International Journal of Law and Psychiatry最新文献

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The RECAPACITA project: Description of the clinical, neuropsychological and functional profile of a sample of people with severe mental disorder and legal capacity modification in Spain RECAPACITA项目:描述西班牙严重精神障碍和法律行为能力改变患者样本的临床、神经心理学和功能概况
IF 2.3 4区 医学
International Journal of Law and Psychiatry Pub Date : 2023-05-01 DOI: 10.1016/j.ijlp.2023.101874
Silvia Marcó-García , Georgina Guilera , Marta Ferrer-Quintero , Susana Ochoa , Gemma Escuder-Romeva , Arantxa Martínez-Mondejar , Vanessa Montalbán-Roca , Núria del Cacho , Elena Rubio-Abadal , Ana Escanilla-Casal , Francisco Martínez-Zambrano , Sol Balsells-Mejía , Elena Huerta-Ramos
{"title":"The RECAPACITA project: Description of the clinical, neuropsychological and functional profile of a sample of people with severe mental disorder and legal capacity modification in Spain","authors":"Silvia Marcó-García ,&nbsp;Georgina Guilera ,&nbsp;Marta Ferrer-Quintero ,&nbsp;Susana Ochoa ,&nbsp;Gemma Escuder-Romeva ,&nbsp;Arantxa Martínez-Mondejar ,&nbsp;Vanessa Montalbán-Roca ,&nbsp;Núria del Cacho ,&nbsp;Elena Rubio-Abadal ,&nbsp;Ana Escanilla-Casal ,&nbsp;Francisco Martínez-Zambrano ,&nbsp;Sol Balsells-Mejía ,&nbsp;Elena Huerta-Ramos","doi":"10.1016/j.ijlp.2023.101874","DOIUrl":"10.1016/j.ijlp.2023.101874","url":null,"abstract":"<div><p>Severe mental disorder (SMD) includes people with long-term mental disorders, disability and social dysfunction. The mental capacity evaluation of the people has been a key aspect in legislative systems around the world and different proposals have been made. In countries like Spain, until 2021, the mental capacity of individuals was assessed by means of legal proceedings. In the last years, there has been a notable increase in the number of claims for legal incapacity, but no data are available on the total number of persons with CM, neither on the specific pathologies, or clinical and cognitive profiles. In view of the total absence of data on the profile of people with SMD and modification of capacity, the RECAPACITA study was born. This study includes patients with SMD and CM, as well as those without CM, with the aim to describe exhaustively their clinical, neuropsychological and functional profile of people with SMD and CM, as well as obtaining a basic description of the social environment.</p></div><div><h3>Objectives</h3><p>To describe CM in SMD, to identify clinical diagnoses, clinical severity and neuropsychological deterioration. Methods: Cross-sectional descriptive study. 77 adult patients with SMD and CM, inpatients from the mental health sector of the Parc Sanitari Sant Joan de Déu (Spain), outpatients linked to the community rehabilitation services (CRS), and penitentiary inmates. CM, sociodemographic, clinical, functional and neuropsychological data are collected.</p></div><div><h3>Results</h3><p>In the sample, 59.5% present total CM. 74.7% are men (mean: 52.5 years). 87,0% have a diagnosis of schizophrenia. The estimated premorbid IQ is 91.4. The Global Assessment of Functioning (GAF) had a mean of 50.5, the “Clinical Global Impression Scale” (CGI) was 4.6 and Scale Unawareness of Mental Disorders (SUMD) was 9.28. The cognitive results shows a profile with slow proceeding speed (mean scale score: 6.6), good working memory (mean SC: 8.3) and adequate verbal comprehension (mean SC: 7.3). In memory, coding is altered (Pz: −1.9), and long-term spontaneous recall (Pz: −2.3). In abstract reasoning, a slight alteration is obtained (Mean SC: 6), as well as in semantic fluency (Mean SC: 6.3), phonological (Mean SC: 5.9), and inhibitory capacity (Mean SC: 5.7).</p></div><div><h3>Conclusions</h3><p>Most of the sample are men with schizophrenia, with a total MC assumed by a tutelary foundation. They show a moderate alteration in global functioning and clinical global impression, with partial awareness of the disease. They present dysexecutive mild cognitive impairment, with poor memory coding and free retrieval capacity, and a normal IQ, adequate verbal comprehension and working memory. This study is the first to present objective data on the psychiatric, functional and cognitive status of a group of patients with CM. Such research could be a good starting point to address a topic of great interest from the health, social and legal p","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9629410","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}
