Pub Date : 1999-12-01DOI: 10.1080/09585189908402156
D. C. James
Abstract Ten years after the inception of psychiatric diversion schemes to magistrates' courts in England and Wales, their results are reviewed in order to examine whether they can work, whether in general they do work, and what directions their development should take in future. Both published and extensive unpublished sources are examined. It is concluded that court diversion can be highly effective in the identification and acceleration into hospital of mentally disordered offenders, as one component of comprehensive diversion arrangements. However, most court diversion services are currently inadequately planned, organized or resourced, and are therefore of limited effect. It is argued that the ‘experimental’ phase of court diversion should now be at an end. A central strategy is required, and properly designed and adequately supported court services should be incorporated into, and understood to be a core part of, mainstream local psychiatric provision. Without such action, the future of court divers...
{"title":"Court diversion at 10 years: Can it work, does it work and has it a future?","authors":"D. C. James","doi":"10.1080/09585189908402156","DOIUrl":"https://doi.org/10.1080/09585189908402156","url":null,"abstract":"Abstract Ten years after the inception of psychiatric diversion schemes to magistrates' courts in England and Wales, their results are reviewed in order to examine whether they can work, whether in general they do work, and what directions their development should take in future. Both published and extensive unpublished sources are examined. It is concluded that court diversion can be highly effective in the identification and acceleration into hospital of mentally disordered offenders, as one component of comprehensive diversion arrangements. However, most court diversion services are currently inadequately planned, organized or resourced, and are therefore of limited effect. It is argued that the ‘experimental’ phase of court diversion should now be at an end. A central strategy is required, and properly designed and adequately supported court services should be incorporated into, and understood to be a core part of, mainstream local psychiatric provision. Without such action, the future of court divers...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"8 1","pages":"507-524"},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78660462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-12-01DOI: 10.1080/09585189908402170
A. Berry, C. Duggan, E. Larkin
Abstract A clinician must establish that treatment will alleviate or prevent deterioration in a patient with psychopathic disorder to satisfy the legal conditions in the 1983 Mental Health Act. A researcher prospectively studied a consecutive series of psychopathically disordered patients referred to a Special Hospital over 1 calendar year (i.e. from February 1994 to January 1995) to determine how this test of treatability was applied. Of the 48 cases studied, 21 (44%) were deemed untreatable. The following factors were associated with untreatability: a referral from prison (rather than hospital); previous poor compliance with and response to treatment; an offence in which the victim was unknown to the patient; and low levels of motivation for treatment. Demographic, criminological and diagnostic factors showed no significant association with apparent treatability. This study suggests that clinicians are using a pragmatic approach to the treatability test relatively uninfluenced by demographic, criminolog...
{"title":"The treatability of psychopathic disorder: How clinicians decide","authors":"A. Berry, C. Duggan, E. Larkin","doi":"10.1080/09585189908402170","DOIUrl":"https://doi.org/10.1080/09585189908402170","url":null,"abstract":"Abstract A clinician must establish that treatment will alleviate or prevent deterioration in a patient with psychopathic disorder to satisfy the legal conditions in the 1983 Mental Health Act. A researcher prospectively studied a consecutive series of psychopathically disordered patients referred to a Special Hospital over 1 calendar year (i.e. from February 1994 to January 1995) to determine how this test of treatability was applied. Of the 48 cases studied, 21 (44%) were deemed untreatable. The following factors were associated with untreatability: a referral from prison (rather than hospital); previous poor compliance with and response to treatment; an offence in which the victim was unknown to the patient; and low levels of motivation for treatment. Demographic, criminological and diagnostic factors showed no significant association with apparent treatability. This study suggests that clinicians are using a pragmatic approach to the treatability test relatively uninfluenced by demographic, criminolog...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"13 1","pages":"710-719"},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85881050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-12-01DOI: 10.1080/09585189908402169
J. Shaw, A. Silver, A. Pearson, T. Amos
The characteristics of all admissions to a new service for patients requiring high levels of staff support in a low-security setting (the High Dependency Network) were examined and compared with the patient characteristics outlined in the service specification. A range of standardized measures was used to assess patients' social and clinical functioning. The individual units within the High Dependency Network were compared with each other and variation was found in their degree of adherence to the service specification. Implications for the development of new services are discussed.
