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Accountability and psychiatric disorders: how do forensic psychiatric professionals think?

https://arctichealth.org/en/permalink/ahliterature148112
Source
Int J Law Psychiatry. 2009 Nov-Dec;32(6):355-61
Publication Type
Article
Author
Pontus Höglund
Sten Levander
Henrik Anckarsäter
Susanna Radovic
Author Affiliation
Forensic Psychiatry, Institute of Clinical Science, Malmo, Lund University, Sweden. pontus.hoglund@med.lu.se
Source
Int J Law Psychiatry. 2009 Nov-Dec;32(6):355-61
Language
English
Publication Type
Article
Keywords
Adult
Alcoholism - diagnosis - psychology
Attitude of Health Personnel
Character
Commitment of Mentally Ill - legislation & jurisprudence
Comorbidity
Dementia - diagnosis - psychology
Educational Status
Forensic Psychiatry
Humans
Insanity Defense
Life Change Events
Male
Mental Competency - legislation & jurisprudence
Mental Disorders - diagnosis - psychology
Middle Aged
Patient care team
Personality Disorders - diagnosis - psychology
Psychotic Disorders - diagnosis - psychology
Social Responsibility
Social Support
Substance-Related Disorders - diagnosis - psychology
Sweden
Abstract
Swedish penal law does not exculpate on the grounds of diminished accountability; persons judged to suffer from severe mental disorder are sentenced to forensic psychiatric care instead of prison. Re-introduction of accountability as a condition for legal responsibility has been advocated, not least by forensic psychiatric professionals. To investigate how professionals in forensic psychiatry would assess degree of accountability based on psychiatric diagnoses and case vignettes, 30 psychiatrists, 30 psychologists, 45 nurses, and 45 ward attendants from five forensic psychiatric clinics were interviewed. They were asked (i) to judge to which degree (on a dimensional scale from 1 to 5) each of 12 psychiatric diagnoses might affect accountability, (ii) to assess accountability from five case vignettes, and (iii) to list further factors they regarded as relevant for their assessment of accountability. All informants accepted to provide a dimensional assessment of accountability on this basis and consistently found most types of mental disorders to reduce accountability, especially psychotic disorders and dementia. Other factors thought to be relevant were substance abuse, social network, personality traits, social stress, and level of education.
PubMed ID
19811835 View in PubMed
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An investigation of the construct of competence: a comparison of the FIT, the MacCAT-CA, and the MacCAT-T.

https://arctichealth.org/en/permalink/ahliterature174651
Source
Law Hum Behav. 2005 Apr;29(2):229-52
Publication Type
Article
Date
Apr-2005
Author
Patricia A Zapf
Ronald Roesch
Author Affiliation
Department of Psychology, John Jay College of Criminal Justice, The City University of New York, New York 10019, USA. pzapf@jjay.cuny.edu
Source
Law Hum Behav. 2005 Apr;29(2):229-52
Date
Apr-2005
Language
English
Publication Type
Article
Keywords
Adult
Canada
Commitment of Mentally Ill - legislation & jurisprudence
Criminal Law
Humans
Informed Consent - legislation & jurisprudence
Interview, Psychological
Male
Mental Competency - legislation & jurisprudence
Models, Statistical
Personality Assessment - statistics & numerical data
Prisoners - legislation & jurisprudence - psychology
Psychometrics - statistics & numerical data
Psychotic Disorders - diagnosis - psychology - therapy
Reproducibility of Results
Treatment Refusal - legislation & jurisprudence
United States
Violence - legislation & jurisprudence - psychology
Abstract
The 1990s witnessed Supreme Court decisions in both Canada and the United States on issues of competence that went against longstanding case law, psychological research, and common sense. These decisions held that there is to be one standard for all types of criminal competencies. The present research attempts to investigate whether this is an appropriate assumption and thus tests whether there are one or more constructs that underlie different types of competence. Two divergent types of competence were examined, competence to stand trial (both Canadian and American conceptualizations) and competence to consent to treatment, to determine if these different types of competence share a common underlying construct. Confirmatory factor analysis was used to test this question and results indicate that there is a common construct that underlies different types of competence.
PubMed ID
15912726 View in PubMed
Less detail

