Characteristics and Re-Offending Rates Amongst Individuals Found Not Guilty by Reason of Mental Illness (NGMI): A Comparison of Men and Women in a 25-Year Australian Cohort

Dean, Kimberlie; Singh, Sara; Kemp, Richard I.; Johnson, Anina; Nielssen, Olav

doi:10.1080/14999013.2020.1795011

Cited by 12 publications

(11 citation statements)

References 39 publications

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“…Swedish FP patients can be compared to a sample of long-stay patients in English medium and high security FP clinics in which the most prevalent diagnosis was found to be schizophrenia, followed by personality disorders (antisocial and borderline being the most common), intellectual disability and substance abuse issues (5). Similarly, an Australian study of not guilty by reason of mental illness forensic patients over 25 years found that the main primary diagnosis recorded for the patient sample was schizophrenia-spectrum disorder, and the most common comorbid disorders were personality disorders, substance abuse disorders, and intellectual disability (6).…”

Section: Introductionmentioning

confidence: 99%

“…Despite being a combined subset of psychiatric patients and criminal offenders, the assessment and treatment of FP patients cannot simply be extrapolated from general psychiatry or programs within prison and probation services. For example, FP patients frequently have poor literacy skills (7), low motivation for assessment and treatment (8), suffer from multiple psychiatric disorders (6,9), and are involuntarily restricted in their interactions with their community. Unfortunately, for former FP patients and for society at large, reoffending and readmission are common after discharge (10), and increase with length of follow-up (11,12).…”

Section: Introductionmentioning

confidence: 99%

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Immersive Virtual Reality Simulation in Forensic Psychiatry and Adjacent Clinical Fields: A Review of Current Assessment and Treatment Methods for Practitioners

Sygel

Wallinius

2021

Front. Psychiatry

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Background: Research has indicated that interactive, computerized case simulations using immersive virtual reality (VR) technology may be beneficial in the augmentation of conventional methods of assessment and treatment in forensic psychiatry, primarily through providing an engaging and safe environment in which the user can practice and learn skills and behaviors. However, there does not appear to be an overview of current developments available in the field, which may be an obstacle to clinicians considering the use of VR in their clinical practice.Objectives: Current, clinically relevant assessment and treatment methods applying immersive VR in forensic or adjacent clinical settings, were analyzed.Methods: This review surveyed the practical use of immersive VR in forensic psychiatry and relevant adjacent psychiatric and forensic fields from 2016 to 2020 and was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Results: Out of the 1,105 journal articles screened, 14 met criteria for inclusion. Four articles described VR interventions directly addressing forensic psychiatric settings (treatment of general aggression and assessment of sexual offenders against children). The majority of the remaining articles were in the clinical domain of psychosis treatment. Several interventions were designed as part of comprehensive treatment programs, and others were intended as one-off assessments or paired with pre-existing psychological treatment. The degree to which the VR simulations were individualized to the user appeared to be largely dependent upon the extent of provider input. A variety of research methodologies were used in the included articles and the majority had limitations common to small-scale, non-randomized studies. None of the studies reported serious adverse effects.Discussion: There is a lack of large randomized controlled trials of current assessments or treatments using VR simulation in forensic psychiatry, let alone those with long-term follow-up, showing clear advantages of VR over standard practice. The evidence thus far is insufficient to recommend immediate and large-scale implementation of any one VR intervention, however, several have been shown to be feasible and acceptable to the participants and to provide insights and inspiration for future research and development.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Immersive Virtual Reality Simulation in Forensic Psychiatry and Adjacent Clinical Fields: A Review of Current Assessment and Treatment Methods for Practitioners

Sygel

Wallinius

2021

Front. Psychiatry

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“…Findings from this project will be situated within the literature generated by other longitudinal studies investigating outcomes in mentally disordered offenders. For example: the retrospective follow-up National Trajectory Project in Canada ( 37 ); a 25-year retrospective follow-up of men and women found not guilty by reason of mental illness in Australia ( 38 ); and recent register-based retrospective follow-up studies in Sweden, such as a 24-year follow-up of sexual offenders with/without psychotic disorders ( 39 ) and a study of post-discharge recidivism for patients admitted to forensic services between 2009 and 2018 ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

Protocol for the CONNECT Study: A National Database and Prospective Follow-Up Study of Forensic Mental Health Patients in Germany

