Background Persons of African-Caribbean origin are more frequently imprisoned, and increasing evidence suggests they are detained more frequently in psychiatric hospitals, following offending behaviour. Aims To estima...
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Background Persons of African-Caribbean origin are more frequently imprisoned, and increasing evidence suggests they are detained more frequently in psychiatric hospitals, following offending behaviour. Aims To estimate population-based prevalence rates of treated mental disorder in different ethnic groups compulsorily admitted to secure forensic psychiatry services. Method A survey was recorded of 3155 first admissions, from 1988 to 1994, from half of England and Wales, with 1991 census data as the denominator adjusted for under-enumeration. Results Compulsory admissions for Black males were 5.6 (Cl 5.1-6.3) times as high as, and for Asian males were half, those for White males;for Black females, 2.9 (Cl 2.4-4.6) times as high and for Asian females one-third of those for White females. Admissions of non-Whites rose over the study period. Patterns of offending and diagnoses differed between ethnic groups. Conclusions Variations in compulsory hospitalisation cannot be entirely attributed to racial bias. Community-based services may be less effective in preventing escalating criminal and dangerous behaviour associated with mental illness in African-Caribbeans. Declaration of interest None. Funding was provided by the Department of Health.
Over the past ten years, FSH has seen the initial implementation of the SLP grow from a single ward in the maximum-security forensic unit to include three additional wards within that unit, two wards on the medium-sec...
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Over the past ten years, FSH has seen the initial implementation of the SLP grow from a single ward in the maximum-security forensic unit to include three additional wards within that unit, two wards on the medium-security forensic unit, and two wards within the general adult psychiatric service. There are now four FSH group homes, which admit clients from the hospital's forensic as well as nonforensic populations. Six to eight clients live in each home and function in a relatively self-sufficient manner, and many more (including forensic clients) have been discharged from the group homes and now live independently in the community. They work in supported employment or competitive job settings and manage their own households. Several of our discharged clients even return to visit us from time to time. The FSH administration remains solidly committed to being a rehabilitation-ready facility. We have had a number of positive outcomes over the years (Baldwin and others, 1992;Beck and others, 1991;Beck and others, 1997;Finnell, Card, and Menditto, 1997;Menditto, Baldwin, O'Neal, and Beck, 1991;Menditto, Valdes, and Beck, 1994;Menditto and others, 1996;Menditto, Beck, and Stuve, in press;Pestle, Card, and Menditto, 1998), and we regularly host visitors from other state hospitals seeking consultation on how to make their own facilities rehabilitation-ready. Recently, we were featured on a segment of the nationally broadcast medical education program psychLINK (Glazer, 1998), where it was suggested that rehabilitation programming models such as ours represent the future of state hospitals. The "Not Ready for Rehab Players" think so too.
States differ widely in their delivery of pretrial forensic evaluation services, in terms of organizational structure and training requirements of forensic examiners. It was hypothesized that defendants adjudicated in...
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States differ widely in their delivery of pretrial forensic evaluation services, in terms of organizational structure and training requirements of forensic examiners. It was hypothesized that defendants adjudicated incompetent to proceed in stares using community-based, private-practitioner systems would show less impairment on a competence assessment measure, the MacArthur Competence Assessment Tool-Criminal Adjudication (MacCAT-CA), than defendants adjudicated incompetent in states using traditional, inpatient systems. It also was hypothesized that mean MacCAT-CA scores for incompetent defendants from states requiring forensic training/certification would be lower than for defendants from states lacking such requirements. Results indicated significant differences across the four types of service delivery systems examined. However;planned comparisons revealed no differences between a stare using a traditional, inpatient model and a stare employing a community-based, private-practitioner model. Analyses examining the effects of mandatory forensic training failed to support the hypothesis that training requirements result in the adoption of higher thresholds for determining incompetence.
There is evidence that mentally ill offenders (MIOs) in prisons commit more infractions, serve longer sentences, and are more likely to be victimized than inmates who are not mentally ill. Humanistic and prison manage...
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There is evidence that mentally ill offenders (MIOs) in prisons commit more infractions, serve longer sentences, and are more likely to be victimized than inmates who are not mentally ill. Humanistic and prison management interests are served if intervention programs minimize symptoms and promote coping and other functional skills. A collaborative agreement was established between Washington State Department of Corrections and a consortium of University of Washington faculty to mutually develop a prison-based program of clinical management and psychoeducation for MIOs. The resulting program is described, along with rationale, planning processes, implementation, and initial evaluation. Most aspects of the planned program are in place. Clinical and behavioral progress by inmates following program participation has been documented. Issues concerning treatment program implementation in prisons are discussed. Copyright 2002, Elsevier Science (USA). All rights reserved.
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