STSM – Training of professionals in forensic systems under renovation

Written by Luca Castelletti (Medical Director, REMS Carlo Poma Mantova, Italy)

The whole Italian forensic sector is undergoing a radical process of renovation, as since 1st of april 2015 the 6 national forensic hospital have been closed down and are going to be replaced by small regional 20 bedded-units named REMS standing for Residencies for the Application of  Security Measures. As the process is delegated to the 20 regional health systems, the institution of the residencies is at different speed of building up. In our contest, in the Lombardy region, with a catchment area of around 10 milion people including Milan area, the project is to refurbish and renovate the “old” Ospedale Psichiatrico Giudiziario (OPGs) into a system of 6 REMS for a total of 120 beds. In the regional and central political plans it’s going to be the main forensic centre serving the Country. At the moment we host around 180 patients, of whom 45 are women, as we supply the momentary lack of ready residencies of some other regions.

(more…)

Read More

Ward climate and (long term) forensic care

(How and why) should ward climate differ between forensic facilities?

Written by Meike de Vries, Researcher: Pompestichting, The Netherlands

Ward climate is an important factor within the treatment of inpatients in secure settings. Ward climate can be seen as a multifactorial construct including the material, social, and emotional conditions of a given ward and the interaction between these factors (Moos, 1989). In several studies, climate is found to play a role in therapeutic outcomes and regarded as an aspect of program responsivity that enhances treatment effects. Within high secure forensic hospitals establishing and maintaining an optimal climate is an important, but also a very challenging task due to the complex patient population and setting which incorporates both therapeutic- and security goals.

(more…)

Read More

Strengths and weaknesses in mental health and legal systems in the European Union: An evaluation

Written by Caty Connel (Senior Forensic Occupational Therapist, Birmingham and Solihull Mental Health NHS Foundation Trust, United Kingdom)

This blog summarises the findings from a study to evaluate the strengths and weaknesses of legal and mental health systems in the European Union.

Aim
To identify which external factors impact on length of stay in forensic mental health services.

Method
Representatives with expertise in long-term forensic care from 16 European countries reported the strengths and weaknesses of the mental health and legal systems in their respective countries. Thematic analysis [1] of the data was conducted for strengths and weaknesses independently, then overarching themes were identified by combining these analyses.

(more…)

Read More

A STSM comparing patients and services in long term forensic psychiatry in Germany (Vitos-Haina) & Ireland (Dundrum, Dublin).

Written by Padraic O’ Flynn (Senior Occupational Therapist, Central Mental Hospital, Dundrum, Ireland).  

This short term scientific mission explored two forensic psychiatric services in Ireland (Central Mental Hospital, Dundrum, NFMHS) and Germany (Vitos Haina) which cater for long term forensic psychiatric patients. The completed report detailed the overall model and design of the two services, the patient characteristics (diagnosis, average length of stay, index offence, “step”, nationality, IQ)  on long stay wards,  procedures in both services for identifying patient need for psychosocial treatment, comparisons of what psychosocial interventions are offered on long stay units/ with long stay patients, and finally comparisons on quality of life from self reported measures on long stay wards in Ireland and Germany. The report also detailed recommendations for future research in this area. Below the points from the main report are summarised with graphs and diagrams included. Further exploration of comparisons of descriptive characteristics, service models etc. are available in the full report.

(more…)

Read More

Training School 2015 – Long Stay in Forensic Psychiatric Services

What is the programme like?

The programme involves lectures, videos, discussions, debates and field visits in small groups. The speakers are international experts in the field of forensic psychiatry and mental health and bring with them a wealth of experience ( speakers list). The training school will cover best practice in long stay forensic psychiatric care as well as EU issues in forensic psychiatry.

Participants will have the opportunity to visit all three levels of security in forensic psychiatric care in the United Kingdom – high, medium and low and availability of such visits is very rare. It is an excellent opportunity to gain insight into what is happening on the ground. You will need to bring along two pieces of ID with you during each of these visits.

Please find here a time-table for the 3 day programme.

English will be the official language of the training school although some of the speakers speak other European languages.