2022

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In Germany, the most frequently used legal section to order forensic mental health treatment is § 63 of the Penal Code (Strafgesetzbuch; StGB). This disposition is primarily aimed at individuals with major mental illnesses who are not fully responsible for a criminal act they committed. Despite evaluation and follow-up studies being conducted within individual hospitals or federal states we lack key epidemiological data on this patient group across the whole country. The present study aims to fill this gap by conducting an annual survey of all eligible forensic mental health hospitals to develop a database of basic clinical, legal and demographic data. Staff at participating hospitals will complete an online survey answering questions about individual patients using routinely collected hospital records. Over the duration of the study, eight-and-a-half years, we aim to collect data on approximately N = 6,450 patients. Alongside important clinical data, we will use official reconviction data at 3- and 6-year follow-ups to investigate the number and types of crimes committed by discharged patients. We aim to extend the scientific literature on factors associated with reconviction in the Risk-Needs-Responsivity model by also measuring the extent to which treatment engagement and programme completion during care predicts reconviction. This study protocol describes the background and theoretical framework for this study, its methods of data collection and analysis, and steps taken to ensure compliance with ethical and data protection principles.

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“…Sex was also not associated with recidivism in a study on 315 patients discharged from a medium-secure hospital in the UK ( 60 ). In a recent study of 477 offenders with mental disorders by Dean et al results suggested that while sex was not associated with reconviction rates overall, women reoffended to a higher degree than men during the first 12 months following release ( 61 ). Sex differences in criminal recidivism studies in populations of offenders with mental disorders thus present diverging results.…”

Section: Discussionmentioning

confidence: 99%

Criminal recidivism in offenders with and without intellectual disability sentenced to forensic psychiatric care in Sweden—A 17-year follow-up study

et al. 2022

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BackgroundOffenders with intellectual disability (ID) constitute a distinct subgroup of offenders with mental disorders. Regarding criminal recidivism, it is unclear whether or not offenders with ID in forensic psychiatric settings differ from offenders without ID. Factors associated with criminal recidivism among offenders with ID have been scarcely investigated.AimTo investigate the association between ID and criminal recidivism among offenders sentenced to forensic psychiatric care and to explore the impact of clinical, sociodemographic and offense variables.Materials and methodsWe conducted a retrospective cohort study based on Swedish nationwide registers. A total of 3,365 individuals being sentenced to forensic psychiatric care in Sweden in 1997–2013 were followed from the forensic psychiatric assessment until first reconviction, death, emigration, or 31 December 2013, whichever occurred first. Cox regression models compared rates of recidivism in individuals with and without ID. Impact of clinical, sociodemographic, and offense variables on risk of criminal recidivism was presented as hazard ratios (HRs) with 95% confidence intervals (CIs).ResultsOut of 3,365 offenders sentenced to forensic psychiatric care, 259 (7.7%) were diagnosed with ID. During follow-up (0–17 years, median 6 years), one third (n = 1,099) of the study population relapsed into criminality, giving a recidivism rate of 50.5 per 1,000 person-years. We observed an association between ID and a decreased risk of recidivism (HR 0.8, 95% CI 0.6–1.0, p = 0.063), although this reached statistical significance only for the subgroup of male offenders (HR 0.8, 95% CI 0.6–1.0, p = 0.040) and not females (HR 1.0, 95% CI 0.6–1.8). ID offenders with concurrent ADHD tended to have a higher rate of recidivism (73.9 per 1,000 person-years, HR 1.2, 95% CI 0.6–2.4) than ID offenders without ADHD (42.5 per 1,000 person-years, HR 0.8, 95% CI 0.6–1.1). Amongst ID offenders, concurrent autism spectrum disorder, young age or male sex were not associated with recidivism, while previous criminal convictions were strongly associated with recidivism.ConclusionA diagnosis of ID was associated with a lower risk of criminal recidivism among male offenders sentenced to forensic psychiatric care. The association between ADHD and recidivism among ID offenders highlights eligible focus areas in the management of offenders with ID.

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Characteristics and Re-Offending Rates Amongst Individuals Found Not Guilty by Reason of Mental Illness (NGMI): A Comparison of Men and Women in a 25-Year Australian Cohort

Cited by 12 publications

References 39 publications

Immersive Virtual Reality Simulation in Forensic Psychiatry and Adjacent Clinical Fields: A Review of Current Assessment and Treatment Methods for Practitioners

Immersive Virtual Reality Simulation in Forensic Psychiatry and Adjacent Clinical Fields: A Review of Current Assessment and Treatment Methods for Practitioners

Protocol for the CONNECT Study: A National Database and Prospective Follow-Up Study of Forensic Mental Health Patients in Germany

Criminal recidivism in offenders with and without intellectual disability sentenced to forensic psychiatric care in Sweden—A 17-year follow-up study

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