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Forensic Psychiatry

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Tasman’s Psychiatry
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Abstract

Forensic psychiatry is an exciting specialty of psychiatry. It takes care of chronic, highly complicated psychiatric patients with problems in various domains, e.g., diagnostic comorbidity, and circumstantial risks. In this chapter, we will provide a brief overview of the most important issues in forensic psychiatry. First, we define forensic psychiatry. Next, key themes in the practice of forensic psychiatry are described. Important data about the relationship between psychiatric disorders and offending are shown. Several steps in the assessment of forensic psychiatry are highlighted: the process, information gathering, diagnosis, formulation, identification of risk factors, and risk assessment and risk management. Psychological and biological treatment, therapeutic milieu, therapeutic use of security, and multidisciplinary and multiagency working are also briefly reviewed. Principles of treatment in various settings, such as community treatment, secure forensic psychiatric hospitals, and prison treatment, are mentioned as well. Finally, some special populations are described, such as sex offenders, female offenders, intellectually disabled offenders, stalkers, older offenders, and lesbian, gay, bisexual, and transgender inmates. The issue of cultural competence and the situation in low- and middle-income countries are also considered.

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References

  • Abdulmalik, J., Abiodun Badru, O., & Ozioma Madu, M. (2021). Forensic mental health care: Practice and policy in Africa. In A. Ogunwale, A. Ogunlesi, S. M. Shepherd, K. I. Serpa, & J. P. Singh (Eds.), The handbook of forensic mental health in Africa. Routledge.

    Google Scholar 

  • Alarcon, R. D. (1993). Perspectivas de la investigacion psiquiatrica en America Latina para el siglo XXI [Perspectives in psychiatric research in Latin America for the 21st century]. Acta Psiquiatrica y Psicologica de America Latina [Acta Psychiatry Psychology Latin America], 39, 19–31.

    CAS  PubMed  Google Scholar 

  • Alarcon, R. D., & Aguilar-Gaxiola, S. A. (2000). Mental health policy developments in Latin America. Bulletin of the World Health Organization, 78, 483–490.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Almanzar, S., Katz, C. L., & Harry, B. (2015). Treatment of mentally ill offenders in nine developing Latin American countries. Journal of the American Academy of Psychiatry and the Law, 43, 340–349.

    PubMed  Google Scholar 

  • American Academy of Psychiatry and the Law. (2005). Ethics guidelines for the practice of forensic psychiatry (adopted May 2005). http://aapl.org/ethics.htm. Accessed 13 Mar 2021.

  • Andrews, D. A., & Bonta, J. (2006). The psychology of criminal conduct (4th ed.). LexisNexis.

    Google Scholar 

  • Andrews, D. A., & Bonta, J. (2010). Rehabilitating criminal justice policy and practice. Psychology, Public Policy, and Law, 16, 39–55.

    Article  Google Scholar 

  • Bannon, S. M., Salis, K. L., & O’Leary, K. D. (2015). Structural brain abnormalities in aggression and violent behavior. Aggression and Violent Behavior, 25, 323–331.

    Article  Google Scholar 

  • Baranyi, G., Scholl, C., Fazel, S., Patel, V., Priebe, S., & Mundt, A. P. (2019). Severe mental illness and substance use disorders in prisoners in low-income and middle-income countries: A systematic review and meta-analysis of prevalence studies. The Lancet Global Health, 7, e461–e471.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bhugra, D., Ventriglio, A., & Bhui, K. S. (2018). Practical cultural psychiatry. Oxford University Press.

    Book  Google Scholar 

  • Binswanger, I. A., Krueger, P. M., & Steiner, J. F. (2009). Prevalence of chronic medical conditions among jail and prison inmates in the USA compared with the general population. Journal of Epidemiology and Community Health, 63(11), 912–919.

