International Journal of Law and Psychiatry最新文献

{"title":"Stakeholder experiences with compulsory treatment at home: A focus-group study","authors":"D.A. de Waardt ,&nbsp;C.L. Mulder ,&nbsp;G.A.M. Widdershoven","doi":"10.1016/j.ijlp.2025.102072","DOIUrl":"10.1016/j.ijlp.2025.102072","url":null,"abstract":"<div><h3>Background</h3><div>Since 2020, Dutch mental health legislation has provided scope for compulsory treatment at home (CTH). Unlike compulsory community treatment (CCT), CTH allows for the use of compulsion in a patient's home, and thus not only in hospital.</div></div><div><h3>Aim</h3><div>To examine several stakeholders' experiences and views regarding CTH and its implementation.</div></div><div><h3>Methods</h3><div>Four focus-groups were performed: one with patients, one with significant others, one with psychiatrists, and one with a mixed group of stakeholders. The transcripts were analyzed thematically.</div></div><div><h3>Results</h3><div>We identified three themes and 16 subthemes. The first theme concerned the potential benefits of CTH, one of which was avoiding admission to hospital. The second theme focused on preconditions for the delivery of CTH, mainly on communication between mental health workers, patients, and significant others; and the importance of a dialogue well in advance of any compulsory care. With regard to the third theme, considerations regarding the delivery of CTH, all stakeholder groups believed that CTH would be most suitable for patients who had a longer history with their treatment team: between them, they would be able to draw up a plan for compulsory care.</div></div><div><h3>Conclusion</h3><div>Stakeholders felt that CTH can work for patients with a longer treatment history whose home situation allows for treatment at home. They regard an advance dialogue and jointly drawing up a crisis plan as important preconditions. Overall, CTH can be regarded as an extra option for enabling an individually tailored approach.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"100 ","pages":"Article 102072"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143444502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overview of forensic outpatients on the medical treatment and supervision act in Japan","authors":"Kumiko Ando ,&nbsp;Kanako Nakazawa ,&nbsp;Shota Matsunaga ,&nbsp;Takayuki Okada","doi":"10.1016/j.ijlp.2025.102074","DOIUrl":"10.1016/j.ijlp.2025.102074","url":null,"abstract":"<div><div>In Japan, the Medical Treatment and Supervision Act (MTSA) has been in effect since 2005, and a support system has been established for those found not guilty by reason of insanity (NGRIs). Under this law, the reintegration of the subjects into society is underway. This paper summarizes the status of forensic outpatients during the seven years after its enactment. Information on forensic outpatients was obtained from 224 designated outpatient medical institutions under the law between 2005 and 2011, the period after the law's implementation. Information on demographic factors, psychiatric status, forensic background, clinical treatment history, and social service utilization was collected. Among the 690 outpatients, the most common diagnosis was F2 (Schizophrenia) (76.4 %), and the most common criminal offense was homicide/attempted homicide (28.8 %). Among the outpatients, 46.2 % developed problematic behavior during treatment, and suicidal behavior was observed in 6.0 % of the patients. Since problematic behaviors during treatment, including suicidal behavior, have been observed, it is necessary to expand support, including the development of proper relationships with patients and the early stages of treatment to promote the integration of forensic patients into society.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"100 ","pages":"Article 102074"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in insanity evaluation. Potential opportunities and current challenges","authors":"Cristina Scarpazza ,&nbsp;Andrea Zangrossi","doi":"10.1016/j.ijlp.2025.102082","DOIUrl":"10.1016/j.ijlp.2025.102082","url":null,"abstract":"<div><div>The formulation of a scientific opinion on whether the individual who committed a crime should be held responsible for his/her actions or should be considered not responsible by reason of insanity is very difficult. Indeed, forensic psychopathological decision on insanity is highly prone to errors and is affected by human cognitive biases, resulting in low inter-rater reliability. In this context, artificial intelligence can be extremely useful to improve the inter-subjectivity of insanity evaluation. In this paper, we discuss the possible applications of artificial intelligence in this field as well as the challenges and pitfalls that hamper the effective implementation of AI in insanity evaluation. In particular, thus far, it is possible to apply only supervised algorithms without knowing which is the ground truth and which data should be used to train and test the algorithms. In addition, it is not known which percentage of accuracy of the algorithms is sufficient to support partial or total insanity, nor which are the boundaries between sanity and partial or total insanity. Finally, ethical aspects have not been sufficiently investigated. We conclude that these pitfalls should be resolved before AI can be safely and reliably applied in criminal trials.