Forensic Psychiatry
Insanity Defense
Dangerous Behavior
Psychiatry
Social Control, Formal
Commitment of Mentally Ill
Crime
Mental Disorders
Biological Psychiatry
Child Psychiatry
Community Psychiatry
Adolescent Psychiatry
Medical practice: defendants and prisoners. (1/133)
It is argued in this paper that a doctor cannot serve two masters. The work of the prison medical officer is examined and it is shown that his dual allegiance to the state and to those individuals who are under his care results in activities which largely favour the former. The World Health Organisation prescribes a system of health ethics which indicates, in qualitative terms, the responsibility of each state for health provisions. In contrast, the World Medical Association acts as both promulgator and guardian of a code of medical ethics which determines the responsibilities of the doctor to his patient. In the historical sense medical practitioners have always emphasized the sanctity of the relationship with their patients and the doctor's role as an expert witness is shown to have centered around this bond. The development of medical services in prisons has focused more on the partnership between doctor and institution. Imprisonment in itself could be seen as prejudicial to health as are disciplinary methods which are more obviously detrimental. The involvement of medical practitioners in such procedures is discussed in the light of their role as the prisoner's personal physician. (+info)Dilemmas of medical ethics in the Canadian Penitentiary Service. (2/133)
There is a unique hospital in Canada-and perhaps in the world-because it is built outside prison walls and it exists specifically for the psychiatric treatment of prisoners. It is on the one hand a hospital and on the other a prison. Moreover it has to provide the same quality and standard of care which is expected of a hospital associated with a university. From the time the hospital was established moral dilemmas appeared which were concerned with conflicts between the medical and custodial treatment of prisoners, and also with the attitudes of those having the status of prisoner-patient. Dr Roy describes these dilemmas and attitudes, and in particular a special conference which was convened to discuss them. Not only doctors and prison officials took part in this meeting but also general practitioners, theologians, philosophers, ex-prisoners, judges, lawyers, Members of Parliament and Senators. This must have been a unique occasion and Dr Roy's description may provide the impetus to examine these prison problems in other settings. (+info)Food refusal in prisoners: a communication or a method of self-killing? The role of the psychiatrist and resulting ethical challenges. (3/133)
Food refusal occurs for a variety of reasons. It may be used as a political tool, as a method of exercising control over others, at either the individual, family or societal level, or as a method of self-harm, and occasionally it indicates possible mental illness. This article examines the motivation behind hunger strikes in prisoners. It describes the psychiatrist's role in assessment and management of prisoners by referring to case examples. The paper discusses the assessment of an individual's competence to commit suicide by starvation, legal restraints to intervention, practical difficulties and associated ethical dilemmas. Anecdotal evidence suggests that most prisoners who refuse food are motivated by the desire to achieve an end rather than killing themselves, and that hunger-strike secondary to mental illness is uncommon. Although rarely required, the psychiatrist may have an important contribution to make in the management of practical and ethical difficulties. (+info)Stalking--a contemporary challenge for forensic and clinical psychiatry. (4/133)
BACKGROUND: Stalking is causing pervasive and intense personal suffering and is an area of psychiatry that is currently overlooked. AIMS: To review demographic and clinical characteristics of stalkers as well as the psychological consequences for victims of stalking. METHOD: A Medline and PsycLit search was conducted on stalking, forensic psychiatry, personality disorders, de Clerambault syndrome and erotomania, with respect to the relevance of the articles selected for stalking. RESULTS: Stalkers are best thought of as a heterogeneous group whose behaviour can be motivated by different forms of psychopathology, including psychosis and severe personality disorders. CONCLUSIONS: There is a clear need to arrive at a consensus on a typology of stalkers and associated diagnostic criteria. The effectiveness of psychological and pharmacological treatments have not yet been investigated. Treatment may need to be supplemented with external incentives provided by the legal system. (+info)Evidence-based rehabilitation in forensic psychiatry. (5/133)