University-of-Warwick-new-007

(more…)

Read More

TRAINING SCHOOL 2015 – Koper, Slovenia – 14-17th July 2015

Written by Ana Cristina Neves (Forensic Psychology Assistant Professor at Instituto Superior de Ciências da Saúde Egas Moniz, Portugal) and Valentina Campani (Psychology Master Student, trainee at Reggio Emilia Forensic Unit, Italy)

The Training School (TS) was focused on the concepts of quality of life (QoL) and needs within a long-term forensic psychiatric context, how to assess them and how to improve conditions of long-term patients while meeting their needs. As one of the aims of the TS was the interaction between participants, we were just 18, what allowed the experience of a friendly and functional environment. Treatment realities vary substantially within Europe according to different legal frameworks and resources, so group work and discussion was actively stimulated by the trainers. They also provided valuable advises on how to integrate both concepts into everyday practice.

(more…)

Read More

Pcall-3-DUNDRUM-MENTAL-00052294-390x285

STSM of Mareike Eckert in Central Mental Hospital Dundrum in Dublin, Ireland

Written by Mareike Eckert, MSc,
Junior Researcher of the Pompe Foundation, the Netherlands

In May 2015 I completed a short term scientific mission (STSM) of one week to the Central Mental Hospital Dundrum in Dublin, Ireland in the context of the COST Action IS1302, working group 1: Determination of patient characteristics. The purpose of my stay was to explore, understand and compare factors affecting length of stay in a forensic population in the Netherlands and Ireland using the DUNDRUM toolkit and also a questionnaire about patient characteristics. Factors such as basic demographic information, length of stay, offending and psychiatric history, security and urgency needs, program completion and patient recovery were therefore assessed prior to the STSM including about 60 non-long term patients from different wards in the Pompe clinic in Nijmegen and about 60 long term patients, admitted to the long term forensic psychiatric care unit in Zeeland. Throughout my STSM I gained insight into how the DUNDRUM toolkit is used in practice in the Central Mental Hospital in Dublin. This was an important aspect of my STSM in order to fully understand how to use the toolkit in the research project.

(more…)

Read More

Long-Term Suicide Risk in Forensic Psychiatric Patients

Based on the article Long-Term Suicide Risk in Forensic Psychiatric Patients by Clarke, M., Davies, S., Clive, H. & Duggan, C. (2011) in Archives of Suicide Research, 15: 1, 16 — 28

It is often said that psychiatric patients are a greater risk to themselves than others; while this may be true for general samples, the risk that patient treated in Forensic Psychiatric Units present to themselves, rather than to others, which by the nature of the sample is high, had not been a focus for study. Clarke et al. (2011) investigated the long-term suicide risk in forensic psychiatric patients. They performed a retrospective study, which considered the mortality outcomes of a cohort of 595 former patients of a medium secure unit in Leicester, England. Patients were admitted during the 20-year period between 1983 and 2003. The study found an increased risk of mortality in former forensic patients, from all causes, and particularly from suicide.

(more…)

Read More

How do Dutch LFPC-patients experience their quality of life and are their case managers aware of these experiences?

Written by Sandra Schel
Junior Researcher, Pompefoundation, The Netherlands

Quality of life is seen as an important treatment goal in Dutch LFPC. Since 2007 QoL has been measured on a yearly basis at the LFPC-wards of the Dutch Pompefoundation, using the Forensic Inpatient Quality of Life Questionnaire (FQL; Vorstenbosch, Bulten, Bouman, & Braun, 2007). The FQL is a setting- and disease-specific questionnaire for QoL-assessment in long-care forensic psychiatry, which is based on patients’ and forensic psychiatric nurses’ experiences and their perceptions on quality of life (Vorstenbosch, Bulten, Bouman, & Braun, 2010). In Dutch LFPC every member of the forensic psychiatric nursing staff is linked to specific patients. Therefore, additionally, Vorstenbosch and colleagues developed a proxy version of the FQL, which consists of exactly the same questions, but then rephrased as to how the forensic psychiatric nurse assigned to the patient (henceforth: case manager) thinks the patient would answer.

(more…)

Read More