引用次数: 1
Criminal recidivism of patients in Swedish forensic psychiatry: A register-based comparison study 瑞典法医精神病学患者的犯罪再犯:一项基于登记的比较研究
IF 2.3 4区 医学
International Journal of Law and Psychiatry Pub Date : 2023-05-01 DOI: 10.1016/j.ijlp.2023.101884
Eirini Alexiou , Thomas Nilsson , Peter Andiné , Alessio Degl' Innocenti
{"title":"Criminal recidivism of patients in Swedish forensic psychiatry: A register-based comparison study","authors":"Eirini Alexiou ,&nbsp;Thomas Nilsson ,&nbsp;Peter Andiné ,&nbsp;Alessio Degl' Innocenti","doi":"10.1016/j.ijlp.2023.101884","DOIUrl":"10.1016/j.ijlp.2023.101884","url":null,"abstract":"<div><h3>Background</h3><p>The aim of this study was to evaluate criminal outcomes of mentally disordered offenders in compulsory forensic psychiatric care during the year 2010 versus 2018. More specifically, we sought to identify the occurrence of new criminal sentences during ongoing treatment and possible factors associated with recidivistic criminality. Another aim was to map previous criminality, types of index crime, and whether there were any changes within this decade.</p></div><div><h3>Methods</h3><p>Crime-, clinical, and treatment-related variables were collected from the Swedish National Forensic Psychiatric Register for all unique inpatients registered from January 1–December 31 in 2010 (<em>N</em> = 717) and 2018 (<em>N</em> = 757). The mean, frequency, percentage, and standard deviation were calculated per variable and stratified by study year and gender. Between-group comparisons were made using <em>t</em>-tests and Chi-square tests. Binary logistic regression was performed to determine whether variables expected to be associated with recidivism showed any relation to criminal recidivism for each study cohort.</p></div><div><h3>Results</h3><p>Most patients were male and approximately one-quarter and one-half of the men, respectively, had a previous sentence for non-violent and violent crimes. The 2018 cohort showed significantly lower rates of sentences to forensic psychiatry with special court supervision although the numbers were low in both cohorts and for both men and women. Previous violent conviction was associated with criminal recidivism during treatment in 2010, while this was joined by index crime under the influence of alcohol/illicit drugs for the 2018 cohort.</p></div><div><h3>Conclusions</h3><p>Overall, these results showed more similarities between the 2010 and 2018 cohorts then dissimilarities, while on the other hand some quite substantial differences were described between males versus females. The results of this study indicate that it may be possible to tailor forensic psychiatric treatment to gender as a proxy for other variables related to increased criminal recidivism in offenders sentenced to forensic psychiatric care.</p></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9576559","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}
引用次数: 0
A scoping review of the forensic psychiatric expertise for compulsory treatment application in Brazil 对巴西强制治疗应用的法医精神病学专业知识的范围审查
IF 2.3 4区 医学
International Journal of Law and Psychiatry Pub Date : 2023-05-01 DOI: 10.1016/j.ijlp.2023.101887
Rita de Cassia Consule, Carla Aparecida Arena Ventura
{"title":"A scoping review of the forensic psychiatric expertise for compulsory treatment application in Brazil","authors":"Rita de Cassia Consule,&nbsp;Carla Aparecida Arena Ventura","doi":"10.1016/j.ijlp.2023.101887","DOIUrl":"10.1016/j.ijlp.2023.101887","url":null,"abstract":"<div><p>In the Brazilian penal system, a person with a mental disorder who commits an offense may be exempt from penalty if, at the time of the offense, they were entirely unable to understand the illicit character of the fact. A forensic psychiatric expert makes this determination and may also recommend to the magistrate the type of commitment to be applied. As a rule, this measure is stipulated based on the judge's sentence rather than the kind of treatment that the mental disorder requires. This difference motivates the present study that seeks to identify criteria for expertise. Additionally, this work