BACKGROUND: The extent to which forensic psychiatric rehabilitation alters an individual's level of risk is unclear. AIMS: To highlight some essential features of a forensic psychiatric rehabilitation system, and to discuss risk assessment in this context to create a conceptual framework for risk research and practice. METHOD: The applicability of risk assessment instruments to forensic psychiatric rehabilitation was examined. Core processes and elements considered essential in this type of rehabilitative work were reviewed. RESULTS: Current risk research has limited application to rehabilitation. Future research aimed at analysing forensic psychiatric rehabilitation will be hampered by the complexity of the treatment systems and the number of methodological issues relevant to this type of research. CONCLUSIONS: Novel research approaches are suggested to analyse further the risk factors and processes important in forensic psychiatric rehabilitation. (+info)Future directions for treatment in forensic psychiatry. (6/133)
BACKGROUND: As the availability of mental hospital beds has fallen, so the number of people in prison has risen. AIMS: To review current policy trends in British forensic psychiatry and put them in an international context. METHOD: Literature on the prevalence rates of psychiatric disorder in prisons and jails has been examined for the USA, England & Wales and New Zealand. RESULTS: All studies show a high prevalence of mental disorder in prisons and jails. Authors in the USA suggest that prisons are replacing mental hospitals. In England & Wales rates of psychosis are reported as 4-10% for remanded prisoners and 2-7% for sentenced prisoners. Substance misuse among prisoners is a major problem. Prison is the preferred place of disposal for large numbers of mentally disordered people. Does this matter? Why should this be the case? Is this the cheapest option? Politicians are considering new powers to direct more people into institutions (presumably prisons) on the grounds of public protection. CONCLUSIONS: We need more information about attitudes and their formation. We need more interprofessional dialogue about the best arrangements for people with mental disorders, and inter-disciplinary education. (+info)Violence in the workplace: new perspectives in forensic mental health services in the USA. (7/133)
BACKGROUND: This paper reviews current research on workplace violence in the USA and offers suggestions concerning the roles that mental health professionals with forensic expertise can play in this expanding field. AIMS: To clarify the role of the mental health professional in evaluating issues related to workplace violence. METHOD: Manual and computer literature searches were performed. RESULTS: The incidence of reported workplace violence is on the rise and can be devastating beyond the immediate injury. Forensically oriented mental health professionals can assist companies by providing pre-employment screenings, fitness-for-duty evaluations and threat assessment by using the results of current research on potentially violent individuals. CONCLUSIONS: With the growing interest in workplace violence come many opportunities for mental health professionals to assist companies in assessment, intervention and prevention. (+info)Ethnic differences in admissions to secure forensic psychiatry services. (8/133)
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 (CI 5.1-6.3) times as high as, and for Asian males were half, those for White males; for Black females, 2.9 (CI 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. (+info)Forensic psychiatry is a subspecialty of psychiatry that intersects with the law. It involves providing psychiatric expertise to legal systems and institutions. Forensic psychiatrists conduct evaluations, provide treatment, and offer expert testimony in criminal, civil, and legislative matters. They assess issues such as competency to stand trial, insanity, risk assessment, and testamentary capacity. Additionally, they may be involved in the treatment of offenders in correctional settings and providing consultation on mental health policies and laws. Forensic psychiatry requires a thorough understanding of both psychiatric and legal principles, as well as the ability to communicate complex psychiatric concepts to legal professionals and laypersons alike.
The Insanity Defense is a legal concept, rather than a medical one, but it is based on psychological and psychiatric assessments of the defendant's state of mind at the time of the crime. It is used as a criminal defense in which the defendant claims that they should not be held criminally responsible for their actions due to mental illness or disorder that prevented them from understanding the nature and wrongfulness of their behavior.
The specific criteria for an insanity defense vary by jurisdiction, but generally, it requires evidence that the defendant had a severe mental illness or cognitive impairment that significantly affected their ability to appreciate the nature and wrongfulness of their conduct or to conform their behavior to the requirements of the law. If successful, the insanity defense can result in an acquittal, hospitalization, or other dispositions that do not involve incarceration.
It's important to note that the insanity defense is not a determination of whether the defendant is "crazy" or "insane," but rather an assessment of their mental state at the time of the offense and its impact on their legal responsibility for their actions.
