The closing of forensic psychiatric hospitals in Italy: Determinants, current status and future perspectives. A scoping review

Lorito, Claudio Di; Castelletti, Luca; Lega, Ilaria; Gualco, Barbara; Scarpa, Franco; Völlm, Birgit

doi:10.1016/j.ijlp.2017.10.004

Cited by 27 publications

(17 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Not all data used to measure wider social context variables were taken from the same year or source. Italy has closed forensic psychiatric hospitals and converted to fully residential services in 2017 with a 40% reduction in the number of patients compared to the numbers included in our analysis [24]. In Latvia and Finland, forensic epidemiological data were taken from specific districts only.…”

Section: Limitationsmentioning

confidence: 99%

Forensic mental health in Europe: some key figures

Tomlin

Lega

Braun³

et al. 2020

Soc Psychiatry Psychiatr Epidemiol

Self Cite

View full text Add to dashboard Cite

Purpose While the number of forensic beds and the duration of psychiatric forensic psychiatric treatment have increased in several European Union (EU) states, this is not observed in others. Patient demographics, average lengths of stay and legal frameworks also differ substantially. The lack of basic epidemiological information on forensic patients and of shared indicators on forensic care within Europe is an obstacle to comparative research. The reasons for such variation are not well understood. Methods Experts from seventeen EU states submitted data on forensic bed prevalence rates, gender distributions and average length of stay in forensic in-patient facilities. Average length of stay and bed prevalence rates were examined for associations with country-level variables including Gross Domestic Product (GDP), expenditure on healthcare, prison population, general psychiatric bed prevalence rates and democracy index scores. Results The data demonstrated substantial differences between states. Average length of stay was approximately ten times greater in the Netherlands than Slovenia. In England and Wales, 18% of patients were female compared to 5% in Slovenia. There was a 17-fold difference in forensic bed rates per 100,000 between the Netherlands and Spain. Exploratory analyses suggested average length of stay was associated with GDP, expenditure on healthcare and democracy index scores. Conclusion The data presented in this study represent the most recent overview of key epidemiological data in forensic services across seventeen EU states. However, systematically collected epidemiological data of good quality remain elusive in forensic psychiatry. States need to develop common definitions and recording practices and contribute to a publicly available database of such epidemiological indicators.

show abstract

Section: Limitationsmentioning

confidence: 99%

Forensic mental health in Europe: some key figures

Tomlin

Lega

Braun³

et al. 2020

Soc Psychiatry Psychiatr Epidemiol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Finally, the Italian forensic psychiatric system and its recent reforms have been described extensively (2,43). However, the lack of studies supported by data is considered an eminent gap within the Italian system (5), and several authors stress the importance of systematically collecting data for service evaluation (1,44).…”

Section: Introductionmentioning

confidence: 99%

Exploring Needs and Quality of Life of Forensic Psychiatric Inpatients in the Reformed Italian System, Implications for Care and Safety

Vorstenbosch

Castelletti

2020

Front. Psychiatry

Self Cite

View full text Add to dashboard Cite

The Italian forensic psychiatric system underwent drastic reforms. The newly developed facilities are inspired by psychiatric community services, embracing a recovery-oriented approach. Needs and quality of life are broader concepts that consider the more rehabilitative and humanitarian aspects of treatment. In one of the new Italian forensic psychiatric services, this cross-sectional study aimed to investigate the needs and quality of life of forensic psychiatric patients. A second aim was to validate the Italian version of the Forensic inpatient Quality of Life questionnaire Short Version (FQL-SV). Overall, 42 forensic psychiatric patients were assessed using the Forensic version of the Camberwell Assessment of Need (CANFOR), the Historical-Clinical-Risk-Management-20 (HCR-20), the FQL-SV, and the World Health Organization Quality of Life (WHOQoL-Bref). Patients reported significantly fewer needs, whether met or unmet, than their treating clinicians. The general level of agreement between patients and clinicians on specific needs was low Kappa values were < .40 for 64% of the total needs and 46% of the unmet needs. Risk factors according to the HCR-20 mean scores were 13.1, 4.6, and 6.4 for the historical, clinical and risk management subscale. Quality of life was moderate to high for 74% of the patients. Our results showed that lower numbers of needs, whether reported by patients or clinicians, were associated with a better quality of life. The Italian FQL-SV had a Cronbach's alpha of 0.86 and correlated as expected with the WHOQoL-Bref. The FQL-SV is a valid and reliable tool, justifying its use for routinely assessing QoL in Italian forensic psychiatric services. This study enhances our understanding of needs and quality of life of forensic psychiatric patients and how their assessment could have an additional value for recoveryoriented treatment in forensic psychiatry. Although the detained status of forensic patients imposes real limits on the capacity for autonomy and choice, incorporating the patient's perspective on decision-making processes, in relation to aspects of treatment, care, and daily life, may have benefits such as a better treatment adherence or therapeutic alliance. Future research should clarify how routinely assessing needs and quality of life can contribute to the recovery of these forensic psychiatric patients.

show abstract

“…The incarceration or the hospitalization, by themselves, do little to interrupt the vicious circle of mental illnesses and criminal behavior, mainly for those ones who have comorbidity with drug abuse that can make the offenses more frequent or serious (22,23,24). Mentally ill offenders sentenced to incarceration, hospitalization, security measures, exhibit a high rate of recidivism, once they are discharged, and sometimes the relapse into crime seems to be more dangerous.…”

Section: Resultsmentioning

confidence: 99%

“…Correct and loyal relationships with the media help to give the correct information and help people to have a sense of security. News can be blown up out of proportion, stressing the bad points, instead of simply informing people about what really happened [22][23][24][25]. It is good to have contacts with schools and adolescents, so that they can understand that patients are not rejected by society but are still part of it.…”

Section: Information Managementmentioning

confidence: 99%

Patients and carers involvement: Methodologies and experiences in the forensic system

Scarpa¹,

Campani²,

Castelletti³

et al. 2019

psychology-cognition

Self Cite

View full text Add to dashboard Cite

The involvement of the patients inside the forensic institutions can have an added value for enhancing the efficacy of the treatments, improving the Quality of Life for patients and make lesser their length avoiding the long stayer. The Cost Action IS1302 has developed a special goal for Patient Involvement and at the end of the 4 year Action it was held a Training School on this issue. The main techniques and methodology for patient Involvement (Rehabilitation, Advocacy, Recovery) are described and analyzed and collected the paper of the experiences in forensic Institution in Europe. The component of the Training School elaborated a paper with recommendations for achieving the target of Patient Involvement in Forensic treatment.

show abstract

The closing of forensic psychiatric hospitals in Italy: Determinants, current status and future perspectives. A scoping review

Cited by 27 publications

References 28 publications

Forensic mental health in Europe: some key figures

Forensic mental health in Europe: some key figures

Exploring Needs and Quality of Life of Forensic Psychiatric Inpatients in the Reformed Italian System, Implications for Care and Safety

Patients and carers involvement: Methodologies and experiences in the forensic system

Contact Info

Product

Resources

About