The utility of the Historical Clinical Risk-20 Scale as a predictor of outcomes in decisions to transfer patients from high to lower levels of security--a UK perspective.
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Security and psychiatry: the British experience and implications for forensic psychiatry services in Israel.
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The courts have recently become increasingly involved in the administration of compulsory psychiatric services in Israel. Data reveal a gradual increase in the rate of court-ordered hospitalizations according to Section 15 of the Law for the Treatment of the Mentally Ill. This paper examines the implications of this trend, particularly the issues of security and safety in psychiatric hospitalization. We present highlights from extensive British experience, focusing on the implications on forensic psychiatry in Israel. We review the development of the hierarchy of security in the British psychiatric services, beginning in the early 1970s with the establishment of the Butler Committee that determined a hierarchy of three levels of security for the treatment of patients, culminating with the establishment of principles for the operation of medium security units in Britain (Read Committee, 1991). These developments were the basis for the forensic psychiatric services in Britain. We discuss the relevance of the British experience to the situation in Israel while examining the current status of mental health facilities in Israel. In our opinion, a safe and suitable environment is a necessary condition for a treatment setting. The establishment of medium security units or forensic psychiatry departments within a mental health facility will enable the concentration and classification of court-ordered admissions and will enable systemic flexibility and capacity for better treatment, commensurate with patient needs. (+info)
Violence and personality disorders: clinical and forensic implications.
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Several studies have provided strong evidence that personality disorders (PD) represent a significant clinical risk for violence. This review has aimed to examine the relationship of greater risk for violence among persons with certain PD in terms of four fundamental personality dimensions: 1) impulse control; 2) affect regulation; 3) threatened egotism or narcissism; and 4) paranoid cognitive personality style. Two of these dimensions -impulse control and affect regulation- are probably substantially affected by virtually all PDs linked to violence. Narcissism or threatened egotism and paranoid cognitive personality style have also been empirically linked to violence and mental disorder. PD symptoms have proven to be even stronger predictors of violence than the PDs per se. In fact, increased symptoms of DSM-IV cluster A or cluster B PD, such as paranoid, narcissistic and antisocial PD symptoms, correlate significantly with violence. Finally, there are three important principles about the relationship between PDs and violence: 1) PDs are rarely egosyntonic; 2) most patients and violent situations that come to clinical attention involve comorbid conditions; and 3) violence and risk of violence are often associated with substance abuse. Implications of this review for further research are discussed. (+info)
Characteristics of young suicides by violent methods in rural China.
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The summary mental examination in criminal proceedings.
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This article discusses the inception (in 1955) and history of the inclusion of the summary mental examination in criminal proceedings. It then reviews the procedures for diagnosing easily diagnosed cases such as frank psychosis or obvious mental normality. An overview is then provided of the manner in which the reliability of the summary examination can be maintained by deeming those cases where diagnosis can be made without the use of suggestive questions as easily "diagnosed cases" and by avoiding positively diagnosing obvious mental normality. The importance of ensuring that test proceedings in summary examinations do not interfere with formal forensic psychiatric examinations that may be conducted later is then reviewed. These proceedings, through the summary examination, provide material for an expert to state an opinion in court as to the criminal responsibility of the accused suspect. (+info)
The impact of ADHD and conduct disorder in childhood on adult delinquency: a 30 years follow-up study using official crime records.
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