S.H. Pedersen , F. Lindström , J. Nyman , A.G. Crocker , L. Eriksson , T. Nilsson
{"title":"瑞典住院法医精神卫生服务的实际目标——在向门诊护理过渡的过程中,对满足和未满足的康复需求进行定性比较分析","authors":"S.H. Pedersen , F. Lindström , J. Nyman , A.G. Crocker , L. Eriksson , T. Nilsson","doi":"10.1016/j.ijlp.2025.102138","DOIUrl":null,"url":null,"abstract":"<div><div>Forensic mental health services (FMHS) seek to alleviate mental illness and reduce the risk of (violent) recidivism, but they may also be understood to be responsible for supporting patients with many other aspects of their often challenging lives. In practice, the task of an inpatient institution such as FMHS is concluded when the patient can transition to outpatient care, a move which is governed by law. Therefore, the practical goals are at least partly set by legal criteria for transition to outpatient care. Using qualitative comparative analysis, this study identifies systematic patterns of rehabilitative needs as assessed by clinicians that differentiate between FMHS patients who are deemed ready for outpatient care and those who are not. It also identifies how such systematic patterns align with legal criteria governing the transition to outpatient care. We find systematic patterns of rehabilitative needs that are associated with being considered ready for outpatient care and that these patterns map meaningfully onto the legislative criteria for forensic psychiatric care in Sweden. Mental health needs, violence risk needs, and needs associated with social functioning all bear on readiness for outpatient care but only in conjunction with one of the other. The results indicate that the transition to forensic outpatient care in Sweden depends on aspects outside the core objectives of non-recidivism and mental health, and rest on efforts by actors external to FMHS. This places high demands on clarity of institutional boundaries and the role of social functioning needs in decisions about compulsory care.</div></div>","PeriodicalId":47930,"journal":{"name":"International Journal of Law and Psychiatry","volume":"103 ","pages":"Article 102138"},"PeriodicalIF":1.3000,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The practical goals of inpatient forensic mental health services in Sweden – A qualitative comparative analysis of met and unmet rehabilitative needs in the transition to outpatient care\",\"authors\":\"S.H. Pedersen , F. Lindström , J. Nyman , A.G. Crocker , L. Eriksson , T. Nilsson\",\"doi\":\"10.1016/j.ijlp.2025.102138\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>Forensic mental health services (FMHS) seek to alleviate mental illness and reduce the risk of (violent) recidivism, but they may also be understood to be responsible for supporting patients with many other aspects of their often challenging lives. In practice, the task of an inpatient institution such as FMHS is concluded when the patient can transition to outpatient care, a move which is governed by law. Therefore, the practical goals are at least partly set by legal criteria for transition to outpatient care. Using qualitative comparative analysis, this study identifies systematic patterns of rehabilitative needs as assessed by clinicians that differentiate between FMHS patients who are deemed ready for outpatient care and those who are not. It also identifies how such systematic patterns align with legal criteria governing the transition to outpatient care. We find systematic patterns of rehabilitative needs that are associated with being considered ready for outpatient care and that these patterns map meaningfully onto the legislative criteria for forensic psychiatric care in Sweden. Mental health needs, violence risk needs, and needs associated with social functioning all bear on readiness for outpatient care but only in conjunction with one of the other. The results indicate that the transition to forensic outpatient care in Sweden depends on aspects outside the core objectives of non-recidivism and mental health, and rest on efforts by actors external to FMHS. This places high demands on clarity of institutional boundaries and the role of social functioning needs in decisions about compulsory care.</div></div>\",\"PeriodicalId\":47930,\"journal\":{\"name\":\"International Journal of Law and Psychiatry\",\"volume\":\"103 \",\"pages\":\"Article 102138\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-08-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Law and Psychiatry\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0160252725000718\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"LAW\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Law and Psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0160252725000718","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"LAW","Score":null,"Total":0}
The practical goals of inpatient forensic mental health services in Sweden – A qualitative comparative analysis of met and unmet rehabilitative needs in the transition to outpatient care
Forensic mental health services (FMHS) seek to alleviate mental illness and reduce the risk of (violent) recidivism, but they may also be understood to be responsible for supporting patients with many other aspects of their often challenging lives. In practice, the task of an inpatient institution such as FMHS is concluded when the patient can transition to outpatient care, a move which is governed by law. Therefore, the practical goals are at least partly set by legal criteria for transition to outpatient care. Using qualitative comparative analysis, this study identifies systematic patterns of rehabilitative needs as assessed by clinicians that differentiate between FMHS patients who are deemed ready for outpatient care and those who are not. It also identifies how such systematic patterns align with legal criteria governing the transition to outpatient care. We find systematic patterns of rehabilitative needs that are associated with being considered ready for outpatient care and that these patterns map meaningfully onto the legislative criteria for forensic psychiatric care in Sweden. Mental health needs, violence risk needs, and needs associated with social functioning all bear on readiness for outpatient care but only in conjunction with one of the other. The results indicate that the transition to forensic outpatient care in Sweden depends on aspects outside the core objectives of non-recidivism and mental health, and rest on efforts by actors external to FMHS. This places high demands on clarity of institutional boundaries and the role of social functioning needs in decisions about compulsory care.
期刊介绍:
The International Journal of Law and Psychiatry is intended to provide a multi-disciplinary forum for the exchange of ideas and information among professionals concerned with the interface of law and psychiatry. There is a growing awareness of the need for exploring the fundamental goals of both the legal and psychiatric systems and the social implications of their interaction. The journal seeks to enhance understanding and cooperation in the field through the varied approaches represented, not only by law and psychiatry, but also by the social sciences and related disciplines.