{"title":"An evaluation of a new low-secure service, the High Dependency Network, in the North-West","authors":"J. Shaw, A. Silver, A. Pearson, T. Amos","doi":"10.1080/09585189908402169","DOIUrl":"https://doi.org/10.1080/09585189908402169","url":null,"abstract":"The characteristics of all admissions to a new service for patients requiring high levels of staff support in a low-security setting (the High Dependency Network) were examined and compared with the patient characteristics outlined in the service specification. A range of standardized measures was used to assess patients' social and clinical functioning. The individual units within the High Dependency Network were compared with each other and variation was found in their degree of adherence to the service specification. Implications for the development of new services are discussed.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"14 1","pages":"696-709"},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78368586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-12-01DOI: 10.1080/09585189908402159
P. Vaughan
Abstract In 1997–8 the Wessex Consortium commissioned a project team to identify and assess the security and accommodation needs of mentally disordered offenders (MDOs) from within the consortium area and to ascertain the distribution and shortfall of suitable inpatient and residential facilities. MDOs in Special Hospitals, in regional secure units (RSUs) and in extra-contractual referral (ECR) placements on 31 October 1997 were identified and their needs assessed. Questionnaires were sent to all health and social services lead managers for mental illness and learning disabilities in order to catalogue existing services. The needs assessments identified two mam groups of individuals with unmet needs, i.e. people with mental health problems needing long-term secure care and those with learning disabilities and personality disorder causing severe challenging behaviour needing long-term and short-term secure care. The findings also revealed a total absence of intensive care beds in some areas and no long-ter...
{"title":"A consortium approach to commissioning services for mentally disordered offenders","authors":"P. Vaughan","doi":"10.1080/09585189908402159","DOIUrl":"https://doi.org/10.1080/09585189908402159","url":null,"abstract":"Abstract In 1997–8 the Wessex Consortium commissioned a project team to identify and assess the security and accommodation needs of mentally disordered offenders (MDOs) from within the consortium area and to ascertain the distribution and shortfall of suitable inpatient and residential facilities. MDOs in Special Hospitals, in regional secure units (RSUs) and in extra-contractual referral (ECR) placements on 31 October 1997 were identified and their needs assessed. Questionnaires were sent to all health and social services lead managers for mental illness and learning disabilities in order to catalogue existing services. The needs assessments identified two mam groups of individuals with unmet needs, i.e. people with mental health problems needing long-term secure care and those with learning disabilities and personality disorder causing severe challenging behaviour needing long-term and short-term secure care. The findings also revealed a total absence of intensive care beds in some areas and no long-ter...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"10 1","pages":"553-566"},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88124602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-12-01DOI: 10.1080/09585189908402167
J. Milton, P. McLean
This case-report details the management of an intravenous drug misuser who had become dependent upon heroin, citing its usefulness in depressing paedophilic urges. A discussion of the interaction between opiates and sexuality in addition to the clinical and ethical dilemmas of the case is presented.
{"title":"Treatment of heroin misuse and deviant sexual thoughts: Harm reduction or collusion?","authors":"J. Milton, P. McLean","doi":"10.1080/09585189908402167","DOIUrl":"https://doi.org/10.1080/09585189908402167","url":null,"abstract":"This case-report details the management of an intravenous drug misuser who had become dependent upon heroin, citing its usefulness in depressing paedophilic urges. A discussion of the interaction between opiates and sexuality in addition to the clinical and ethical dilemmas of the case is presented.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"17 1","pages":"679-686"},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89524676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-12-01DOI: 10.1080/09585189908402157
M. Cavadino
Abstract Psychiatrists have a number of ‘gaoler roles’: that is, they are involved in the detention and compulsory treatment of patients for the protection of others rather than for the good of the patient. Psychiatrists often feel uneasy about these roles, and may even deny that they exercise them. In principle—an argument based on human rights theory—it can be justifiable for the state to ‘gaol’ in appropriate cases. One line of argument contends that, none the less, this should not be the job of doctors. This argument is rejected in principle. Moreover, in practice psychiatrists will inevitably take other people's interests into account whether consciously or not, and political reality dictates that psychiatrists cannot escape their gaoler function.
{"title":"The psychiatrist as gaoler","authors":"M. Cavadino","doi":"10.1080/09585189908402157","DOIUrl":"https://doi.org/10.1080/09585189908402157","url":null,"abstract":"Abstract Psychiatrists have a number of ‘gaoler roles’: that is, they are involved in the detention and compulsory treatment of patients for the protection of others rather than for the good of the patient. Psychiatrists often feel uneasy about these roles, and may even deny that they exercise them. In principle—an argument based on human rights theory—it can be justifiable for the state to ‘gaol’ in appropriate cases. One line of argument contends that, none the less, this should not be the job of doctors. This argument is rejected in principle. Moreover, in practice psychiatrists will inevitably take other people's interests into account whether consciously or not, and political reality dictates that psychiatrists cannot escape their gaoler function.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"70 1","pages":"525-537"},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86070163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-12-01DOI: 10.1080/09585189908402158
Alan D. Smith
Abstract A search of Home Office records was completed for all 80 restricted hospital order inpatients with schizophrenia, resident in any hospital in England and Wales during May 1997, with an index conviction for a contact sex offence against a woman committed whilst psychotic. Almost one quarter of the men (19) had aggressive sexual fantasies at the time of their index offences and in 13 of these men the fantasy was sadistic in nature. Men with aggressive sexual fantasies were more likely to have a history of sexual offending before the onset of schizophrenia, when compared with men without such fantasies; and more likely to have evidence of disturbed and adverse childhood experiences as indicated by a range of childhood variables, again when compared with men without such fantasies. However, controlling for other variables, only childhood social isolation and childhood deviant sexual behaviour remained significantly associated with future presence of aggressive sexual fantasy at the time of the index ...