    Article  CAS  PubMed  Google Scholar 

  • Bonta, J., & Wormith, J. S. (2013). Applying the risk-need-responsivity to offender assessment. In L. A. Craig, L. Dixon, & T. A. Gannon (Eds.), What works in offender rehabilitation: An evidence based approach to assessment and treatment (pp. 72–93). Wiley.

    Google Scholar 

  • Bonta, J., Wallace-Capretta, S., & Rooney, J. (2000). A quasi-experimental evaluation of an intensive rehabilitation supervision program. Criminal Justice and Behavior, 27(3), 312–329.

    Article  Google Scholar 

  • Brown, D., Larkin, F., Sengupta, S., Romero-Ureclay, J. L., Ross, C. C., Gupta, N., et al. (2014). Clozapine: An effective treatment for seriously violent and psychopathic men with antisocial personality disorder in a UK high-security hospital. CNS Spectrum, 19, 391–402.

    Article  Google Scholar 

  • Cantor, J. M., Blanchard, R., Robichaud, L. K., & Christensen, B. K. (2005). Quantitative reanalysis of aggregate data on IQ in sexual offenders. Psychological Bulletin, 131, 555–568.

    Article  PubMed  Google Scholar 

  • Craven, S., Brown, S. J., & Gilchrist, E. (2006). Sexual grooming of children: Review of literature and theoretical considerations. Journal of Sexual Aggression, 12(3), 287–299.

    Article  Google Scholar 

  • Crocker, A. G., Livingston, J. D., & Leclair, M. C. (2017). Forensic mental health systems internationally. In R. Roesch & A. N. Cook (Eds.), Handbook of forensic mental health services (pp. 3–76). Routledge.

    Chapter  Google Scholar 

  • De Vogel, V., & Krabbendam, A. (2019). Meisjes en vrouwen in de forensische psychiatrie [Girls and women in forensic psychiatry]. In K. Goethals, G. Meynen, & A. Popma (Eds.), Leerboek forensische psychiatrie [Textbook of forensic psychiatry] (pp. 103–117). de Tijdstroom.

    Google Scholar 

  • Douglas, K. S., Hart, S. D., Webster, C. D., & Belfrage, H. (2013). HCR:V3 Historical, clinical, risk management (version 3): Professional guidelines for evaluating risk of violence. Mental Health, Law, and Policy Institute, Simon Fraser University.

    Google Scholar 

  • Eastman, N., Adshead, G., Fox, S., Latham, R., & Whyte, S. (2012). Forensic psychiatry. OUP Oxford.

    Google Scholar 

  • Eytan, A., Ngirababyeyi, A., Nkubili, C., & Mahoro, P. N. (2018). Forensic psychiatry in Rwanda. Global Health Action, 11(1), 1509933.

    Article  PubMed  PubMed Central  Google Scholar 

  • Fazel, S., & Danesh, J. (2002). Serious mental disorder in 23,000 prisoners: A systematic review of 62 surveys. Lancet, 359, 545–550.

    Article  PubMed  Google Scholar 

  • Fazel, S., Fiminska, Z., Cocks, S., & Coid, J. (2016). Patient outcomes following discharge from secure psychiatric hospitals: Systematic review and meta-analysis. British Journal of Psychiatry, 208, 17–25.

    Article  Google Scholar 

  • Frogley, C., Taylor, D., Dickens, G., & Picchioni, M. (2012). A systematic review of the evidence of clozapine’s anti-aggressive effects. International Journal of Neuropsychopharmacology, 15, 1351–1371.

    Article  CAS  PubMed  Google Scholar 

  • Ghossoub, E., & Felthous, A. R. (2020). Mental illness and the Lebanese criminal justice system: Practices and challenges. International Journal of Law and Psychiatry, 71, 101604.

    Article  PubMed  Google Scholar 

  • Goethals, K. (2019). Forensic psychiatry. In M. Hermans, T. Chay-Hoon, & E. Pi (Eds.), Education about mental health and illness (pp. 231–243). Springer.