focuses on the biopsychological method which influences the application of the measure as detailed in the expert's report. Expert reports have considerable importance in criminal proceedings and often influence determinations of the deadline for compliance and, potentially, hospitalisation. For this question, a scoping review searched for relevant literature, regardless of the study design. Of 1014 references, 27 answered the guiding question, giving rise to 10 categories with several items corresponding to the criteria for expertise. These items, although not exhaustive, demonstrated the deficient interrelationship between law and mental health due to the lack of communication and interaction between them the two. This could be addressed through interdisciplinary legislation or alteration of criminal and criminal procedural laws. Additionally, the lack of communication could be further addressed through the magistrate's interpretation of mental health laws as a new parameter for criminal law based on the human dignity principle which recognises fundamental human rights.</p></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9931772","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}
引用次数: 0
Hospital break. An eight-year review of escapes and absconds from two high security forensic centers 医院休息。这是两所高度戒备的法医中心八年来的越狱和潜逃案件回顾
IF 2.3 4区 医学
International Journal of Law and Psychiatry Pub Date : 2023-05-01 DOI: 10.1016/j.ijlp.2023.101886
Inge Jeandarme , Sam Vandenbosch , Jan Boucké , Ingrid Dekkers , Gokhan Goktas , Peter Vanhopplinus
{"title":"Hospital break. An eight-year review of escapes and absconds from two high security forensic centers","authors":"Inge Jeandarme ,&nbsp;Sam Vandenbosch ,&nbsp;Jan Boucké ,&nbsp;Ingrid Dekkers ,&nbsp;Gokhan Goktas ,&nbsp;Peter Vanhopplinus","doi":"10.1016/j.ijlp.2023.101886","DOIUrl":"10.1016/j.ijlp.2023.101886","url":null,"abstract":"<div><h3>Background</h3><p>Increasing freedom of movement and community reintegration is a vital part of recovery for forensic service users. Clinical teams realize that risk of unauthorized leave exists when granting leave, tasking them with balancing the recovery-based treatment needs of the patients with the larger obligation to protect the public from undue risk of harm. While considerable literature exists on unauthorized leave from acute psychiatric units, there is still little research specific to unauthorized leave from forensic settings.</p></div><div><h3>Aims</h3><p>The aim of this study is twofold. First, to examine the prevalence rates and characteristics of unauthorized leaves (i.e., absconds and escapes) among 654 high security forensic patients. Second, to identify individual patient factors associated with unauthorized leaves. A broad array of risk factors is taken into account, including demographic, clinical, judicial and criminal factors.</p></div><div><h3>Principal results</h3><p>During the 8-year period (17th of November 2014 until 17th of November 2022), there were 59 unauthorized leaves, which represents a very low percentage (0.2%) relative to the total number of leaves. Most patients returned to the hospital or were caught within one week. The reasons that led to an unauthorized leave were in more than half of the incidents frustration and in more than a third goal-directed. Only a minority of the unauthorized leaves was associated with subsequent offending, notwithstanding substance use was more frequent. Patients that absconded or escaped more often had a personality and comorbid substance misuse disorder, but less often a paraphilic disorder. They were younger, had more convictions and higher risk scores. After logistic regression, only personality disorder, comorbid substance misuse disorder and number of convictions were independently associated with unauthorized leave.</p></div><div><h3>Conclusions</h3><p>The results of this study indicate that ULs occurred rarely, and in most instances, patients returned within a short period without further incidents. Personality disordered patients with comorbid substance misuse and prior convictions posed the greatest risk to abscond or escape. Overall, the rate of unauthorized leaves and subsequent offending was small relative to the total number of leaves. This suggests that the risk for absconding was assessed in an adequate manner by the clinical teams. The study hopefully adds to reducing the stigma towards leaves from forensic psychiatric hospitals.</p></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9568073","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}