[Anorexia nervosa and involuntary treatment].

https://arctichealth.org/en/permalink/ahliterature132967
Source
Duodecim. 2011;127(11):1090-6
Publication Type
Article
Date
2011
Author
Nina Lindberg
Eila Sailas
Author Affiliation
HYKS, psykiatrian tulosyksikkö, nuorisopsykiatrian klinikkaryhmä, HUS.
Source
Duodecim. 2011;127(11):1090-6
Date
2011
Language
Finnish
Publication Type
Article
Keywords
Adolescent
Anorexia Nervosa - psychology - therapy
Body Image
Child
Commitment of Mentally Ill - legislation & jurisprudence
Fear
Female
Finland
Humans
Abstract
Anorexia nervosa is a mental health disorder typical for adolescent girls and young adults. The clinical picture is often characterized by distorted body image and intense fear of gaining weight or becoming fat in spite of actual underweight. It is associated with severe disturbance of psychological, physical and social functioning. When the patient strongly resist all weight gaining measures clinicians may have to consider the possibility of involuntary treatment. In the Finnish Mental Health Act there are different definitions for involuntary treatment in adults as compared with under-aged patients. In adults the core question is whether anorexia nervosa can be defined as a psychotic disorder or not. The present review also summarizes literature concerning benefits and disadvantages of involuntary treatment in these patients.
PubMed ID
21755800 View in PubMed
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Assessing the outcome of compulsory treatment orders on management of psychiatric patients at 2 McGill University-associated hospitals.

https://arctichealth.org/en/permalink/ahliterature123619
Source
Can J Psychiatry. 2012 Jun;57(6):359-65
Publication Type
Article
Date
Jun-2012
Author
Arash Nakhost
John Christopher Perry
Daniel Frank
Author Affiliation
McGill University, Institute of Community and Family Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada.
Source
Can J Psychiatry. 2012 Jun;57(6):359-65
Date
Jun-2012
Language
English
Publication Type
Article
Keywords
Adult
Commitment of Mentally Ill - legislation & jurisprudence - statistics & numerical data
Community Mental Health Services - legislation & jurisprudence - statistics & numerical data
Delirium, Dementia, Amnestic, Cognitive Disorders - epidemiology - psychology - therapy
Female
Follow-Up Studies
Hospitals, University
Humans
Insanity Defense
Kaplan-Meier Estimate
Male
Mental Disorders - epidemiology - psychology - therapy
Middle Aged
Patient Readmission - statistics & numerical data
Personality Disorders - epidemiology - psychology - therapy
Prisoners - psychology
Psychiatric Department, Hospital
Psychotic Disorders - epidemiology - psychology - therapy
Quebec
Retrospective Studies
Schizophrenia - epidemiology - therapy
Treatment Outcome
Abstract
Some literature suggests that compulsory community treatment orders (CTOs) are effective in reducing hospitalizations in a subgroup of psychiatric patients with histories of repeated hospitalization, allowing them to be treated in the community under less restrictive measures. However, studies have yielded contradictory findings, in part because of methodological differences. Our study examines the effectiveness of CTOs in reducing hospitalizations and increasing community tenure of such patients.
The sample included all psychiatric patients who had been given a CTO during a 9-year period at 2 of McGill University's hospitals. This is a naturalistic, observational, retrospective, before-and-after study where patients acted as their own control subjects. We examined variables, including the number, duration, and time to psychiatric admissions, comparing 4 time periods: early, pre-index, index (when the first CTO was in force), and post-index periods. The total study duration per subject encompasses the longest period of observation within existing studies in Canada.
Psychiatric patients with histories of frequent readmissions demonstrated a significant reduction in their number of hospitalizations as well as an increase in the median time to re-hospitalization, during the period when they were treated under a CTO. This effect of CTO was sustained even after the CTO had expired.
Our study suggests that CTOs are effective in assisting psychiatric patients with histories of repeated hospitalizations to live and be treated in the community, diminishing the occurrence of frequent hospitalization.
PubMed ID
22682573 View in PubMed
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The assessment of risk management systems for patients on Warrants of the Lieutenant Governor in Ontario psychiatric hospitals.

