TRAINING SCHOOL 2017 – Vilnius, Lithuania – 11-13 January 2017

Written by Inga Markiewicz (law assistant and psychologist at the Department of Forensic Psychiatry, Institute of Psychiatry and Neurology in Warsaw, Poland)

The main topic of the COST Training School (TS) in Vilnius was: Treatment pathways and aftercare for forensic psychiatric patients. At the Vilnius University, in a very welcoming atmosphere, we were exchanging scientific opinions and practical experiences gathered when working with the forensic patients. The representatives of four member states (Lithuania, Poland, The Netherlands and UK) participated in the above-mentioned event.

Overall logistics was provided by our Lithuanian hosts / the Lithuanian’s COST Action representatives – Ass. Prof. Ilona Cesniene and Prof. Arunas Germanavicius, while the scientific programme was lead by two members of the Core Group of the COST Action 1302 – Mr. Peter Braun and Dr. Erik Bulten.

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The TS consisted of lectures, workshops and self-study. The participants had an opportunity to listen to presentations about the theory of ‘recovery’ and the Good Lives Model in the context of Risk Needs Responsibility – principles of forensic psychiatric care.

Taking into account that different countries have different good points and weaknesses in their forensic systems, TS participants characterized the models of forensic psychiatric care in their countries. All good and bad solutions of the systems were analysed in relation to the regulations and common practice, both at the stage of ‘pre-trial’, and the process of diagnosis, as well as detailed studies, risk assessment, comprehensive treatment (bio-psycho-social model), aftercare and discharge aspects.

All contributors of the TS agreed that treatment process and aftercare must involve jurisdictions and legal frameworks to make satisfactory progress within the system and/or in aftercare.

These multi-dimensional analyses and comparisons of various solutions in the system of forensic psychiatry in Lithuania, Poland, England and the Netherlands were used to develop a joint model that can offer guidelines for forensic psychiatry for all European countries. The initial ideas have been put into tables (Table 1) and all participants have been working on them.

Vilnius Table 1


Vilnius Table 1a

 

The ideas and results of our work during the TS in Vilnius should materialize in a paper with recommendations on best practice in treatment and aftercare in forensic psychiatry (the universal model),

based on the SWOT analysis of the systematic best solutions practiced in individual countries. We started editing the common text during TS and now its final version is being prepared.

The TS in Vilnius was very well organized, broadening our knowledge about forensic systems, treatment and aftercare in different EU countries.

During our TS we had an opportunity to visit the Vilnius City Mental Health Centre, where we saw the facilities and talked with the staff and patients. We all found that field trip very interesting.

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Our local organizers also remembered about intellectual, historical, cultural and social activities during TS. We took part in a planned guided tour, visiting many historical places (e.g. Vilnius University Library and Palace of the Grand Dukes of Lithuania) and greatly enjoying excellent national food.

At the end, I would like to thank COST Action IS 1302 and all participants of the TS in Vilnius for providing me with better knowledge, a broader view at the quality of forensic psychiatric care, a number of ideas and solutions that I could draw from the systems of other countries, also for the opportunity to exchange experiences, listen to valuable comments and to take part in constructive discussions in a pleasant working atmosphere.

All in all, the TS in Vilnius has been a very enriching experience.

 

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ts-helsinki

Training School 2016 Helsinki 21–23th September

Written by Mika Rautanen (M.D. specialising in forensic psychiatry, Helsinki University, Finland)

The COST Training School was comprised of two workshop days for selected participants and a general lecture day in the middle targeted for everyone interested in how modern forensic facilities should be designed today. Altogether, there were well over 70 professionals representing medical, psychological, nursing, juridical and architectural fields of expertise from various European countries.

A fruitful and open discussion was set as the leading principle through the Training School by Dr. Allan Seppänen, clinical director at Helsinki University Hospital and Finland’s COST- Action representative. He kept the content of the program open in the sense that instead of tight schedules we had time to tackle and discuss real-life problems presented by the trainers and us trainees. Due to great interest in participating, the lectures had to be moved to a larger venue which proved to be a necessary solution for the workgroup days too. Facilities and catering were just right for our purposes.

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Training School 2017 – Treatment pathways and aftercare for forensic psychiatric patients

What is the training school about?

Forensic patients can get stuck in the system due to patient characteristics, quality of treatment but also the quality and availability of facilities with a lower level of security and/or aftercare. The focus will be on the quality and availability of facilities with a lower level of security and/or aftercare, the transitions between systems and the boundaries and problems of these transitions will be connected to the aims of the Action.

Models of aftercare will be discussed. The mechanisms behind pathways and aftercare will be analysed. The theory of ‘recovery’ and the ‘Good Lives Model’ approach will be presented and connected to the aim of this training school; both models will be integrated in the Risk Needs Responsivity-principles of forensic psychiatric care.

Different countries will have different strengths and weaknesses in their treatment pathways and aftercare. Based on specific SWOT analysis of the system characteristics of the participating countries, a guided discussion will result in specific issues, opportunities, best practices, legislation and threats on the patient’s progress through the specific stages of treatment and aftercare.

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Training School 2016 – Modern forensic in-patient facility design standards

What is the training school about?

Forensic psychiatric care is aimed at improving mental health and reducing the risk of recidivism of mentally disordered offenders, within the least restrictive setting possible and with a view to community reintegration, whilst simultaneously maintaining a secure treatment environment. However, the way the services are defined and governed across Europe differ significantly: some countries have issued detailed criteria for different levels of secure care, whereas in other countries security is much more loosely defined and has essentially developed over time along with clinical practices. Also, different historical factors have dictated that in some countries there are secure units that operate in densely populated urban areas, whereas in some countries forensic facilities have been placed further from the surrounding communities.

The rationale behind developing urban forensic services is that this can provide various forms of rehabilitative stimuli not as easily accessible in a more rural environment. However, issues concerning the safety of both the patients themselves and their environment merit particular planning in a more centrally placed location. Drugs, alcohol and antisocial interaction are all factors to take into consideration. A sensitive balance between providing care and security is vital for a well-functioning urban forensic service. Buildings must be used to facilitate the treatment model and care pathway, and to promote community engagement and recovery. Maintaining a high standard in building materials and continually improving the design of the environment will help to improve outcomes for patients. The building should help to ensure comfortable, secure surroundings for patients many of whom are detained for prolonged periods of time.

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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.

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Training School 2015 – Quality of Life and Needs in a Forensic Psychiatric Context

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The first Training School of 2015 will take place in Koper (Slovenia, 14-17 July) and will focus on quality of life and meeting needs within a forensic psychiatric context as well as on how to assess both concepts within the restrictive context of LFPC.

More specifically, this Training School will focus on the needs brought about by (severe) psychiatric symptoms and long-term residence in a highly restrictive setting, and how meeting these needs might optimize quality of life of patients in LFPC. For more details and a complete overview of the program please click here.

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