    Chapter  Google Scholar 

  • Goethals, K., Gunn, J., & Calcedo-Barba, A. (2012). Selling forensic psychiatry: Recruiting for the future, establishing services. Criminal Behaviour and Mental Health, 22(4), 261–270.

    Article  PubMed  Google Scholar 

  • Gunn, J. (1986). Education and forensic psychiatry. Canadian Journal of Psychiatry, 31, 273–279.

    Article  CAS  PubMed  Google Scholar 

  • Gunn, J., & Mevis, P. (2018). Adversial versus inquisitorial systems of trial and investigation. In K. Goethals (Ed.), Forensic psychiatry and psychology in Europe. A cross-border study guide (pp. 3–17). Springer.

    Chapter  Google Scholar 

  • Gunn, J., Joseph, P., & Mackay, R. D. (2014). Criminal and civil law for the psychiatrist in England and Wales. In J. Gunn & P. Taylor (Eds.), Forensic psychiatry. Clinical, legal and ethical issues (2nd ed., pp. 18–55). CRC Press.

    Chapter  Google Scholar 

  • Hanson, K., Bourgon, G., Helmus, L., & Hodgson, S. (2009). A meta-analysis of the effectiveness of treatment for sexual offenders: risk, need, and responsivity. Public Safety Canada (Ottawa Ontario).

    Google Scholar 

  • Hanson, R. K., & Bussière, M. T. (1998). Predicting relapse: A meta-analysis of sexual offender recidivism studies. Journal of Consulting and Clinical Psychology, 66(2), 348–362.

    Article  CAS  PubMed  Google Scholar 

  • Hanson, R. K., & Morton-Bourgon, K. E. (2004). Predictors of sexual recidivism: An updated meta-analysis. Corrections user report no. 2004-02. Public Safety Canada.

    Google Scholar 

  • Hanson, R. K., & Morton-Bourgon, K. E. (2005). The characteristics of persistent sexual offenders: A meta-analysis of recidivism studies. Journal of Consulting and Clinical Psychology, 73, 1154–1163.

    Article  PubMed  Google Scholar 

  • Hart, S., Michie, C., & Cooke, D. (2007). Precision of actuarial risk assessment instruments: Evaluating the ‘margins of error’ of group v. individual predictions of violence. The British Journal of Psychiatry. Suppl. 49(49), s60–65.

    Google Scholar 

  • Harris, A. J. R., Phenix, A., Hanson, R. K., & Thornton, D. (2003). STATIC-99R coding manual: Revised 2003. Her Majesty the Queen in Right of Canada.

    Google Scholar 

  • Harris, G. T., Rice, M. E., & Quinsey, V. L. (2016). Violence risk appraisal guide-revised, 2013: User guide. Data Services, Queen’s University Library.

    Google Scholar 

  • Hassan, T., Nizami, A. T., & Asmer, M. S. (2017). Forensic psychiatric service provision in Pakistan and its challenges. British Journal of Psychiatry International, 14(2), 40–44.

    PubMed  PubMed Central  Google Scholar 

  • Holland, T., Clare, C. H., & Mukhopadhyay, T. (2002). Prevalence of criminal offending by men and women with intellectual disability and the characteristics of the offenders: Implications for research and service development. Journal of Intellectual Disability, 46(S1), 6–20.

    Article  Google Scholar 

  • Houweling-Meiers, O., & Visser, K. (2005). Sociaal-agogisch werk [Social work]. Van Gorcum.

    Google Scholar 

  • Howner, K., Andiné, P., Engberg, G., Hoxha Ekström, E., Linström, E., Nilsson, M., et al. (2020). Pharmacological treatment in forensic psychiatry – A systematic review. Frontiers in Psychiatry. https://doi.org/10.3389/fpsyt.2019.00963

  • Kapoor, R., & Griffith, E. E. H. (2015). Cultural competence. In R. L. Trestman, K. L. Appelbaum, & J. L. Metzner (Eds.), Oxford textbook of correctional psychiatry (pp. 315–320). Oxford University Press.

