法医心理健康:设想一个更注重经验的未来。

IF 30.8 1区 医学 Q1 PSYCHIATRY Lancet Psychiatry Pub Date : 2024-11-01 Epub Date: 2024-06-27 DOI:10.1016/S2215-0366(24)00164-0
John Tully, Jonathan Hafferty, Daniel Whiting, Kimberlie Dean, Seena Fazel
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引用次数: 0

摘要

法医心理健康服务为社会提供重要的干预措施。这些服务为犯有暴力和其他严重罪行的精神障碍患者提供护理,在保护公众方面发挥着关键作用。为了实现这些目标,这些服务的成本必然很高,但它们也因成本高、数量少、缺乏一致的护理标准、忽视人权和其他伦理因素而受到批评。一个主要的问题是,没有足够的证据来证明限制出院和长期拘留病人等常见做法的合理性。心理治疗、药物治疗、隔离和约束等核心干预措施也缺乏高质量的证据。造成证据不足的原因很复杂,但包括对研究基础设施的投资不足,以及国内和国际服务的分散和孤立。在这篇个人观点中,我们强调了法医精神卫生证据基础中的一些主要差距,以及解决这些差距所面临的挑战。我们提出了在临床、社会和公共卫生政策层面都有影响的解决方案。
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Forensic mental health: envisioning a more empirical future.

Forensic mental health services provide crucial interventions for society. Such services provide care for people with mental disorders who commit violent and other serious crimes, and they have a key role in the protection of the public. To achieve these goals, these services are necessarily expensive, but they have been criticised for a high-cost, low-volume approach, for lacking consistent standards of care, and for neglecting human rights and other ethical considerations. A key concern is an insufficient evidence base to justify common practices, such as restricting leave from hospital and detaining patients for long periods. There is also insufficient quality evidence for core interventions, including psychological therapies, pharmacotherapy, and seclusion and restraint. The causes for this evidence deficit are complex but include insufficient investment in research infrastructure and fragmentation and isolationism of services, both nationally and internationally. In this Personal View, we highlight some of the major gaps in the forensic mental health evidence base and the challenges in addressing these gaps. We suggest solutions with implications at clinical, societal, and public health policy levels.

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来源期刊
Lancet Psychiatry
Lancet Psychiatry PSYCHIATRY-
CiteScore
58.30
自引率
0.90%
发文量
0
期刊介绍: The Lancet Psychiatry is a globally renowned and trusted resource for groundbreaking research in the field of psychiatry. We specialize in publishing original studies that contribute to transforming and shedding light on important aspects of psychiatric practice. Our comprehensive coverage extends to diverse topics including psychopharmacology, psychotherapy, and psychosocial approaches that address psychiatric disorders throughout the lifespan. We aim to channel innovative treatments and examine the biological research that forms the foundation of such advancements. Our journal also explores novel service delivery methods and promotes fresh perspectives on mental illness, emphasizing the significant contributions of social psychiatry.
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