https://arctichealth.org/en/permalink/ahliterature232019
Source
Health Law Can. 1989;9(3):83-91
Publication Type
Article
Date
1989
Author
W. McKerrow
Source
Health Law Can. 1989;9(3):83-91
Date
1989
Language
English
Publication Type
Article
Keywords
Commitment of Mentally Ill - legislation & jurisprudence
Financial Management - standards
Forensic Psychiatry
Hospitals, Psychiatric - organization & administration
Humans
Insanity Defense
Ontario
Questionnaires
Risk Management - standards
Security Measures
Violence
Abstract
An assessment of risk management systems for patients on Warrants of the Lieutenant Governor in the provincial psychiatric hospitals was conducted. The assessment revealed that, to date, with some exceptions, the system has coped reasonably well. However, with a present count of over 400, and the ever increasing number of patients on warrants, there is a pressing need to improve the overall coordination of the system. The numbers, types and location of beds required to serve the system must be reviewed. Staff needs and training must be addressed. Increased numbers of coordinated research studies and improved information systems are required. System-wide policies and procedures for releasing information to policy, employers and home operators are necessary. As well, there must be a consistent approach in dealing with potential abuse of alcohol and non-prescribed drugs. Systems for authorizing and documenting patient privileges can be improved in some hospitals. A set of guidelines for interpreting terms and conditions of warrants is necessary. Lastly, information for staff treating patients on warrants should be developed and distributed.
PubMed ID
10313024 View in PubMed
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The attitudes toward committal of patients hospitalized in a psychiatric facility for the first time.

https://arctichealth.org/en/permalink/ahliterature229153
Source
Can J Psychiatry. 1990 May;35(4):324-7
Publication Type
Article
Date
May-1990
Author
P. Conlon
H. Merskey
C. Zilli
K. Frommhold
Author Affiliation
Department of Psychiatry, Victoria Hospital, London, Ontario.
Source
Can J Psychiatry. 1990 May;35(4):324-7
Date
May-1990
Language
English
Publication Type
Article
Keywords
Adjustment Disorders - psychology
Adult
Aged
Bipolar Disorder - psychology
Commitment of Mentally Ill - legislation & jurisprudence
Consumer Satisfaction
Delirium, Dementia, Amnestic, Cognitive Disorders - psychology
Female
Humans
Male
Mental Disorders - psychology
Middle Aged
Ontario
Psychotic Disorders - psychology
Schizophrenic Psychology
Substance-Related Disorders - psychology
Suicide, Attempted - psychology
Abstract
This study examines the attitudes toward committal of patients admitted to a psychiatric facility for the first time. Sixteen patients, from a group of 28 patients consecutively admitted to hospital on an Ontario Form 1 certificate were able to complete a satisfactory interview. In general, patients viewed the committal procedure favourably. They endorsed medical professionals as being best qualified to institute the committal procedure. A discrepancy between behaviour documented on the committal form and the patients' own perception of their mental state at the time of committal was noted. These findings are discussed with reference to previous research on civil commitment.
PubMed ID
2346898 View in PubMed
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[Between the legal system and medical and psychosocial intervention: the reality of family members of individuals with mental illness].

https://arctichealth.org/en/permalink/ahliterature144524
Source
Sante Ment Que. 2009;34(2):31-8
Publication Type
Article
Date
2009
Author
Hélène Fradet
Author Affiliation
FFAPAMM, Canada.
Source
Sante Ment Que. 2009;34(2):31-8
Date
2009
Language
French
Publication Type
Article
Keywords
Commitment of Mentally Ill - legislation & jurisprudence
Family
Humans
Mental Disorders - therapy
Mental health services
Mentally Ill Persons
Quebec
Abstract
In this article, the author examines the impact of judicial intervention of individuals with mental illness on family members. The author subunits the hypothesis that an offer of more diversified services could reduce legal intervention of these individuals and consequently attenuate the devastating effects on family members. According to the families' equation, the more services will be developed and adapted, the less frequent family will have to call upon the legal system to intervene and fewer individuals with mental illness will find themselves behind bars.
PubMed ID
20361107 View in PubMed
Less detail