引用次数: 0
A systematic mapping review identifying key features of restraint research in inpatient pediatric psychiatry: A human rights perspective 一项确定住院儿科精神病学约束研究关键特征的系统制图审查:人权视角
IF 2.3 4区 医学
International Journal of Law and Psychiatry Pub Date : 2023-05-01 DOI: 10.1016/j.ijlp.2023.101894
Elvira Pértega , Christopher Holmberg
{"title":"A systematic mapping review identifying key features of restraint research in inpatient pediatric psychiatry: A human rights perspective","authors":"Elvira Pértega ,&nbsp;Christopher Holmberg","doi":"10.1016/j.ijlp.2023.101894","DOIUrl":"10.1016/j.ijlp.2023.101894","url":null,"abstract":"<div><h3>Introduction</h3><p>Restraints, a highly regulated and contentious measure in pediatric psychiatry, have significant negative impacts on children. The application of international human rights standards, such as the Convention of the Rights of the Child (CRC) and the Convention of the Rights of Persons with Disabilities (CRPD), has spurred global efforts to reduce or eliminate the use of restraints. However, a lack of consensus on definitions and terminology, as well as quality indicators in this field, hinders the ability to compare studies and evaluate interventions consistently.</p></div><div><h3>Aim</h3><p>To systematically map existing literature on restraints imposed upon children in inpatient pediatric psychiatry against a human rights perspective. Specifically, to identify and clarify gaps in literature in terms of publication trends, research approaches, study contexts, study participants, definitions and concepts being used, and legal aspects. These aspects are central to assess whether published research is contributing to achieve the CRPD and the CRC in terms of interpersonal, contextual, operational, and legal requirements of restraints.</p></div><div><h3>Methods</h3><p>A systematic mapping review based on PRISMA guidelines was conducted, adopting a descriptive-configurative approach to map the distribution of available research and gaps in the literature about restraints in inpatient pediatric psychiatry. Six databases were searched for literature reviews and empirical studies of all study designs published between each database's inception and March 24, 2021, manually updated on November 25, 2022.</p></div><div><h3>Results</h3><p>The search yielded 114 English-language publications, with a majority (76%) comprising quantitative studies that relied primarily on institutional records. Contextual information about the research setting was provided in less than half of the studies, and there was an unequal representation of the three main stakeholder groups: patients, family, and professionals. The studies also exhibited inconsistencies in the terms, definitions, and measurements used to examine restraints, with a general lack of attention given to human rights considerations. Additionally, all studies were conducted in high-income countries and mainly focused on intrinsic factors such as age and psychiatric diagnosis of the children, while contextual factors and the impact of restraints were not adequately explored. Legal and ethical aspects were largely absent, with only one study (0.9%) explicitly referencing human rights values.</p></div><div><h3>Conclusions</h3><p>Research on restraints of children in psychiatric units is increasing; however, inconsistent reporting practices hinder the understanding of the meaning and frequency of restraints. The exclusion of crucial features, such as the physical and social environment, facility type, and family involvement, indicates inadequate incorporation of the CRPD. Additionally, t","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9581144","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}
引用次数: 0
“Everyone means well but the one person who's really going to go to bat” - experiences and perspectives of substitute decision makers in caring for their loved ones with serious mental illness “每个人都是好意,但只有一个人真正要去战斗”——替代决策者在照顾患有严重精神疾病的亲人时的经验和观点
IF 2.3 4区 医学