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"100 ","pages":"Article 102082"},"PeriodicalIF":1.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143430341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is this an underestimated problem? Using coercion before psychiatric hospitalization","authors":"Urszula Zaniewska-Chłopik ,&nbsp;Marcin Zarzycki ,&nbsp;Maria Załuska","doi":"10.1016/j.ijlp.2025.102068","DOIUrl":"10.1016/j.ijlp.2025.102068","url":null,"abstract":"<div><h3>Background</h3><div>The Mental Health Act (1994) specifies rules of use for direct coercion in Poland.</div><div>Coercion in psychiatric wards may improve the safety of patients and surroundings but influences compliance and satisfaction with treatment. Legal (formal) coercion regulated by law isn't the one and only form of coercion used on people with mental disorders. Pressure, threats and orders from relatives and medical staff in relation to procedures of referral and admission to a psychiatric hospital can be described as informal coercion. In Poland there aren't many studies on the use of coercion before psychiatric hospitalization, which justifies the need to conduct this research.</div></div><div><h3>Objectives</h3><div>Assessment of the extent of coercive measures used prior to admission and the relationships between the use of direct coercion and selected demographic-clinical factors.</div></div><div><h3>Material and methods</h3><div>This study was conducted as part of statutory research at the 4th Clinic of the Institute of Psychiatry and Neurology at the Bielanski Hospital in Warsaw from 1.06.13. to 31.05.14. on all the patients admitted to the psychiatric ward in that period. We gathered data on the extent of coercion in the process of hospital referral, and demographic and clinical data was collected. The following tools were used: a specially prepared questionnaire on the extent of the coercion used prior to admission at the hospital, questionnaire on demographic and clinical data, the Brief Psychiatric Rating Scale (BPRS).</div></div><div><h3>Results</h3><div>Coercion prior to admission to the hospital was applied to 53 % of patients, 45 % received informal coercion, and 8 % were physically coerced. Man were more likely to be coerced than women, for people diagnosed with F10-F19 and F20-F29, physical coercion was used more frequently than in patients with other disorders. Patients undergoing informal coercion on the way to the hospital were significantly older than those who weren't exposed on coercion or experienced physical coercion. Higher severity of almost all BPRS subscales (without anxiety and depression subscale) be found in patients who were coerced on their way to hospital than in patients who were not coerced.</div><div>In the analysis of the logistic regression use of coercion prior to admission to the hospital was positively associated with admission without consent, severity of negative symptoms as well as negatively associated with severity of depression symptoms.</div></div><div><h3>Conclusions</h3><div>The high probability of experience coercion before admission to the psychiatric hospital suggests more attention should be paid to procedures connected with referral and transport before psychiatric hospitalization.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"99 ","pages":"Article 102068"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coercive measures in disability and mental health care services: Mechanical restraints from a bioethical and legal perspective in Spain","authors":"Sergio Ramos-Pozón ,&nbsp;Begoña Román-Maestre ,&nbsp;Blas Blánquez","doi":"10.1016/j.ijlp.2024.102067","DOIUrl":"10.1016/j.ijlp.2024.102067","url":null,"abstract":"<div><div>This article explores the use of coercive measures, particularly mechanical and pharmacological restraints, in disability care settings and mental health services from a bioethical perspective, focusing on how these practices impact the human rights of individuals with mental disorder, focusing on how these practices impact the human rights of individuals with mental disorders. A robust bioethical framework is presented, advocating for principles of autonomy, beneficence, non-maleficence, dignity, dialogical justice, distributive justice, and vulnerability. These principles are integrated to reframe interventions and promote respect for patient rights. The article provides a detailed account of the legal framework governing these practices in Spain, addressing both national and regional legislation, and emphasizing its significance in protecting human rights. Finally, practical recommendations are offered, which have proven effective in significantly reducing the need for coercive interventions. The article concludes by advocating for a transformation in clinical practices, promoting dignified and respectful care in line with a human rights framework, and moving away from unnecessary coercive measures.