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Management of offenders with mental disorder in specialist forensic mental health services 

Management of offenders with mental disorder in specialist forensic mental health services
Chapter:
Management of offenders with mental disorder in specialist forensic mental health services
Author(s):

Pamela J. Taylor

and Emma Dunn

DOI:
10.1093/med/9780199696758.003.0270
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date: 17 September 2019

Specialist forensic mental health (fmh) services are for people with serious mental disorders and grave offending behaviour who tend to be rejected from mainstream services. Although often triggered by single high profile cases, these specialist services are among the best planned and commissioned services in psychiatry, founded in evidence of need, risk and efficacy of interventions. They are grounded in a multidisciplinary clinical perspective and often have integrated academic units. They interface both with other clinical services and with the criminal justice service. Good relationships with the local community are vital for establishment and growth. Secure psychiatric hospitals have two overarching aims: improving health and delivering safety for patients and others. In secure hospitals, patients’ autonomy is limited in a number of important ways: they may not be allowed to leave the hospital at all, may be confined to a particular area within the hospital, and/or treatment may be enforced. Although these restrictions are undoubtedly at least partly in the interests of the patients themselves, they are commonly also in the interests of others. This chapter looks at service structure, including planning principles, principles of assessment, admission criteria, the pathway to treatment, and finally assessing outcomes.

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