Pub Date : 1999-12-01DOI: 10.1080/09585189908402153
J. Massie, S. Lewis
{"title":"Duration of treatment in schizophrenia","authors":"J. Massie, S. Lewis","doi":"10.1080/09585189908402153","DOIUrl":"https://doi.org/10.1080/09585189908402153","url":null,"abstract":"","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89213158","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: 10.1080/09585189908402166
J. Crichton
This paper reviews the literature on the relationship between mental disorder and crime from 1997 and 1998. There is a brief examination of the importance of the topic and methodological challenges in researching the subject. Studies are divided between those that are designed to include a control, and which are therefore of greater use in establishing causality, and those that do not. The more specific that studies have been in comparing particular diagnosis and symptom clusters with specific criminal behaviour, the more useful they have been in establishing causality. An emerging theme is the importance of dual diagnosis, particularly substance misuse and psychosis, and violent crime.
{"title":"Mental disorder and crime: Coincidence, correlation and cause","authors":"J. Crichton","doi":"10.1080/09585189908402166","DOIUrl":"https://doi.org/10.1080/09585189908402166","url":null,"abstract":"This paper reviews the literature on the relationship between mental disorder and crime from 1997 and 1998. There is a brief examination of the importance of the topic and methodological challenges in researching the subject. Studies are divided between those that are designed to include a control, and which are therefore of greater use in establishing causality, and those that do not. The more specific that studies have been in comparing particular diagnosis and symptom clusters with specific criminal behaviour, the more useful they have been in establishing causality. An emerging theme is the importance of dual diagnosis, particularly substance misuse and psychosis, and violent crime.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88393682","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: 10.1080/09585189908402161
P. Snowden, J. McKenna, A. Jasper
Abstract There is no literature available on the styles of service provision for the supervision of high-risk mentally disordered offenders, in particular those subject to the provisions of s.41 of the Mental Health Act 1983. This article describes the historical background to the terms ‘integrated’ and ‘parallel’ care for mentally disordered offenders. It is argued that these terms no longer have any value. A four-level model of managing high-risk patients in the community is proposed, which relates to the assessment of clinical risks. Research into models of service provision is urgently required so that these patients can receive the best care possible, in the least restrictive manner, whilst the safety of the community is not compromised.
{"title":"Management of conditionally discharged patients and others who present similar risks in the community: Integrated or parallel?","authors":"P. Snowden, J. McKenna, A. Jasper","doi":"10.1080/09585189908402161","DOIUrl":"https://doi.org/10.1080/09585189908402161","url":null,"abstract":"Abstract There is no literature available on the styles of service provision for the supervision of high-risk mentally disordered offenders, in particular those subject to the provisions of s.41 of the Mental Health Act 1983. This article describes the historical background to the terms ‘integrated’ and ‘parallel’ care for mentally disordered offenders. It is argued that these terms no longer have any value. A four-level model of managing high-risk patients in the community is proposed, which relates to the assessment of clinical risks. Research into models of service provision is urgently required so that these patients can receive the best care possible, in the least restrictive manner, whilst the safety of the community is not compromised.","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89537779","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: 10.1080/09585189908402156
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":null,"pages":null},"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: 10.1080/09585189908402162
E. W. Mitchell
Abstract Common-sense notions of justice dictate that those who create the conditions of their own defence should be held more culpable. Anglo-American criminal law lends credence to such notions by denying justification or excuse to those whose incapacity such as automatism or intoxication has been self-induced. However, no such provision is made for the excusatory defence of insanity. There are a number of ways in which an insanity defendant may be the cause of his or her own incapacity, thus having a high degree of responsibility for his or her criminal responsibility or ‘meta-responsibility’. The defendant may have failed to seek psychiatric help when so advised, failed in medication-compliance, or taken proscribed drugs or medicines. This article argues that there is a hitherto unconsidered autonomous component to mental disorder in which the defendant may have acquiesced in the illness, failed to resist it, or actively propagated it, perhaps to afford sympathy and excuse. Clinical, philosophical, fo...
{"title":"Madness and meta-responsibility: The culpable causation of mental disorder and the insanity defence","authors":"E. W. Mitchell","doi":"10.1080/09585189908402162","DOIUrl":"https://doi.org/10.1080/09585189908402162","url":null,"abstract":"Abstract Common-sense notions of justice dictate that those who create the conditions of their own defence should be held more culpable. Anglo-American criminal law lends credence to such notions by denying justification or excuse to those whose incapacity such as automatism or intoxication has been self-induced. However, no such provision is made for the excusatory defence of insanity. There are a number of ways in which an insanity defendant may be the cause of his or her own incapacity, thus having a high degree of responsibility for his or her criminal responsibility or ‘meta-responsibility’. The defendant may have failed to seek psychiatric help when so advised, failed in medication-compliance, or taken proscribed drugs or medicines. This article argues that there is a hitherto unconsidered autonomous component to mental disorder in which the defendant may have acquiesced in the illness, failed to resist it, or actively propagated it, perhaps to afford sympathy and excuse. Clinical, philosophical, fo...","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82462708","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":null,"pages":null},"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: 10.1080/09585189908402155
Moira Potier, J. McGuire
{"title":"A case of selective deafness","authors":"Moira Potier, J. McGuire","doi":"10.1080/09585189908402155","DOIUrl":"https://doi.org/10.1080/09585189908402155","url":null,"abstract":"","PeriodicalId":47524,"journal":{"name":"Journal of Forensic Psychiatry & Psychology","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"1999-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83526038","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":null,"pages":null},"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":null,"pages":null},"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":null,"pages":null},"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}
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