Treatment and Control

Abstract

The life of older mentally ill offenders (OMIOs) is often characterized by successive periods of detention in correctional facilities, admissions to psychiatric services, and unsuccessful attempts to live independently. Through in-depth interviews, eight personal stories from OMIOs under supervision of the commission of social defence in Ghent (Belgium) were analyzed in the phenomenological research tradition. The results of the study reveal that OMIOs had more positive and less negative experiences in prison settings when compared with other institutional care settings. Independent living, unsurprisingly, is favored the most. This may be due to the fact that the latter option fosters personal competence, feelings of being useful, personal choices, and contact with the “outside” world. Even in later lifetime, a combined approach of risk assessment with improvement of well-being remains valuable to stimulate offender rehabilitation. Therefore, more research into concepts that could be used to support OMIOs needs further consideration.

Care for older forensic mental health patients: A consensus guidance document

“…Views on activities were mixed. Some patients felt there were enough [25, 29]; others not [27]. However, dissatisfaction with the accessibility or meaningfulness of activities was widespread [23, 25, 26].…”

“…Most participants in De Smet et al [27] had extensive histories of placements in penal or psychiatric settings. Patients in two studies identified psychological needs as especially problematic, expressing that they wanted more psychological support [27, 29]. Sexual needs were not often discussed, but Di Lorito et al [29] reported these were important for some patients, but not everyone.…”

“…Studies described negative perceptions of service provision. For instance, patients identified that missing from service provision was help for alcohol misuse, appropriate psychological and psychiatric support, that there were not enough activities, that some activities provided were not useful and/or were age inappropriate and patients experienced boredom in relation to certain activities [27]. This held true across inpatients and community service provision.…”

Psychogeriatric Care in a Forensic Setting: Mitigating Stress and Burnout for Forensic Nurses

“…De Smet, et al, state that age-related cognitive disorders are an underestimated element in the forensic evaluation of older offenders, and that "the need for an early mental health assessment, particularly for age-related cognitive mental disorders and physical problems is warranted." 9 Regarding patients from long-term residential care, "very little has been published on the epidemiology or issues regarding criminal offenders in long-term care facilities." 8 In the case study by Valdez et al, 8 nursing home staff voiced being highly distressed with having to care for a patient who was diagnosed with vascular dementia, had a history of incarceration for sexual assault; "some staff members wondered if it would be appropriate for them to file criminal complaints regarding his behaviour.…”

What characterizes a good mental health professional in court-mandated treatment settings?: Findings from a qualitative study with older patients and mental health care professionals

“…The fact that they are a population of high needs requiring intensive resources substantiates the need for research on particular therapy requirements for this age group. Also existing studies with older adults in the forensic context discuss service experiences of older persons [ 62 – 65 ], but they do not specifically investigate whether and how therapist characteristics and activities can impact on the therapy.…”