Short-term outcomes for forensic patients receiving an absolute discharge under the Canadian Criminal Code

Simpson, Alexander I. F.; Chatterjee, Sumeeta; Duchcherer, Maryana; Ray, Ipsita; Prosser, Aaron; Penney, Stephanie R.

doi:10.1080/14789949.2018.1439992

Cited by 13 publications

(13 citation statements)

References 24 publications

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“…Previous research on patients with schizophrenia also implies that offending behaviors reflects a range of factors from before, during and after active illness [ 32 ], which may be the case for MDOs in general as well. Further investigation on whether these patients’ mental states had worsened and led to reoffending because they had stopped taking their prescribed medication since discharge would nevertheless be highly interesting, especially since Canadian research has shown that medication non-compliance increased significantly in the year following absolute discharge [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

The reconvictions of mentally disordered offenders—how, when, and where?

2022

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Background Little is known about the recidivism of mentally disordered offenders after discharge from forensic psychiatric services. This is problematic because such knowledge could (i) help professionals who encounter this group to better plan interventions to prevent recidivism, (ii) clarify the rates of recidivism post-discharge from forensic psychiatric care and (iii) further develop instruments for specific risk assessment. The aim of this study was to investigate the new crimes of mentally disordered offenders who had been reconvicted after discharge from forensic psychiatric care. Methods Included in this study were all individuals (n = 1142) who had been discharged from forensic psychiatric care in Sweden during 2009–2018, were included in the Swedish National Forensic Psychiatric Register, and had been reconvicted in a criminal court within the follow-up period of 2009–2018 (n = 157, 14% of the population). The follow-up times of the discharged patients within the period varied from 4 to 3644 days, (m = 1697, Md = 1685). Retrospective registry data along with coded data from criminal court judgments (n = 210) were used to create a database. Kaplan–Meier survival analysis and descriptive statistical analysis was performed. Results 75% of included individuals were reconvicted for at least one violent crime, but only 9 individuals were reconvicted for a serious violent crime, which can be compared to the 44 individuals with serious violent index crimes. The most common crime was “Other violent”. The most common sentence was probation. The offender’s most common relationship to the victim was having no known relationship, followed by the victim being a person of authority. The most common circumstance of the crime leading to the reconviction was that it occurred without apparent provocation; other common circumstances were related to the exercise of public authority. The most common crime scene was a public place. Conclusions Even though the reconvictions of this group included many violent crimes, there were very few serious violent crimes. The findings that the victims of the crimes of mentally disordered offenders are most commonly either unknown to the perpetrator or persons of authority, and that the crimes are often perpetrated without apparent provocation or reason, are important information for all professionals who encounter this group and should be taken into consideration to assess risk more accurately.

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Section: Discussionmentioning

confidence: 99%

The reconvictions of mentally disordered offenders—how, when, and where?

2022

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“…All are over the age of 18, fewer than 10% of patients are over 65 years of age. 10,11 About 90% have been found NCRMD, the remainder are UST with about 15% women. Upward of 80% have a primary psychotic illness, another 10% an affective psychosis, and about 10% a primary developmental disorder.…”

Section: The Patient Populationmentioning

confidence: 99%

Management of COVID-19 Response in a Secure Forensic Mental Health Setting: Réponse à la gestion de la COVID-19 dans un établissement sécurisé de santé mentale et de psychiatrie légale

et al. 2020

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Objectives: The coronavirus disease 2019 (COVID-19) pandemic presents major challenges to places of detention, including secure forensic hospitals. International guidance presents a range of approaches to assist in decreasing the risk of COVID-19 outbreaks as well as responses to manage outbreaks of infection should they occur. Methods: We conducted a literature search on pandemic or outbreak management in forensic mental health settings, including gray literature sources, from 2000 to April 2020. We describe the evolution of a COVID-19 outbreak in our own facility, and the design, and staffing of a forensic isolation unit. Results: We found a range of useful guidance but no published experience of implementing these approaches. We experienced outbreaks of COVID-19 on two secure forensic units with 13 patients and 10 staff becoming positive. One patient died. The outbreaks lasted for 41 days on each unit from declaration to resolution. We describe the approaches taken to reduction of infection risk, social distancing and changes to the care delivery model. Conclusions: Forensic secure settings present major challenges as some proposals for pandemic management such as decarceration or early release are not possible, and facilities may present challenges to achieve sustained social distancing. Assertive testing, cohorting, and isolation units are appropriate responses to these challenges.

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“…Protective factors may simply be the absence of risk in a particular domain (e.g., no history of substance abuse), but also include positive personal characteristics (e.g., coping skills, employability), social factors (e.g., peer support, prosocial relationships), and factors related to treatment compliance and responsivity [11,13]. At present, we know strikingly little about the prevalence of strengths-based factors and successful outcomes experienced by forensic patients as they recover and progress from inpatient forensic care to the community [24,42].…”

Section: Risk Assessment and Its Relationship With Patient Recoverymentioning

confidence: 99%

Perceptions of procedural justice and coercion among forensic psychiatric patients: a study protocol for a prospective, mixed-methods investigation

et al. 2020

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Background: The risk and recovery paradigms are the dominant frameworks informing forensic mental health services and have been the focus of increasing research interest. Despite this, there are significant gaps in our understanding of the nature of mental health recovery in forensic settings (i.e., 'secure recovery'), and specifically, the key elements of recovery as perceived by forensic patients and their treatment providers. Importantly, we know little about how patients perceive the forensic mental health system, to what extent they see it as fair and legitimate, and how these perceptions impact upon treatment engagement, risk for adversity, and progress in recovery. Methods: In this prospective, mixed-methods study, we investigate patient perceptions of procedural justice and coercion within the context of the forensic mental health system in Ontario, Canada (final N = 120 forensic patients and their primary care providers). We elicit patient self-assessments of risk and progress in recovery, and assess the degree of concordance with clinician-rated estimates of these constructs. Both qualitative and quantitative methods are used to assess the degree to which patient perceptions of coercion, fairness and legitimacy impact upon their level of treatment engagement, risk for adversity and progress in recovery. A prospective, two-year follow-up will investigate the impact of patient and clinician perspectives on outcomes in the domains of forensic hospital readmission, criminal reoffending, and rate of progress through the forensic system. Discussion: Results from this mixed-methods study will yield a rich and detailed account of patient perceptions of the forensic mental health system, and specifically whether perceptions of procedural fairness, justice and legitimacy, as well as perceived coercion, systematically influence patients' risk for adversity, their ability to progress in their recovery, and ultimately, advance through the forensic system towards successful community living. Findings will provide conceptual clarity to the key elements of secure recovery, and

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Short-term outcomes for forensic patients receiving an absolute discharge under the Canadian Criminal Code

Cited by 13 publications

References 24 publications

The reconvictions of mentally disordered offenders—how, when, and where?

The reconvictions of mentally disordered offenders—how, when, and where?

Management of COVID-19 Response in a Secure Forensic Mental Health Setting: Réponse à la gestion de la COVID-19 dans un établissement sécurisé de santé mentale et de psychiatrie légale

Perceptions of procedural justice and coercion among forensic psychiatric patients: a study protocol for a prospective, mixed-methods investigation

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