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Organizing Forensic Mental Health Care Delivery: Putting the Trinitarian Model of Therapeutic Security to the Test 组织法医心理保健服务:检验治疗安全的三位一体模型
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2021-03-01 DOI: 10.1080/14999013.2021.1876795
Marjolein De Pau, P. Nicaise, D. Bourmorck, W. Vanderplasschen, F. Vander Laenen
Abstract The Trinitarian model of therapeutic security is used to organize forensic mental health care in Ireland, England and Scotland. However, it remains unclear whether this model captures all significant factors for the organization of forensic mental health care delivery. In this case study, the Trinitarian model is applied to and tested on Belgian forensic mental health services. Relational security as a discriminative factor is debated and an extension of this institution-oriented model to the policy- and service users’ level is recommended. Finally, we propose to disentangle the concepts of therapeutic security, risk and care in forensic mental health.
摘要在爱尔兰、英格兰和苏格兰,使用三位一体的治疗安全模型来组织法医心理健康护理。然而,目前尚不清楚该模型是否涵盖了组织法医心理健康护理的所有重要因素。在本案例研究中,三位一体模型被应用于比利时法医心理健康服务并在其上进行了测试。将关系安全作为一个判别因素进行了辩论,并建议将这种面向机构的模型扩展到策略和服务用户级别。最后,我们建议在法医心理健康中理清治疗安全、风险和护理的概念。
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引用次数: 7
Wechsler Adult Intelligence Scale Full Scale IQ of Male Admissions to a High Secure Psychiatric Hospital Over Six Decades 韦氏成人智力量表:一家高度安全的精神病院六十年来男性住院病人的全面智商
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2021-02-26 DOI: 10.1080/14999013.2021.1895376
D. Murphy, Joanna L. Mitchell, Joseph Vacher, Emily Morley, Ignazio Puzzo
Abstract The present study describes the Wechsler Adult Intelligence Scale (WAIS) full scale IQ (FIQ) of admissions to one UK High Secure Psychiatric Care hospital. WAIS IV comparative data and the FIQ of admissions from the 1960s to the 2010s are presented (n = 639). Results suggest 75% of current admissions have FIQs within the ‘low average’ and ‘extremely low’ classifications, with significant discrepancies between composite scales being common and processing speed being the most compromised area of cognitive functioning. A one standard deviation decline in FIQs of admissions since the 1960s to the 2010s is also present. The results are discussed in terms of the changing clinical presentations of admissions, along with research and clinical implications.
摘要本研究描述了英国一家高级安全精神病护理医院的韦氏成人智力量表(WAIS)全量表IQ(FIQ)。WAIS IV的比较数据和20世纪60年代至2010年代招生的FIQ如下所示(n = 639)。结果表明,75%的当前入院患者的FIQ属于“低平均”和“极低”分类,复合量表之间的显著差异很常见,处理速度是认知功能最受影响的领域。从20世纪60年代到2010年代,招生FIQ也出现了一个标准差的下降。研究结果从入院的临床表现变化以及研究和临床意义的角度进行了讨论。
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引用次数: 2
Restrictive Practices in Adult Secure Mental Health Services: A Scoping Review 成人安全心理健康服务中的限制性做法:范围界定综述
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2021-02-19 DOI: 10.1080/14999013.2021.1887978
Danielle A. Lawrence, Ruth Bagshaw, D. Stubbings, Andrew Watt
Abstract Restrictive practices are often harmful and many academics, policy-makers and clinicians agree that their use should be reduced in care settings. Specific focus on secure mental health services is warranted because restrictive practices are often seen as an integral part of forensic psychiatry but have received limited research attention relative to other areas of psychiatric practice. The aim of this scoping review was to map and evaluate recent empirical research that examines the use of restrictive practices, the consequences of using them and efforts to reduce restrictive practices, in secure mental health settings published since June 2015. The purpose of this review was to identify limitations and gaps in the literature in order to inform further research. PsycINFO, Medline, Embase, CINAHL, Scopus and ASSIA databases were searched for studies published between 2015 and 2020. Following electronic and manual searches, 36 studies were included. The studies were grouped into four main areas: 1) Nature of the problem describing the type, incidence, prevalence and scope of restrictive practices in secure mental health services; 2) Service user perceptions and experiences of restrictive practices; 3) Staff experiences, views and decision making; and 4) Interventions designed to reduce the use of restrictive practices. Findings support the notion that restrictive practices have a detrimental impact on the wellbeing of most service users in adult secure services as well as the staff who use them. Continued efforts to reduce restrictive practices are needed and the importance of collaborative working cannot be understated. Implications for future research, clinical practice, policy and best practice guidelines are all discussed.
