An increase in substance misuse rather than other mental disorders has led to increased forensic treatment rates in the Czech Republic

Abstract

It is suggested that limited access to appropriate care forces psychiatric patients towards forensic treatment or to the prison system. According to our data, the number of prisoners, the number of hospitalized psychiatric patients (from 1987 to 2007), the number of court ordered forensic treatments in the Czech Republic (from 1991 to 2007), and the rate of people in psychiatric and sex offender forensic treatment has remained constant. However, an increase (162%) in number of treatments imposed for abusing illicit drugs did occur during this period. This increase contributed to the correlation between both the number of sentences given for protective treatment and the number of all sentenced persons (Pearson cor. 0.647, p < 0,001) and the number of prisoners (Pearson cor. 0.798, p < 0,001). The analysis of all admissions to a forensic facility from a catchment area of 1,260,318 inhabitants shows no increase in number of admission between 2002 and 2007. The same data prove that the number of patients ordered to psychiatric and sexology treatment remained steady and did not reflect changes in the number of prisoners or number of hospitalized patients. This could be explained by a high number of psychiatric hospitalizations protecting the patients from deteriorating to criminal behaviour.

Changes in the Provision of Institutionalized Mental Health Care in Post-Communist Countries

“…This does not necessarily show in the ten-year intervals that we chose for the presentation of the data (e.g. Czech Republic): after the steep drop in the post-revolutionary years, the prison population had gradually increased to the level of before 1989 again, raising the question as to whether people with mental health problems, especially with drug addiction [34], may have replaced dissidents in prisons.…”

Forensic Treatment Services in the Czech Republic: Current State and Future Challenges

“…FT can be imposed either in the inpatient or outpatient setting and can be ordered separately, in addition to punishment or instead of a punishment. Although no legal standard specifies them, FT is traditionally ordered in four areas: a) psychiatry b) sex offender treatment (that is, in offenders with paraphilias and other sexual disorders) c) substance abuse (Vevera et al, 2009) and d) pathological gambling. These treatments can also be imposed in combinations, e.g.…”

“…Data from the registry of the Ministry of Justice does not show a significant rise of FT sentences in the past decade; the numbers of ordered (both outpatient and inpatient FT) oscillate around 600 treatments a year (Figure 1). Since 1990 there has been a rise in ordered FT-476 cases in 1991 to 592 in 2007; this rise is probably due to increased substance abuse treatment (Vevera et al, 2009). There has been only one prevalence study regarding ordered PT diagnosis; this showed on the sample of PH Bohnice (catchment area 1.2million) between the 2002-2007 a rise of PT patients with substance abuse with reduction of PT ordered for schizophrenia (Vevera et al, 2009).…”

“…Salize & Dressing, 2004;H. J. and D. H. Salize, 2005;Sampson, Edworthy, Völlm, & Bulten, 2016a ) or only partially (Mundt et al, 2012;Vevera et al, 2009); therefore this publication attempts to provide some of this missing information.…”