Dangerous behavior is a term used to describe any action or inaction that has the potential to cause harm, injury, or damage to oneself or others. This can include a wide range of behaviors, such as:
* Physical violence or aggression towards others
* Substance abuse, including alcohol and drug use
* Risky sexual behavior, such as unprotected sex or multiple partners
* Self-harm, such as cutting or burning oneself
* Suicidal ideation or attempts
* Reckless driving or operating machinery while impaired
* Neglecting one's own health or the health of others
Dangerous behavior can be the result of a variety of factors, including mental illness, substance abuse, trauma, environmental factors, and personality traits. It is important to note that dangerous behavior can have serious consequences for both the individual engaging in the behavior and those around them. If you or someone you know is engaging in dangerous behavior, it is important to seek help from a qualified medical professional as soon as possible.
Psychiatry is the branch of medicine focused on the diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders. A psychiatrist is a medically trained doctor who specializes in psychiatry, and they are qualified to assess both the mental and physical aspects of psychological problems. They can use a variety of treatments, including psychotherapy, medications, psychoeducation, and psychosocial interventions, to help patients manage their symptoms and improve their quality of life.
Psychiatrists often work in multidisciplinary teams that include other mental health professionals such as psychologists, social workers, and mental health nurses. They may provide services in a range of settings, including hospitals, clinics, community mental health centers, and private practices.
It's important to note that while I strive to provide accurate and helpful information, my responses should not be used as a substitute for professional medical advice, diagnosis, or treatment. If you or someone else has concerns about mental health, it is always best to consult with a qualified healthcare provider.
Formal social control, in the context of medical sociology or health sciences, refers to the systematic mechanisms and processes through which society regulates and guides the behavior of its members in accordance with established laws, rules, and norms, particularly in relation to health and healthcare. This can include various formal institutions and agencies such as governmental bodies, regulatory authorities, professional organizations, and healthcare providers that are responsible for enforcing standards, policies, and regulations aimed at ensuring quality, safety, and effectiveness of healthcare services and products.
Examples of formal social control in healthcare may include licensing and accreditation requirements for healthcare professionals and facilities, clinical guidelines and protocols for diagnosis and treatment, quality improvement initiatives, and regulatory oversight of pharmaceuticals and medical devices. These mechanisms help to maintain order, promote compliance with ethical and professional standards, and protect the public's health and well-being.
The "commitment of the mentally ill" refers to a legal process where a person who is deemed to have a mental illness and poses a danger to themselves or others is involuntarily placed in a psychiatric hospital or treatment facility for their own safety and well-being. The specific criteria and procedures for commitment vary by jurisdiction, but generally require a formal evaluation and court order.
The purpose of commitment is to provide intensive treatment and supervision for individuals who are unable to make informed decisions about their own care due to the severity of their mental illness. This legal process is designed to balance the need to protect the individual's civil liberties with the need to ensure public safety and provide necessary medical treatment.
It's important to note that commitment is typically a last resort, after other less restrictive options have been tried or considered. The goal of commitment is to stabilize the individual's condition and help them develop the skills and resources they need to live safely and independently in the community.
I am not a medical professional, but I can tell you that the term "crime" is typically not used in a medical context. A crime is a violation of laws or regulations established by a government and enforced by its authorities. It's a legal concept, not a medical one. However, there are some overlaps between criminal behavior and mental health, as certain mental health conditions may increase the risk of criminal behavior. But it's essential to understand that having a mental health condition does not automatically make someone a criminal.
A mental disorder is a syndrome characterized by clinically significant disturbance in an individual's cognition, emotion regulation, or behavior. It's associated with distress and/or impaired functioning in social, occupational, or other important areas of life, often leading to a decrease in quality of life. These disorders are typically persistent and can be severe and disabling. They may be related to factors such as genetics, early childhood experiences, or trauma. Examples include depression, anxiety disorders, bipolar disorder, schizophrenia, and personality disorders. It's important to note that a diagnosis should be made by a qualified mental health professional.