摘要限制性做法通常是有害的,许多学者、决策者和临床医生都认为,在护理环境中应该减少使用限制性做法。有必要特别关注安全的心理健康服务,因为限制性做法通常被视为法医精神病学的一个组成部分,但与精神病实践的其他领域相比,受到的研究关注有限。本次范围界定审查的目的是绘制和评估自2015年6月以来发表的最近的实证研究,该研究考察了在安全的心理健康环境中使用限制性做法、使用限制性措施的后果以及减少限制性做法的努力。这篇综述的目的是确定文献中的局限性和差距,以便为进一步的研究提供信息。检索PsycINFO、Medline、Embase、CINAHL、Scopus和ASSIA数据库中2015年至2020年间发表的研究。经过电子和手动搜索,纳入了36项研究。这些研究分为四个主要领域:1)问题的性质,描述了安全心理健康服务中限制性做法的类型、发生率、流行率和范围;2) 服务使用者对限制性做法的看法和经验;3) 工作人员的经验、观点和决策;以及4)旨在减少使用限制性做法的干预措施。研究结果支持这样一种观点,即限制性做法对成人安全服务中的大多数服务用户以及使用这些服务的工作人员的福祉产生了不利影响。需要继续努力减少限制性做法,合作工作的重要性不容低估。对未来研究、临床实践、政策和最佳实践指南的影响都进行了讨论。
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引用次数: 17
Ten Years of Operation of a Small Belgian Medium-Security Unit—How Are We Doing? 比利时一个小型中等安全单位的十年运作——我们做得怎么样?
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2021-02-19 DOI: 10.1080/14999013.2021.1887409
Louis De Page, P. Titeca
Abstract International literature suggests that forensic care is best organized by independent security levels with appropriate infrastructure, procedures, and therapeutic goals. However, resources are not always sufficient to allow for organizing this way. We describe the functioning of a medium-security unit (MSU) where we not only rehabilitate forensic patients for their transition from prison to community life but also readmit relapsing patients and provide time-outs for patients in crisis. We discuss the advantages and disadvantages of this cohabitation for patients and personnel. This study is also the first to present figures regarding readmissions of relapsing patients and prison remittal in Belgium from a MSU point of view.
国际文献表明,法医护理最好由具有适当基础设施、程序和治疗目标的独立安全级别组织。然而,资源并不总是足以允许以这种方式组织。我们描述了一个中等安全单位(MSU)的功能,在那里我们不仅帮助法医病人从监狱过渡到社区生活,而且重新接纳复发的病人,并为处于危机中的病人提供暂停治疗。我们讨论了这种同居对病人和工作人员的利弊。这项研究也是第一次从密歇根州立大学的角度提出关于比利时复发患者再入院和监狱汇款的数字。
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引用次数: 2
An Exploration of Risk and Protective Characteristics of Violent Youth Offenders in Singapore across Adolescent Developmental Stages 新加坡青少年暴力罪犯在青少年发展阶段的风险与保护特征探讨
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2021-02-19 DOI: 10.1080/14999013.2021.1886203
Li Lian Koh, A. Day, Bianca Klettke, M. Daffern, C. Chu
Abstract The risk and protective factors in a sample of 224 Singaporean youths who have engaged in violence are investigated using the SAVRY the VRS-YV, and the SAPROF-YV. Youths in the early and middle stages of adolescence exhibited more risk factors and fewer protective factors than late stage adolescents. This may be due to cultural and societal influences as well as maturation processes which guide the development of risk and protective factors over the course of adolescence. These findings highlight the importance of developing treatment programs for violent youth that are developmentally matched and which address specific areas of need.