International Journal of Law and Psychiatry Pub Date : 2023-05-01 DOI: 10.1016/j.ijlp.2023.101873
Samuel Law , Vicky Stergiopoulos , Juveria Zaheer , Arash Nakhost
{"title":"“Everyone means well but the one person who's really going to go to bat” - experiences and perspectives of substitute decision makers in caring for their loved ones with serious mental illness","authors":"Samuel Law ,&nbsp;Vicky Stergiopoulos ,&nbsp;Juveria Zaheer ,&nbsp;Arash Nakhost","doi":"10.1016/j.ijlp.2023.101873","DOIUrl":"10.1016/j.ijlp.2023.101873","url":null,"abstract":"<div><p>In the era of on-going efforts to empower persons with mental illness to be independent decision makers as informed by the United Nations' Convention on the Rights of Persons with Disability (CRPD), family members acting as substitute decision makers (SDM) for people suffering from disabling serious mental illness (SMI) remain an integral part of the medical-legal system in psychiatric care in many parts of the world, including Canada; yet their experiences and perspectives are rarely studied. This explorative qualitative study examines the lived experiences and reflections of 14 family member SDMs in Toronto, Canada. Five key themes related to being SDM emerged: 1) Varied subjective understanding of the responsibility and authority of the SDM role; 2) Varied role demands and impact on SDMs' lives; 3) Challenges in dealing with the mental health system; 4) Leveraging decision making status to promote patient care; and 5) SDM role impact on family relationships. The need to improve SDM understanding of their role, acknowledging their value and care-taker burden, finding a balance for their involvement, and improving their support in efforts to enhance care for the patients are discussed.</p></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9575805","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}
引用次数: 0
Persons with mental disorders and assisted dying practices in Spain: An overview 精神障碍患者和协助死亡的做法在西班牙:概述
IF 2.3 4区 医学
International Journal of Law and Psychiatry Pub Date : 2023-03-01 DOI: 10.1016/j.ijlp.2023.101871
Sergio Ramos-Pozón , Núria Terribas-Sala , Anna Falcó-Pegueroles , Begoña Román-Maestre
{"title":"Persons with mental disorders and assisted dying practices in Spain: An overview","authors":"Sergio Ramos-Pozón ,&nbsp;Núria Terribas-Sala ,&nbsp;Anna Falcó-Pegueroles ,&nbsp;Begoña Román-Maestre","doi":"10.1016/j.ijlp.2023.101871","DOIUrl":"10.1016/j.ijlp.2023.101871","url":null,"abstract":"<div><p>On 25 June 2021, the Law on Euthanasia in Spain came into force, providing for two modes of helping an individual end their life: euthanasia and/or medically assisted suicide. Among the requisites that a request for euthanasia has to fulfil are that the individual must be suffering a <em>severe, chronic and debilitating condition</em> or a <em>severe and incurable disease</em>, at the same time as that person shows the necessary <em>competence to decide</em>. The possibility exists that a patient suffering mental health problems submits such a request; however, the specific characteristics of a mental health disorder make such a request considerably more complex. In this article, based on a narrative review of the law itself and the related literature, the requisites established under the law are analysed from an ethical-legal perspective with the aim of defining when a request for euthanasia from a person with a mental health disorder may be deemed legitimate and in line with legal provisions. This should help clinicians make rational, reasoned decisions when dealing with a request of this type.</p></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9474119","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}
引用次数: 1
England and Wales draft Mental Health Bill: Implications for people with intellectual disabilities 英格兰和威尔士精神卫生法草案:对智力残疾者的影响
IF 2.3 4区 医学
International Journal of Law and Psychiatry Pub Date : 2023-03-01 DOI: 10.1016/j.ijlp.2023.101868
John L. Taylor, Carole Burrell