Canadian compulsory community treatment laws: recent reforms.

https://arctichealth.org/en/permalink/ahliterature176185
Source
Int J Law Psychiatry. 2005 Jan-Feb;28(1):13-22
Publication Type
Article
Author
John E Gray
Richard L O'Reilly
Author Affiliation
Adult Mental Health Services, Ministry of Health Services, Victoria, British Columbia, Canada. jegray@shaw.ca
Source
Int J Law Psychiatry. 2005 Jan-Feb;28(1):13-22
Language
English
Publication Type
Article
Keywords
Canada
Commitment of Mentally Ill - legislation & jurisprudence
Community Mental Health Services - legislation & jurisprudence - organization & administration
Health Care Reform - legislation & jurisprudence
Hospitalization - legislation & jurisprudence
Humans
Informed consent
Mental Disorders - therapy
Patient Rights - legislation & jurisprudence
Recurrence - prevention & control
Abstract
This paper addresses the principles underlying compulsory community treatment (CCT) and discusses the different provisions in Canada's twelve jurisdictions. Comparisons with different models of CCT in other countries are also drawn. CCT is not only intended to reduce relapses it is also a "least restrictive" alternative to in-patient detention. Seven of the twelve Canadian mental health acts allow conditional leave from hospital. Two jurisdictions provide community treatment orders, but require two or three previous in-patient admissions. Criteria for CCT, in most jurisdictions, includes that there is a "likelihood of significant mental or physical deterioration". The requirement for previous hospitalization for CCT in Canada, unlike other countries, precludes CCT for use with first episode patients. Some jurisdictions require consent for CCT. Most jurisdictions explicitly state that the services necessary for the CCT conditions must be available.
PubMed ID
15710446 View in PubMed
Less detail

The Canadian Criminal Code provisions for mentally disordered offenders: a survey of experiences, attitudes, and knowledge.

https://arctichealth.org/en/permalink/ahliterature196183
Source
Can J Psychiatry. 2000 Nov;45(9):816-21
Publication Type
Article
Date
Nov-2000
Author
A S Crisanti
J. Arboleda-Florez
H. Stuart
Author Affiliation
Department of Psychology, University of Hawaii, Kealakekua, Hawaii, USA. crisanti@hawaii.edu
Source
Can J Psychiatry. 2000 Nov;45(9):816-21
Date
Nov-2000
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Canada
Clinical Competence
Commitment of Mentally Ill - legislation & jurisprudence
Criminal Law - education
Curriculum
Education, Medical, Continuing
Female
Forensic Psychiatry - education
Health services needs and demand
Humans
Insanity Defense
Male
Middle Aged
Prisoners - legislation & jurisprudence
Psychiatry - education
Abstract
To systematically survey Alberta psychiatrists and lawyers regarding their knowledge of, attitudes toward, and experiences with the Criminal Code provisions regarding mentally disordered offenders to better understand the lack of impact in practice patterns.
A survey design was used, and 2 questionnaires, 1 for lawyers and 1 for psychiatrists, were developed and mailed out.
Out of 245 surveys sent to psychiatrists, 141 were returned, giving a response rate of 57%. The number of lawyers practising criminal law could not be determined, and 5273 surveys were sent to all lawyers on the Law Society of Alberta mailing list. Of these, 564 were returned, giving an overall response rate of 11%. The response rate for lawyers practising criminal law is unknown. Overall, lawyers were younger than psychiatrists. Most of the respondents in both groups were men. Overall, attitudes toward offenders with mental illness were very similar among lawyers and psychiatrists. Compared with lawyers, psychiatrists had significantly more correct responses to the items assessing knowledge. With a highest possible knowledge score of 27, the average score was 16 (SD 5.7) for psychiatrists and 13 (SD 7.23) for lawyers.
The lack of familiarity with many of the key provisions among psychiatrists and lawyers is worrisome and suggests the need for educational materials to improve knowledge of the Criminal Code provisions governing mentally disordered offenders.
PubMed ID
11143831 View in PubMed
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274 records – page 1 of 28.