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

IF 1.3 4区 医学 Q1 LAW
S.H. Pedersen , F. Lindström , J. Nyman , A.G. Crocker , L. Eriksson , T. Nilsson
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引用次数: 0

摘要

法医心理健康服务(FMHS)寻求减轻精神疾病和减少(暴力)再犯的风险,但它们也可能被理解为负责在患者经常充满挑战的生活的许多其他方面提供支持。在实践中,像FMHS这样的住院机构的任务是在病人可以过渡到门诊治疗时结束的,这是一个受法律管辖的举动。因此,实际目标至少部分是由过渡到门诊护理的法律标准设定的。通过定性比较分析,本研究确定了临床医生评估的康复需求的系统模式,以区分FMHS患者,哪些被认为准备好了门诊治疗,哪些没有。它还确定了这种系统模式如何与管理过渡到门诊护理的法律标准相一致。我们发现康复需求的系统模式与被认为准备好接受门诊治疗有关,这些模式有意义地映射到瑞典法医精神病学护理的立法标准上。心理健康需求、暴力风险需求和与社会功能相关的需求都对门诊护理的准备程度有影响,但只有与另一个相结合。结果表明,瑞典向法医门诊护理的过渡取决于非再犯和精神健康这一核心目标以外的方面,并取决于FMHS以外行为者的努力。这对明确机构界限和社会功能需求在有关强制保健的决定中的作用提出了很高的要求。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.
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来源期刊
CiteScore
4.70
自引率
8.70%
发文量
54
审稿时长
41 days
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.
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