Prevalence of the hospitalisation of mentally ill offenders in the Forensic Unit of the Clinic of Psychiatry in Pristina over a three-year period and long-term strategy implications for the management of the Forensic Mental Health System Service

Medicine, science, and the law (Impact Factor: 0.53). 04/2014; 55(3). DOI: 10.1177/0025802414532247
Source: PubMed


As a new field in our country, forensic psychiatry needs strategies for management and rehabilitation programmes.AimThe aim of this study was to evaluate the sociodemographic characteristics of psychiatrically diagnosed inpatients who were hospitalised in the three years from January 2009 to December 2011 and the prevalence of such diagnoses. The specific objectives of this study were to use our results to identify rehabilitation programmes for the treatment of patients and to identify the specific training needs of mental-health professionals.Methods
In this retrospective study, we collected data about the sociodemographics and violent behaviour of all forensic inpatients who underwent court-ordered psychiatric forensic evaluation and assessment. We reviewed and studied the documented diagnoses based on the following criteria and sources: the ICD-10 criteria for mental disorders, the Structured Clinical Interview (SCID), recidivism rates, criminal data, court records and other hetero-anamnesis data. The data were analysed using a descriptive approach.ResultsThe subjects were referred for forensic psychiatric evaluation, diagnosis and treatment either directly from prison (23.2%) or from the court (76.8%). The majority of the offenders (85.7%) were currently on trial, and charges of physically threatening others were more common than charges of domestic violence or murder. The prevalence of psychiatric diagnosis was 94.6%, and the most common diagnosis was psychosis (69.1%). Drug abuse and personality disorders, including high-risk behaviours, were also common. The overall relapse rate for aggressive behaviour was 48.9%.Conclusion
Rehabilitation programmes for treatment and management are needed that specifically focus on psychotic disorders, severe personality disorders and drug abuse.

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    ABSTRACT: Mentally disordered offenders (MDOs) represent a complex and diverse population who are often regarded as difficult to treat. Accordingly, the practitioners who are tasked with their reintegration face many challenges which are compounded by a paucity of published research on interventions with MDOs and a lack of comprehensive rehabilitation models to orient their practice. This article provides an overview of published literature on interventions used in inpatient forensic mental health services over the past 15 years. The literature is categorized according to its broad theoretical orientation and three broad approaches are identified: (1) Treatments targeting mental illness and other psychological issues; (2) Interventions based on the principles of the Risk-Need-Responsivity (RNR) model that aim to reduce recidivism; and (3) Strength-based models. The literature review highlights a practice of blending divergent models in an attempt to cater to the wide-ranging needs of forensic patients. It is asserted that this practice, which is problematic for a number of reasons, is underpinned by an absence of overarching rehabilitation frameworks to integrate the multiple elements of forensic practice. It is proposed that the Good Lives Model of offender rehabilitation, when adapted for use in a forensic context, may provide a promising way forward.
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