Examining the use of the recovery model with individuals found not criminally responsible on account of mental disorder

M. Gulayets, A. Sawyer
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Abstract

In providing the care and control of individuals found Not Criminally Responsible on Account of Mental Disorder (NCRMD), forensic psychiatry attempts to balance the protection of society with the treatment of mental illness. A new approach in mental health care is the recovery model, which centers on the understanding that there should be a ‘recovery in’, not a ‘recovery from’ serious mental illness. In clinical practice, this means that treatment decisions should be made in collaboration with patients and include their personal circumstances, such as criminality and aspirations. Concepts that intersect with these goals are elements like choice, hope, personal responsibility, and empowerment. This paper examines the implementation of the recovery model in forensic mental health settings and provides an in-depth exploration and evaluation of the model as it is practiced at a forensic psychiatric outpatient clinic with individuals found NCRMD. Ten participants, including both individuals found NCRMD and psychiatric professionals, took part in semi-structured interviews. The paper examines the experiences, perceptions and challenges of implementing the recovery model in a forensic psychiatric setting and compares its strategies to the predominant risk-based forensic practices. The analysis suggests that it is difficult to implement the recovery model in a forensic setting without compromising either the recovery model or the risk management approach. Keywords: NCRMD, recovery model, risk management, outpatient setting, qualitative, forensic mental health
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检查使用恢复模式的个人发现没有刑事责任的精神障碍
法医精神病学在照顾和控制因精神失常而被认定无刑事责任的个人方面,试图在保护社会与治疗精神疾病之间取得平衡。精神卫生保健的一种新方法是康复模式,其核心是认识到应该是“康复”,而不是“从”严重精神疾病中“康复”。在临床实践中,这意味着治疗决定应该与患者合作,并考虑他们的个人情况,如犯罪和愿望。与这些目标相交的概念是选择、希望、个人责任和授权等要素。本文考察了康复模式在法医精神卫生机构的实施情况,并对该模式进行了深入的探索和评估,因为它在法医精神科门诊诊所与发现NCRMD的个体进行了实践。包括NCRMD患者和精神病专家在内的10名参与者参加了半结构化访谈。本文考察了在法医精神病设置实施恢复模式的经验,看法和挑战,并将其策略与主要的基于风险的法医实践进行比较。分析表明,在不损害恢复模型或风险管理方法的情况下,很难在法医环境中实施恢复模型。关键词:NCRMD,康复模式,风险管理,门诊设置,定性,法医心理健康
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