Predictors of improvement in maximum security forensic hospital patients

Rodenhauser, Paul; Khamis, Harry J.

doi:10.1002/bsl.2370060409

Cited by 24 publications

(15 citation statements)

References 36 publications

(31 reference statements)

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“…It is therefore quite clear that mental health treatment resources are currently far more available in state mental hospitals than in prisons. Rodenhauser and Khamis (1988), Golding, Eaves, and Kowaz (1989), and Bennett and Kish (1990) all reported that the average length of inpatient restoration of competence was six months. However, many defendants continue to remain significantly longer than that, particularly in states that have no limits on commitment, or set the limit to the maximum sentence for the crime charged.…”

Section: Clinical Discussionmentioning

confidence: 96%

Hospitalization of criminal defendants for evaluation of competence to stand trial or for restoration of competence: clinical and legal issues

Miller

2003

Behavioral Sci & The Law

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The clinical and legal literature abounds with articles dealing with competence to stand trial; while most agree that criminal defendants must be capable of defending themselves before the state can bring them to trial, a number of articles are quite critical of the procedures by which these concepts are operationalized, some even going so far as to suggest abolishing the requirement for competence altogether. One of the major problems leading to the criticisms is the unnecessary loss of liberty involved. Although the length of incarceration has decreased significantly since the 1970s, the majority of states still permit, or require, hospitalization for evaluation of competence, and even more so for treatment to restore competence. The author reviews case law and presents data from his survey of current state statutes and responses from state forensic mental health program directors, to demonstrate the rarity of outpatient treatment to restore competence. He argues that outpatient treatment for defendants who do not require hospitalization on clinical or public safety grounds should be available, on both clinical and legal grounds, and provides recommendations for establishing such programs in the community.

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Section: Clinical Discussionmentioning

confidence: 96%

Hospitalization of criminal defendants for evaluation of competence to stand trial or for restoration of competence: clinical and legal issues

Miller

2003

Behavioral Sci & The Law

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“…Rhodenhauser and Khamis () noted that diagnoses of schizophrenia and personality disorders were not significantly related to ultimate restoration success, but defendants without a diagnosis of schizophrenia or a prior history of incarceration and, surprisingly, individuals who refused medication for more than one week while hospitalized were relatively successful with competency restoration. Bennett and Kish () determined that race, education, and marital status did not affect average length of stay (LOS) for inpatient restoration efforts.…”

Section: Introductionmentioning

confidence: 99%

Psycholegal Abilities and Restoration of Competence to Stand Trial

Morris

DeYoung

2012

Behavioral Sci & The Law

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Criminal defendants adjudicated incompetent to stand trial are typically hospitalized for competence restoration in state institutions. Prolonged restoration hospitalizations involve civil rights concerns and increasing financial costs, and there remains interest in determining which individuals are likely to be successfully restored. We retrospectively reviewed hospital records of 455 male defendants admitted to a forensic treatment center for competence restoration in an effort to determine whether psychiatric diagnoses, demographic factors, or psycholegal abilities were predictive of successful or failed restoration. At varying stages of restoration efforts, psychotic disorder, mental retardation, and previous state hospitalization predicted unsuccessful restoration, while substance use and personality disorders were predictive of successful restoration. Psycholegal abilities were predictive of successful restoration and appeared to form a continuum, with basic behavior and outlook, factual legal understanding, and rational attorney assistance factors demonstrating progressively increased importance in successful restoration.

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“…hospitalized for a prolonged period of time to be more likely to have engaged in past criminal and violent behaviours (3,26,35) and to be of younger age at their first delinquency or violent incident (3,16,35). Patients who had been admitted to a (forensic) psychiatric institution before or had been younger at their first psychiatric contact also tended to hospitalized longer (1,7,16,17,31,34,38).…”

Section: Regarding Patients' Criminal Histories Empirical Research Imentioning

confidence: 99%

“…In terms of forensic treatment variables, adverse behaviours and events such as violence, substance abuse, absconding, non-compliance, requirement of seclusion, physical restraints, forced medication, or conditional release failure significantly delayed discharge (1,3,16,26,27,31,33,35,38,42).…”

Section: Regarding Patients' Criminal Histories Empirical Research Imentioning

confidence: 99%

Factors And Predictors Of Length Of Stay In Offenders Diagnosed With Schizophrenia- A Machine-learning-based Approach

Kirchebner

Günther

King

et al. 2020

Preprint

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Background Prolonged forensic psychiatric hospitalizations have raised ethical, economic, and clinical concerns. Due to the confounded nature of factors affecting length of stay of psychiatric offender patients, prior research has called for the application of a new statistical methodology better accommodating this data structure. The present study seeks to examine factors responsible for prolonged detentions of schizophrenic offenders referred to a Swiss forensic hospital using machine learning algorithms more apt to reveal non-linear interdependencies between variables.Methods In this retrospective file and registry study, multidisciplinary notes of 143 schizophrenic delinquents were reviewed by using a structured protocol on patients’ characteristics, criminal and medical history and course of treatment. Via a forward selection procedure, the most influential predictors for length of stay were preselected. Machine learning algorithms identified the most efficient model for predicting length-of-stay.Results/ Conclusions Ten factors prolonging forensic hospitalization were identified: Six were related to aspects of the index offence (index offence, number of crimes, extend of injury to the victim of the offence), two were related to psychopathology at admission or even prior to that (hallucinations in psychiatric history), one alluded to the course of therapy (self-harming during inpatient treatment), and one referred to biographical aspects (poverty during childhood/ adolescence). Results are discussed in light of earlier reports on the subject.

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Predictors of improvement in maximum security forensic hospital patients

Abstract: In a maximum security forensic hospital population (n = 339

Cited by 24 publications

References 36 publications

Hospitalization of criminal defendants for evaluation of competence to stand trial or for restoration of competence: clinical and legal issues

Hospitalization of criminal defendants for evaluation of competence to stand trial or for restoration of competence: clinical and legal issues

Psycholegal Abilities and Restoration of Competence to Stand Trial

Factors And Predictors Of Length Of Stay In Offenders Diagnosed With Schizophrenia- A Machine-learning-based Approach

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