et al
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 21(4), August 2010, pp.490-500.
- Publisher:
- Taylor and Francis
Although the Reasoning and Rehabilitation (R&R) programme and other cognitive skills interventions have been shown to have the largest impact on recidivism, it is yet to be established the extent to which mentally disordered offenders can benefit from such interventions. Using a quasi-experimental design, the authors sought to determine: the feasibility of implementing (R&R) with mentally disordered offenders; and whether participation was associated with improved psychosocial function. Eighteen male patients with psychotic disorders were recruited from two forensic medium secure hospitals to receive the full R&R programme, while a further control group of 17 received treatment-as-usual. All participants completed a set of questionnaires both before and after treatment. Only three patients failed to complete the full 36-session R&R programme. Those who completed the programme showed significantly improved problem solving ability and increased coping responses. In conclusion, the authors suggest that mentally disordered offenders can benefit from participation in the R&R programme.
A demographic study of the Orchard Clinic: Scotland's first medium secure unit
- Authors:
- GOW Rona L., et al
- Journal article citation:
- Journal of Forensic Psychiatry and Psychology (The), 21(1), February 2010, pp.139-155.
- Publisher:
- Taylor and Francis
Forensic services in Scotland are evolving, based on similar developments previously in England and Wales. The Orchard Clinic in Edinburgh opened in November 2000 and was the first medium secure unit in Scotland. It was designed to serve a general population of 1.5 million, covering south-east Scotland, with 50 beds split between 2 rehabilitation wards and 1 acute ward. This paper describes all patients admitted to the unit in the first 5 years of its operation, considering antecedents to their admission, patient characteristics and progress through the system. In total 219 admissions were collected and analysed. The majority of patients were single adult males, aged 40 or under, who had a primary diagnosis of paranoid schizophrenia with a co-morbid diagnoses of personality disorder or substance misuse. The average length of admission was 285 days. In order to benchmark against established services a comparison is made with earlier studies of forensic populations in Scotland and elsewhere in the UK.