{"title":"England and Wales draft Mental Health Bill: Implications for people with intellectual disabilities","authors":"John L. Taylor,&nbsp;Carole Burrell","doi":"10.1016/j.ijlp.2023.101868","DOIUrl":"10.1016/j.ijlp.2023.101868","url":null,"abstract":"<div><p>The draft Mental Health Bill published by the UK Government in July 2022 aims to reform mental health legislation in England and Wales. One significant proposal is to remove intellectual disability and autism from the scope of the legislation in all but a limited number of circumstances. The basis for this proposed change is not clear and there are no plans to introduce alternatives to the current legislation for people with intellectual disabilities and autism whose behaviour is challenging and present significant risks to themselves or others. This paper examines the implications of these proposals for people with intellectual disabilities. It considers the New Zealand experience as the only other common-law jurisdiction to implement a similar legislative change. Links to the government's Transforming Care de-institutionalisation programme and associated policies are explored and calls for a review of this approach are set out.</p></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9119441","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}
引用次数: 1
The role of ‘micro-decisions’ in involuntary admissions decision-making for inpatient psychiatric care in general hospitals in South Africa “微观决策”在南非综合医院精神科住院病人非自愿住院决策中的作用
IF 2.3 4区 医学
International Journal of Law and Psychiatry Pub Date : 2023-03-01 DOI: 10.1016/j.ijlp.2023.101869
Marisha Wickremsinhe , Suvira Ramlall , Douglas Wassenaar , Michael Dunn
{"title":"The role of ‘micro-decisions’ in involuntary admissions decision-making for inpatient psychiatric care in general hospitals in South Africa","authors":"Marisha Wickremsinhe ,&nbsp;Suvira Ramlall ,&nbsp;Douglas Wassenaar ,&nbsp;Michael Dunn","doi":"10.1016/j.ijlp.2023.101869","DOIUrl":"10.1016/j.ijlp.2023.101869","url":null,"abstract":"<div><p>While the ethics of involuntary admission for psychiatric inpatient care is widely contested, the practice is legally permissible across most jurisdictions. In many countries, laws governing the use of involuntary admission set out core criteria under which involuntary admission is permitted; these parameters broadly related to either risk of harm to self or others, need for treatment, or both. In South Africa, the use of involuntary admission is governed by the Mental Health Care Act no. 17 of 2002 (MHCA 2002), which sets out clear criteria to direct mental healthcare practitioners' decision-making and delineates a process by which decision-making should occur. However, recent research suggests that, in practice, the process of decision-making differs from the procedure prescribed in the MHCA 2002. To further explore how decision-making for involuntary admission occurs in practice, we interviewed 20 mental healthcare practitioners, all with extensive experience of making involuntary admission decisions, working in district, regional, and tertiary hospitals across five provinces. We also interviewed four mental health advocates to explore patient-centered insights. Our analysis suggests that the final decision to involuntarily admit individuals for a 72-h assessment period under the MHCA 2002 was preceded by a series of ‘micro-decisions’ made by a range of stakeholders: 1) the family's or police's decision to bring the individual into hospital, 2) a triage nurse's decision to prioritise the individual along a mental healthcare pathway in the emergency centre, and 3) a medical officer's decision to sedate the individual. Practitioners reported that the outcomes of each of these ‘micro-decisions’ informed aspects of their final decision to admit an individual involuntarily. Our analysis therefore suggests that the final decision to admit involuntarily cannot be understood in isolation because practitioners draw on a range of additional information, gleaned from these prior ‘micro-decisions’, to inform the final decision to admit.</p></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9473663","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}
引用次数: 1
Assessing the validity of self-report of psychopathy short-form (SRP-SF) in incarcerated offenders from Chile and Uruguay 智利和乌拉圭在押罪犯精神病自我报告的效度评估
IF 2.3 4区 医学
International Journal of Law and Psychiatry Pub Date : 2023-03-01 DOI: 10.1016/j.ijlp.2023.101867
Nicolás Trajtenberg , Olga Sánchez de Ribera , Amy Nivette , Elizabeth León-Mayer , Craig S. Neumann
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