Biological psychiatry is a branch of medicine that aims to understand and treat mental disorders by studying the biological mechanisms underlying behavior, cognition, and emotion. This can include the study of genetics, neurochemistry, brain structure and function, and other physiological processes that may contribute to the development and expression of mental illnesses.
Biological psychiatrists use a variety of approaches to understand and treat mental disorders, including psychopharmacology (the use of medications to treat psychiatric symptoms), neurostimulation techniques (such as electroconvulsive therapy or transcranial magnetic stimulation), and behavioral interventions (such as cognitive-behavioral therapy).
The ultimate goal of biological psychiatry is to develop more effective treatments for mental illnesses by gaining a deeper understanding of the underlying biological mechanisms that contribute to their development and expression.
Child psychiatry is a medical subspecialty that focuses on the diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders in children, adolescents, and their families. It incorporates various disciplines, including psychology, pediatrics, neurology, social work, nursing, and education, to provide comprehensive care for children with complex needs.
Child psychiatrists use a biopsychosocial approach to understand the underlying causes of a child's difficulties, considering genetic, biological, developmental, environmental, and psychological factors. They are trained to perform comprehensive evaluations, including diagnostic interviews, cognitive and neuropsychological testing, and psychiatric assessments, to develop individualized treatment plans.
Treatment modalities may include psychotherapy (individual, family, or group), medication management, psychoeducation, and coordination with other healthcare professionals and community resources. Child psychiatrists often work in various settings, such as hospitals, clinics, private practices, schools, and residential treatment facilities, to ensure that children receive the necessary support and care for their mental health concerns.
Community psychiatry is a branch of psychiatry that focuses on providing mental health services within the context of a person's community, rather than in a traditional clinical setting such as a hospital or clinic. The goal of community psychiatry is to provide comprehensive, accessible, and personalized mental health care that is integrated into the individual's natural support systems, including their family, friends, and social networks.
Community psychiatrists work closely with other mental health professionals, social workers, and community organizations to develop and implement treatment plans that address the unique needs of each individual. They may provide services in a variety of settings, such as community mental health centers, group homes, schools, and primary care clinics.
The approach of community psychiatry recognizes that mental illness affects not only the individual but also their family, friends, and larger community. Therefore, interventions often focus on improving social determinants of health, such as housing, employment, and education, in addition to providing traditional mental health treatments like medication and therapy.
Overall, community psychiatry aims to reduce stigma around mental illness, improve access to care, and promote recovery and resilience in individuals with mental health conditions.
Adolescent Psychiatry is a branch of medicine that deals with the diagnosis, treatment, and prevention of mental disorders in adolescents, which are individuals typically ranging in age from 13 to 18 years old. This field requires specialized knowledge, training, and expertise in the unique developmental, emotional, and behavioral challenges that adolescents face. Adolescent psychiatrists provide comprehensive assessments, including medical and psychological evaluations, and develop individualized treatment plans that may involve psychotherapy, medication management, and/or coordination with other healthcare professionals and community resources. They also work closely with families to help them understand their adolescent's mental health needs and support their recovery process.
Geriatric psychiatry is a subspecialty of psychiatry that focuses on the mental health concerns of older adults, usually defined as those aged 65 and over. This field addresses the biological and psychological changes that occur with aging, as well as the social and cultural issues that impact the mental health of this population.
The mental health conditions commonly seen in geriatric psychiatry include:
1. Dementia (such as Alzheimer's disease)
2. Depression and anxiety disorders
3. Late-life schizophrenia and other psychotic disorders
4. Substance abuse and addiction
5. Neurocognitive disorders due to medical conditions, such as Parkinson's disease or stroke
6. Sleep disturbances and insomnia
7. Delirium and other cognitive changes related to acute illness or hospitalization
8. Mental health concerns related to chronic medical conditions, such as diabetes or heart disease
9. End-of-life issues and palliative care
10. Issues related to grief, loss, and transitions in later life
Geriatric psychiatrists are trained to recognize and manage these conditions while also considering the potential impact of medications, physical health problems, sensory impairments, and social supports on mental health treatment outcomes. They often work closely with primary care physicians, neurologists, social workers, and other healthcare professionals to provide comprehensive care for older adults.
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