Personality Disorder and Serious Offending: Hospital Treatment Models

Personality Disorder and Serious Offending: Hospital Treatment Models

Personality Disorder and Serious Offending: Hospital Treatment Models

Personality Disorder and Serious Offending: Hospital Treatment Models

Synopsis

People with personality disorder who offend tend to be neglected by health services in most countries. In the UK, there has been renewed interest in the field since government initiatives in the end of the 1990s. Government proposals themselves are controversial, but there is growing recognition that it is unsafe, both for the general public and for the primary sufferer alike, if the neglect continues.Years of experience have combined to provide a highly practical reference work covering: Models of understanding of personality development and disorder- Methods of assessment and treatment and how they can be applied and modified- Special issues - drug misuse, long-stay induced secondary disorders, issues pertinent to women only, 'intractable' patients- A path for care - from initial assessment to the logistics of discharge- Management issues - choosing staff, supervision and support of staff Evidence-based and entirely comprehensive in its approach, practitioners will find Personality Disorder and Serious Offending both a practical and insightful adjunct that will assist them in their work."

Excerpt

One of the strengths of forensic psychiatry in the uk is the emphatic focus on the nature of the therapeutic care and treatment of persons held in the custody of the justice system. For example, in a foundational textbook of British forensic psychiatry, Forensic Psychiatry: clinical, legal and ethical issues (Gunn and Taylor, 2000), great attention is paid to treatment of the mental disorders that one is likely to encounter in the clinical practice of psychiatry in forensic settings. the present book, by Newrith, Meux and Taylor, Personality Disorder and Serious Offending: hospital treatment models, is very much in keeping with the therapeutic focus of British forensic psychiatry.

In contrast, in the usa forensic psychiatry has largely addressed the non-therapeutic assessment and disposition of individuals in both criminal and civil law cases. For example, on 20 May 1985, the American Academy of Psychiatry and the Law (AAPL) adopted the following definition: ‘Forensic psychiatry is a subspecialty of psychiatry in which scientific and clinical expertise is applied to legal issues in legal contexts embracing civil, criminal, correctional or legislative matters; forensic psychiatry should be practiced in accordance with guidelines and ethical principles enunciated by the profession of psychiatry’ (AAPL, 2004). AAPL’s definition included ‘correctional’ legal matters, i.e. issues related to jail and prison confinement, but did not specifically include the provision of therapeutic treatment as one of those ‘correctional’ matters. Similarly, in Principles and Practice of Forensic Psychiatry (Rosner, 2003), produced for the AAPL’s Tri-State Chapter, the focus is on the legal regulation of care and treatment, rather than on the nature of the care and treatment to provide to persons detained in the justice system. Even in Correctional Psychiatry (Rosner and Harmon, 1989), an earlier book prepared under the auspices of AAPL’s Tri-State Chapter, there is only one chapter on therapy: ‘Treatment of Antisocial and Other Personality Disorders in a Correctional Setting’ (Weinstock, 1989).

In the usa throughout most of the twentieth century, treatment of persons held in detention in secure hospitals and correctional facilities was widely regarded as peripheral to the core of forensic psychiatry; that core was considered to be the examination and evaluation of persons for potential and actual report writing and testimony in court cases. in the late 1980s and early 1990s, as the price for formal recognition as a subspecialty of psychiatry, organized American forensic psychiatry was obliged to designate the special population forensic . . .

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