{"title":"Aggressive sexual fantasy in men with schizophrenia who commit contact sex offences against women","authors":"Alan D. Smith","doi":"10.1080/09585189908402158","DOIUrl":"https://doi.org/10.1080/09585189908402158","url":null,"abstract":"Abstract A search of Home Office records was completed for all 80 restricted hospital order inpatients with schizophrenia, resident in any hospital in England and Wales during May 1997, with an index conviction for a contact sex offence against a woman committed whilst psychotic. Almost one quarter of the men (19) had aggressive sexual fantasies at the time of their index offences and in 13 of these men the fantasy was sadistic in nature. Men with aggressive sexual fantasies were more likely to have a history of sexual offending before the onset of schizophrenia, when compared with men without such fantasies; and more likely to have evidence of disturbed and adverse childhood experiences as indicated by a range of childhood variables, again when compared with men without such fantasies. However, controlling for other variables, only childhood social isolation and childhood deviant sexual behaviour remained significantly associated with future presence of aggressive sexual fantasy at the time of the index ...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"173 1","pages":"538-552"},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74914560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-12-01DOI: 10.1080/09585189908402163
A. Dalteg, M. Lindgren, S. Levander
A comprehensive assessment procedure involving interviews on social history, childhood hyperactivity, personality (including psychopathy), psychiatric symptoms, SCID diagnoses and deviant alcohol reactions (DAR), and a set of neuropsychological test procedures including dyslexia tests, was gone through by 51 male recidivist prison inmates. Data on crimes were available through the police register from age 15 up to and including a follow-up period of 18 months after release. Childhood hyperactivity was reported by 50% and persisted into adulthood for half of the subjects. DARs were reported by more than 30% of the inmates, covaried with hyperactivity, and were negatively associated with criminality. None of the neuropsychological indices, nor dyslexia, had any explanatory value for hyperactivity or DARs.
{"title":"Retrospectively rated ADHD is linked to specific personality characteristics and deviant alcohol reactions","authors":"A. Dalteg, M. Lindgren, S. Levander","doi":"10.1080/09585189908402163","DOIUrl":"https://doi.org/10.1080/09585189908402163","url":null,"abstract":"A comprehensive assessment procedure involving interviews on social history, childhood hyperactivity, personality (including psychopathy), psychiatric symptoms, SCID diagnoses and deviant alcohol reactions (DAR), and a set of neuropsychological test procedures including dyslexia tests, was gone through by 51 male recidivist prison inmates. Data on crimes were available through the police register from age 15 up to and including a follow-up period of 18 months after release. Childhood hyperactivity was reported by 50% and persisted into adulthood for half of the subjects. DARs were reported by more than 30% of the inmates, covaried with hyperactivity, and were negatively associated with criminality. None of the neuropsychological indices, nor dyslexia, had any explanatory value for hyperactivity or DARs.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"101 1","pages":"623-634"},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85874855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403678
T. Foster
{"title":"When will they ever work","authors":"T. Foster","doi":"10.1080/09585189908403678","DOIUrl":"https://doi.org/10.1080/09585189908403678","url":null,"abstract":"","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"29 1","pages":"245-248"},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90252430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1999-09-01DOI: 10.1080/09585189908403695
K. Rix
Abstract An 18-year-old woman suffered brain injury in a road traffic accident. She brought a personal injury action against the driver of the car. The writ was not served within the limitation period of 3 years from the date of the accident. It was her case that the limitation period should not apply because since the date of the accident she had not ceased to be of unsound mind in that by reason of mental disorder within the meaning of s. 1 of the Mental Health Act 1983 she was incapable of administering her property and affairs. The court found that she had the capacity to manage and administer her property and affairs. Her action therefore failed. The case is used to illustrate the approach which the courts and experts take to the assessment of capacity to manage and administer property and affairs. Proposals for changes in the law relating to capacity are also discussed.
{"title":"Capable of managing and administering property and affairs: Old case, new law","authors":"K. Rix","doi":"10.1080/09585189908403695","DOIUrl":"https://doi.org/10.1080/09585189908403695","url":null,"abstract":"Abstract An 18-year-old woman suffered brain injury in a road traffic accident. She brought a personal injury action against the driver of the car. The writ was not served within the limitation period of 3 years from the date of the accident. It was her case that the limitation period should not apply because since the date of the accident she had not ceased to be of unsound mind in that by reason of mental disorder within the meaning of s. 1 of the Mental Health Act 1983 she was incapable of administering her property and affairs. The court found that she had the capacity to manage and administer her property and affairs. Her action therefore failed. The case is used to illustrate the approach which the courts and experts take to the assessment of capacity to manage and administer property and affairs. Proposals for changes in the law relating to capacity are also discussed.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":"218 1","pages":"436-444"},"PeriodicalIF":1.4,"publicationDate":"1999-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76430403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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