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"99 ","pages":"Article 102067"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘If someone had stopped to talk to me’: A human rights analysis of Spain's mental health system","authors":"María Laura Serra","doi":"10.1016/j.ijlp.2025.102069","DOIUrl":"10.1016/j.ijlp.2025.102069","url":null,"abstract":"<div><div>This study explores the gap between Spain's mental health legal framework and the lived experiences of users and survivors of psychiatry, including persons with psychosocial disabilities. Employing a socio-legal methodology, it critically contrasts domestic legislation with qualitative data from interviews, uncovering systemic issues that perpetuate coercive practices such as inadequate judicial oversight and the routine use of coercion and isolation. The findings highlight a significant failure to protect patient autonomy and dignity. This research advocates for comprehensive legal and structural reforms to align Spain's mental health care system with international human rights standards. It underscores the need for a person-centered, rights-based approach that prioritises autonomy, informed consent, and dignity, ultimately promoting a mental health care environment that fully upholds human rights.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"99 ","pages":"Article 102069"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143324705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mind over matter: Mental illness and sentencing outcomes among homicide cases in Singapore","authors":"Philip Tanpoco ,&nbsp;Stella Tan Wei Ling ,&nbsp;Kenneth Gerard Koh Wun Wu ,&nbsp;Fong Wan Ru ,&nbsp;Harvinder Kaur ,&nbsp;Daren Ong Guanjie","doi":"10.1016/j.ijlp.2024.102053","DOIUrl":"10.1016/j.ijlp.2024.102053","url":null,"abstract":"<div><div>Singapore implemented legal amendments that led to a transition from a mandatory death penalty to a discretionary death penalty in some cases of murder. This has granted judges greater leeway in the sentencing of homicide offenders, with a decade having now passed since the 2012 amendment. A notable scarcity of research exists to understand the relationship between mental illnesses and criminal culpability, as well as how diminished responsibility impacts sentencing outcomes. A quantitative study of all court judgments in all homicide cases recorded on LawNet (Singapore's legal database) from 2006 to 2020 was conducted to examine the relationship between mental illness, psychiatric disputes, and court outcomes. The findings revealed that the introduction of discretionary death penalty reduced death sentences by half. The study also confirmed the presence of a mental illness is correlated to a greater sentence length, and could even act as an aggravating factor in court outcomes. This research also baselined the typologies of psychiatric disputes among homicide cases in Singapore. Further research on mitigating and aggravating factors in Singapore homicide cases and their impact on sentencing outcomes is recommended.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"99 ","pages":"Article 102053"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health and sentencing: How are judicial decisions made in light of the judgement of R v Vowles?","authors":"George Baldwin ,&nbsp;Samantha Young ,&nbsp;Lucy Fitton ,&nbsp;Ian Edwards ,&nbsp;Michael Butler ,&nbsp;Peter Beazley","doi":"10.1016/j.ijlp.2025.102071","DOIUrl":"10.1016/j.ijlp.2025.102071","url":null,"abstract":"<div><div>In England and Wales, s.45A of the Mental Health Act 1983 allows a judge to pass a sentence including both an immediate direction to hospital as well as a punitive custodial element. <em>R v Vowles</em> provides four specific considerations for judges to attend to when considering such sentences (referred to as the ‘Vowles statements’). The section, however, remains infrequently used. The present study adopted an online experimental methodology to explore decision-making in relation to the Vowles statements. We used a proxy judicial sample who made decisions about the same criminal case vignette. The experimental manipulation meant that participants were exposed to the same information except for the clinical diagnosis: ‘complex mental health condition’, ‘Emotionally Unstable Personality Disorder’ (EUPD) or ‘Schizophrenia’. Participants were asked to decide which sentence they were most likely to give and rate their agreement with the each of