    Google Scholar 

  • Kaufman, R., Kapila, K., & Appelbaum, K. L. (2015). Lesbian, gay, bisexual, and transgendered inmates. In R. L. Trestman, K. L. Appelbaum, & J. L. Metzner (Eds.), Oxford textbook of correctional psychiatry (pp. 315–320). Oxford University Press.

    Google Scholar 

  • Kennedy, H., Castelletti, L., & O’Sullivan, O. (2018). Impact of service organization on teaching and training. In K. Goethals (Ed.), Forensic psychiatry and psychology in Europe. A cross-border study guide (pp. 211–238). Springer.

    Chapter  Google Scholar 

  • Konrad, N. (2013). Prison psychiatry. In N. Konrad, B. Völlm, & D. N. Weisstub (Eds.), Ethical issues in prison psychiatry (pp. 3–20). Springer.

    Chapter  Google Scholar 

  • Lindsay, W. R. (2009). The treatment of sex offenders with developmental disabilities. A practice workbook. Wiley.

    Google Scholar 

  • Lipsey, M. W. (2009). The primary factors that characterize effective interventions with juvenile offenders. A meta-analytic overview. Victims and Offenders, 4, 124–147.

    Article  Google Scholar 

  • MacDonald, D. K. (2017). Using the violence risk appraisal guide (VRAG). Retrieved on April 12, 2021 from http://dustinkmacdonald.com/using-violence-risk-appraisal-guide-vrag/

  • Mann, R. E., Hanson, R. K., & Thornton, D. (2010). Assessing risk for sexual recidivism: Some proposals on the nature of psychologically meaningful risk factors. Sexual Abuse, 22(2), 191–217.

    Article  PubMed  Google Scholar 

  • Marquant, T., Sabbe, B., Van Nuffel, M., & Goethals, K. (2016). Forensic assertive community treatment: a review of the literature. Community Mental Health, 52(8), 873–881.

    Google Scholar 

  • McCelland, R., & Harper, C. M. (2016). Respect for confidentiality: Good psychiatric practice. RCP module.

    Google Scholar 

  • McGrath, R. J., Cumming, G., Livingston, J. A., & Hoke, S. E. (2003). Outcome of a treatment program for adult sex offenders: From prison to community. Journal of Interpersonal Violence, 18(1), 3–17.

    Article  Google Scholar 

  • Mullen, P. E., Pathé, M., & Purcell, R. (2009). Stalkers and their victims (2nd ed.). Cambridge University Press.

    Google Scholar 

  • Nedopil, N., Gunn, J., & Thomson, L. (2012). Teaching forensic psychiatry in Europe. Criminal Behaviour and Mental Health, 22(4), 238–246.

    Article  PubMed  Google Scholar 

  • Ogunwale, A., Ogunlesi, A., Shepherd, S., Serpa, K., & Singh, J. (2021). The handbook of forensic mental health in Africa. Routledge.

    Google Scholar 

  • Olangunju, A. T., Oluwaniyi, S. O., Fadipe, B., Ogunnubi, O. P., Oni, A. D., Aina, O. F., et al. (2018). Mental health services in Nigerian prisons: Lessons from a four-year review and the literature. International Journal of Law and Psychiatry, 58, 79–86.

    Article  Google Scholar 

  • Petherick, W. (2017). Stalking. In: The psychology of criminal and antisocial behavior. Victim and offender perspectives (pp. 257–294). Academic.

    Google Scholar 

  • Purvis, M., Ward, T., & Willis, G. (2011). The Good Lives Model in practice: Offence pathways and case management. European Journal of Probation, 3(2), 4–28.

    Article  Google Scholar 

  • Recupero, P. R., & Price, M. (2018). Geriatric forensic psychiatry. In L. H. Gold & R. L. Frierson (Eds.), The APA textbook of forensic psychiatry geriatric FP (3rd ed., pp. 437–450). American Psychiatric Association Publishing.