摘要采用SAVRY、VRS-YV和saprofi - yv对224名新加坡青少年暴力行为的风险和保护因素进行了调查。青少年早期和中期表现出的危险因素多于青春期晚期,而保护性因素较少。这可能是由于文化和社会的影响以及在青春期过程中指导风险和保护因素发展的成熟过程。这些发现强调了为暴力青年制定治疗方案的重要性,这些方案应与发展相匹配,并针对具体需求领域。
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引用次数: 2
Exploring High Secure Forensic Patients’ Experiences of Familial Support: An Interpretative Phenomenological Analysis 探索高安全性法医病人的家庭支持经验:解释性现象学分析
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2021-02-14 DOI: 10.1080/14999013.2021.1885528
M. Gillespie, E. Quayle, Joe Judge
Abstract Research has identified positive relationships between familial support and outcomes for forensic mental health patients. Such support has been linked to reduced recidivism, improved mental health and increased prosocial behavior. Whilst some studies have explored families’ experiences of providing such support, there is a paucity of research exploring patients’ narratives. Using Interpretative Phenomenological Analysis, the current study interviewed patients at a high secure forensic hospital and asked questions about their experiences of familial support. Results indicated four superordinate themes; Connection, Growth, Power, and Ambivalence. These results are discussed in relation to existing findings and clinical implications. Areas for future research are suggested.
摘要研究发现,法医心理健康患者的家庭支持与结果之间存在积极关系。这种支持与减少再犯、改善心理健康和增加亲社会行为有关。虽然一些研究探讨了家庭提供这种支持的经历,但很少有研究探讨患者的叙述。利用解释现象学分析,目前的研究采访了一家高度安全的法医医院的患者,并询问了他们的家庭支持经历。结果表明有四个上级主题;连接、增长、力量和矛盾。这些结果与现有的发现和临床意义进行了讨论。提出了未来研究的领域。
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引用次数: 1
Connectedness in Recovery Narratives of Persons Labeled Not Criminally Responsible: A Qualitative Study 非刑事责任人康复叙述中的连通性:一项定性研究
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2021-02-11 DOI: 10.1080/14999013.2021.1880503
N. Aga, S. Rowaert, F. Vander Laenen, S. Vandevelde, T. Vander Beken, K. Audenaert, W. Vanderplasschen
Abstract Objective Connectedness is placed at the heart of the recovery process in mental health care. However, in regard to persons labeled not criminally responsible (NCR), considerations of recovery and connectedness remain in the background. The aim of this study is to understand and explore how individuals labeled not criminally responsible experience connectedness. Research method Sixty-seven in-depth interviews were examined and thematically analyzed. Results Interviews revealed emotional, functional and personal connectedness as categories of connectedness, each with different qualitative determinants. Conclusion This study shows that connectedness should be considered as an essential ingredient of the recovery process by practitioners as well as policy makers. We recommend a shift from an individualistic, punitive approach toward a recovery-supportive rhetoric and more ‘shared decision making’ between service users and providers at all levels.
摘要目的在心理健康护理中,连接是康复过程的核心。然而,对于被标记为不负刑事责任的人,恢复和联系的考虑仍然是背景。本研究的目的是了解和探索被标记为不负刑事责任的个人是如何体验联系的。研究方法对67次深度访谈进行调查和主题分析。结果访谈揭示了情感联系、功能联系和个人联系是联系的类别,每个类别都有不同的定性决定因素。结论这项研究表明,从业者和政策制定者都应该将连通性视为恢复过程的一个重要组成部分。我们建议从个人主义、惩罚性的方法转向支持复苏的言论,并在各级服务用户和提供商之间进行更多的“共同决策”。
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引用次数: 6
Examining the Influence of Mental Health on Self-Stigma in a Mexican Prison 考察墨西哥监狱心理健康对自我污名的影响
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2021-02-09 DOI: 10.1080/14999013.2021.1876186
Berenice Pérez-Ramírez, Juan J. Barthelemy, R. Gearing, Lindamarie Olson, Natalia Giraldo-Santiago, Luis R. Torres
Abstract Prisons in Mexico, like other countries, struggle to house and effectively treat individuals with mental illness. This study on 194 male Mexican prisoners managing mental disorders aims to 1) explore what mental health symptomology is associated with self-stigma and 2) identify what mental health symptomology predicts increased self-stigma. Results found that depression, mania, and anger significantly predicted harm to self-esteem scores, and education and mania significantly predicted agreement and application subscales. Given the increased number of imprisoned individuals with mental illness in Mexico and minimal treatment available, these findings support the importance of implementing self-stigma interventions within prisons.