the Vowles statements. Analysis considered relationships between Vowles statements, differences between experimental conditions, and the extent to which different factors (including the Vowles statements) predicted the overall sentencing decision. Results identified that s.45A was, by far, the most common sentencing decision, and that agreement on the different Vowles statements was variable. There was limited evidence of an impact of diagnosis on decision-making, except for some weak evidence that an EUPD diagnosis was associated with marginally higher rates of prison sentences. Most importantly, not all of the Vowles statements were predictive of the final sentence, with attitudes towards the need for punishment having the clearest relationship with the final sentencing decision.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"99 ","pages":"Article 102071"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143376871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual liberty, safety and police liabilities under the mental health (care and treatment) act","authors":"Gary K.Y. Chan","doi":"10.1016/j.ijlp.2024.102065","DOIUrl":"10.1016/j.ijlp.2024.102065","url":null,"abstract":"<div><div>How should a society strike a balance between the objective of ensuring safety from dangers that may be posed by individuals believed to have a mental disorder and the deprivation of their liberty? How should police officers discharge their duties in apprehending such individuals with a view to conveying them to a medical practitioner at a psychiatric institution? These legal issues took centrestage in the Singapore High Court decision of <em>Mah Kiat Seng v Attorney-General</em> in which the apprehended individual brought claims in false imprisonment against a police officer. The decision examined the underlying purposes of the Singapore Mental Health (Care and Treatment) Act, the right of the person to be informed of the grounds of apprehension, the bases of the police officer's belief that the person posed a danger to himself or others, and the circumstances in which the police officers may be entitled to immunity from liability to civil or criminal proceedings. The High Court judgment led to statutory amendments to clarify police duties when apprehending such individuals and discussions about enhancements to police training and crisis support services for persons with mental illnesses. With reference to the law and/or policy in Australia and the UK, the paper critiques the judicial findings, the statutory amendments and policy alternatives.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"99 ","pages":"Article 102065"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“It just felt like a rubber stamp”: Family experiences of mental health review board hearings in Ontario, Canada","authors":"Jean-Laurent Domingue ,&nbsp;Steven F Michel ,&nbsp;Jennifer Neves","doi":"10.1016/j.ijlp.2024.102062","DOIUrl":"10.1016/j.ijlp.2024.102062","url":null,"abstract":"<div><div>Involving families in the planning and delivery of care to relatives living with a mental health disorder is beneficial to achieve optimal recovery and medication adherence, and to reduce decompensation and hospital readmission rates. However, in the specific context of forensic mental health, the involvement of families in the planning and dispensation of care to relatives has been difficult. The purpose of our study, which was conducted in Ontario, Canada, was to better understand the interactions between families and the forensic mental health system. To meet this objective, we used a qualitative methodology, namely interpretive phenomenology. We collected data from 17 family members of persons in the forensic mental health system through semi-structured interviews. Interviews were analysed using a three-pronged approach with a particular attention paid to the spatial, temporal, and interpersonal dimensions of families' lived experiences. In this article, we present our findings related to families' experiences with the Review Board, a mental health tribunal responsible for the legal management of patients in the forensic mental health system. We regrouped the experiences of family members in four overarching, and occasionally overlapping, categories: (1) Preparation for Review Board hearings; (2) Review Board hearing processes; (3) Information Discussed during Review Board hearings; and (4) Format of Review Board hearings. Among other things, our findings highlight that Review Boards are experienced by families as rubber-stamping exercises, and that Review Board panels lack sociodemographic diversity. These findings have implications for healthcare professionals and mental health tribunals in Canada and abroad.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"99 ","pages":"Article 102062"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142819820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}