    Google Scholar 

  • Reed, J. (2011). The development of forensic psychiatric services. In T. Clark & D. Singh Rooprai (Eds.), Practical forensic psychiatry (pp. 1–11). Hodder & Stoughton Ltd.

    Google Scholar 

  • Resnick, P. J., & Soliman, S. (2011). Draftsmanship. In A. Buchanan & M. A. Norko (Eds.), The psychiatric report. Principles and practice of forensic writing (pp. 81–91). Cambridge Academia Press.

    Chapter  Google Scholar 

  • Royal College of Psychiatrists. (2010). https://www.rcpsych.ac.uk/docs/default-source/training/curricula-and-guidance/curricula-tw-tr-forensic-psychiatry-curriculum-august-2017.pdf?sfvrsn=833f68e5_2

  • Seto, M. (2017). The motivation-facilitation model of sexual offending. Sexual Abuse, 31(1), 3–24.

    Article  PubMed  Google Scholar 

  • Taylor, P., Graf, M., Schanda, H., & Völlm, B. (2012). The treating psychiatrist as expert in the courts: is it necessary or possible to separate the roles of physician and expert? Criminal Behaviour and Mental Health, 22(4), 271–292.

    Article  PubMed  Google Scholar 

  • Thomson, L., Goethals, K., Nitschke, J., & Nedopil, N. (2018). Multi-agency working. In K. Goethals (Ed.), Forensic psychiatry and psychology in Europe. A cross-border study guide (pp. 143–154). Springer.

    Chapter  Google Scholar 

  • van der Helm, P., & van Tol, N. (2013). Teamsamenwerking in de forensisch psychiatrische zorg [Team composition in forensic psychiatric care]. In P. van der Helm, U. Kröger, P. Schaftenaar, & J. van Vliet (Eds.), Leefklimaat in de klinische forensische zorg [Living environment in clinical forensic care] (pp. 255–261). SWP.

    Google Scholar 

  • Völlm, B. A., Clarke, M., Tort Herrando, V., Seppänen, A. O., Gosek, P., Heitzman, J., et al. (2018). European Psychiatric Association (EPA) guidance on forensic psychiatry: Evidence bases assessment and treatment of mentally disordered offenders. European Psychiatry, 51, 58–73. https://doi.org/10.1016/j.eurpsy.2017.12.007

    Article  PubMed  Google Scholar 

  • Wallace, C., Mullen, P., Burgess, P., Palmer, S., Ruschena, D., & Browne, C. (1998). Serious criminal offending and mental disorder. British Journal of Psychiatry, 172, 477–484.

    Article  CAS  Google Scholar 

  • Ward, T., & Gannon, T. A. (2006). Rehabilitation, etiology, and self-regulation: The comprehensive good lives model of treatment for sexual offenders. Aggression and Violent Behavior, 11, 77–94.

    Article  Google Scholar 

  • Ward, T., & Stewart, C. A. (2003). The treatment of sex offenders: Risk management and good lives. Professional Psychology: Research and Practice, 34, 353–360.

    Article  Google Scholar 

  • Whiting, D., Lichtenstein, P., & Fazel, S. (2020). Violence and mental disorders: A structured review of associations by individual diagnoses, risk factors, and risk assessment. Lancet Psychiatry, 8(2), 150–161.

    Article  PubMed  Google Scholar 

  • WHO. (2018). Mental health atlas 2017. WHO.

    Google Scholar 

  • Winters, G. M., & Jeglic, E. I. (2017). Stages of sexual grooming: Recognizing potentially predatory behaviors of child molesters. Deviant Behavior, 38(6), 724–733.

    Article  Google Scholar 

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Goethals, K. (2023). Forensic Psychiatry. In: Tasman, A., et al. Tasman’s Psychiatry. Springer, Cham. https://doi.org/10.1007/978-3-030-42825-9_121-1

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  • DOI: https://doi.org/10.1007/978-3-030-42825-9_121-1

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