与其他国家一样,墨西哥的监狱也在努力收容和有效治疗精神疾病患者。本研究对194名管理精神障碍的墨西哥男性囚犯进行了研究,目的是:1)探索心理健康症状与自我耻辱感的关系;2)确定心理健康症状对自我耻辱感增加的预测。结果发现,抑郁、躁狂和愤怒显著预测自尊得分的伤害,教育和躁狂显著预测一致性和应用子量表。鉴于墨西哥被监禁的精神疾病患者人数不断增加,而可获得的治疗却很少,这些发现支持了在监狱内实施自我耻辱干预的重要性。
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引用次数: 3
Perceived Credibility of Social Media Data as a Collateral Source in Criminal Responsibility Evaluations Using an Experimental Design 使用实验设计的社会媒体数据作为刑事责任评估附带来源的感知可信度
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2021-02-08 DOI: 10.1080/14999013.2021.1880504
Ashley B. Batastini, M. Vitacco, Ashley C. T. Jones, R. Davis
Abstract Perceived credibility of social media data (i.e., a Twitter post) was compared to more traditional collateral sources in criminal responsibility evaluations using independent samples of laypersons and forensic experts. Overall, results suggested greater skepticism toward social media relative to two other sources, particularly when information suggested a mental illness. Both samples, however, viewed the tweet as potentially useful. Notably, both studies were limited by the use of an experimental design that was intended to capture initial impressions rather than fully mimic standard assessment and courtroom processes. We advocate a cautious but open-minded approach when considering social media data as collateral.
在刑事责任评估中,使用外行和法医专家的独立样本,将社交媒体数据(即Twitter帖子)的感知可信度与更传统的附带来源进行了比较。总的来说,结果表明,相对于其他两种来源,人们对社交媒体的怀疑程度更高,尤其是当信息显示出精神疾病时。然而,这两个样本都认为这条推文可能有用。值得注意的是,这两项研究都受到实验设计的限制,实验设计旨在捕捉初步印象,而不是完全模仿标准评估和法庭程序。在将社交媒体数据作为抵押品时,我们提倡谨慎但开放的态度。
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引用次数: 2
An Examination of Fitness to Stand Trial, Competence to Make Treatment Decisions, and Psychosis in a Canadian Sample 在加拿大样本中对出庭适应度、作出治疗决定的能力和精神病的检验
IF 1.4 4区 医学 Q2 Nursing Pub Date : 2021-01-27 DOI: 10.1080/14999013.2021.1876796
Christopher M King, Jill Del Pozzo, Dwight Ceballo, P. Zapf
Abstract The purpose of this secondary analysis of an archival sample of 100 Canadian men remanded for evaluations of fitness to stand trial was to investigate the relationships among fitness, competence to make treatment decisions, and psychosis. As hypothesized, competence to make treatment decisions was more often impaired in those with impaired fitness. Among unfit defendants, a diagnosis of a psychotic disorder also related to impaired competence to make treatment decisions. The issue of competence to make treatment decisions may have utility for evaluations and restoration of fitness to stand trial and tending to it may help to alleviate systems burdens.
摘要对100名被还押候审的加拿大男子的档案样本进行二次分析的目的是调查健康状况、做出治疗决定的能力和精神病之间的关系。正如假设的那样,那些体质受损的人做出治疗决定的能力更经常受损。在不称职的被告中,精神病障碍的诊断也与做出治疗决定的能力受损有关。做出治疗决定的能力问题可能有助于评估和恢复是否适合接受试验,并有助于减轻系统负担。
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引用次数: 0
期刊
International Journal of Forensic Mental Health
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