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Статті в журналах з теми "Forensic psychiatry – ireland"

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Khosla, Vivek, Phil Davison, Harvey Gordon, and Verghese Joseph. "The interface between general and forensic psychiatry: the present day." Advances in Psychiatric Treatment 20, no. 5 (September 2014): 359–65. http://dx.doi.org/10.1192/apt.bp.109.007336.

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SummaryWith the subspecialisation of psychiatry in the UK, clinicians encounter problems at the interfaces between specialties. These can lead to tension between clinicians, which can be unhelpful to the clinical care of the patient. This article focuses on the interface between general and forensic psychiatry in England and Wales. The pattern of mental health services in England and Wales differs to an extent from those in Scotland, Northern Ireland and in the Republic of Ireland. Consequently, the interface between general and forensic psychiatry is subject to varying influences. Important interface issues include: the definition of a ‘forensic patient’; the remit and organisation of services; resources; clinical responsibility; and care pathways. This article also discusses a general overview of how to improve collaboration between forensic and general adult psychiatric services.Learning Objectives•Develop an understanding of important issues at the forensic/general adult psychiatry interface.•Be aware of areas of conflict that may arise at the forensic/general adult psychiatry interface.•Be aware of options for optimum cooperation at the interface.
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O'Neill, Conor, Hamish Sinclair, Alan Kelly, and Harry Kennedy. "Interaction of forensic and general psychiatric services in Ireland: learning the lessons or repeating the mistakes?" Irish Journal of Psychological Medicine 19, no. 2 (June 2002): 48–54. http://dx.doi.org/10.1017/s0790966700006959.

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AbstractObjective:General psychiatric bed numbers in Ireland have reduced markedly in recent decades. In other jurisdictions such reductions have been accompanied by increases in the prevalence rates of severe mental illness among prisoners. We examined variations in per capita provision of local psychiatric beds and community residential places in Ireland for associations with forensic psychiatric service utilisation.Method:All admissions via the courts and prisons to the national forensic psychiatry service during the years 1997-1999 were assigned to the appropriate health board. Forensic admission and bed utilisation rates were compared with measures of general psychiatric service provision.Results:There were 476 admissions via the criminal justice system during the study period (0.74% of all psychiatric admissions in Ireland). A disproportionate number came from the most urbanised area. There were fivefold differences in overall bed and hostel place allocation between Irish health boards. Combined general psychiatric beds were inversely correlated with forensic bed utilisation (Spearman r = -0.75, p = 0.013). These differences showed a strong inverse correlation with forensic service utilisation.Conclusions:General psychiatric services are relatively under-resourced in areas of greatest predicted need in Ireland. This is associated with increased use of forensic psychiatric services and may reflect accumulation of the mentally ill in Irish prisons.
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Leonard, P., A. Morrison, M. Delany-Warner, and G. J. Calvert. "A national survey of offending behaviour amongst intellectually disabled users of mental health services in Ireland." Irish Journal of Psychological Medicine 33, no. 4 (August 18, 2015): 207–15. http://dx.doi.org/10.1017/ipm.2015.21.

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BackgroundOffenders with an intellectual disability pose a major challenge to Intellectual Disability Service providers in the Republic of Ireland. This is especially so as no national Forensic Intellectual Disability Service currently exists.The Forensic Intellectual Disability Working Group of the Irish College of Psychiatrists was established in order to take steps to address this issue by establishing the level of need for a Forensic Intellectual Disability Service in Ireland and developing a college position paper.No previous study has been carried out to measure offending behaviour amongst persons with an intellectual disability attending mental health services in Ireland.MethodsA postal survey was undertaken targeting the lead clinicians of all Intellectual Disability Psychiatry, General Adult Psychiatry and Forensic Psychiatry Services in the Republic of Ireland. This survey requested anonymous data regarding service users with an intellectual disability and offending behaviour in this population.ResultsData relating to 431 service users was returned. Those reported to engage in offending behaviour were predominantly young males. Assault was the most common offence type. A significant number of serious offences such as unlawful killing, sexual assault and arson were reported.ConclusionsThere is an urgent need for the development of a Forensic Intellectual Disability Service in the Republic of Ireland. The current efforts of the National Forensic Mental Health Service to establish such a service by the creation of a post of Consultant Forensic Psychiatrist (special interest in intellectual disability) are to be welcomed.
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Gordon, Harvey, and Vivek Khosla. "The interface between general and forensic psychiatry: a historical perspective." Advances in Psychiatric Treatment 20, no. 5 (September 2014): 350–58. http://dx.doi.org/10.1192/apt.bp.113.011999.

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SummaryMental disorder and criminality are separate entities but some people with a mental disorder commit criminal offences and some criminals have a mental disorder. Before 1800 there was no separate category of mentally disordered offenders (referred to as criminal lunatics until 1948) in UK legislation. The provision of facilities for mentally disordered offenders in Britain and Ireland overlapped with, but was also separate from, provision for the mentally ill generally. The interface between general and forensic psychiatry is an area of tension and of collaboration. To understand how contemporary general and forensic psychiatry interact, it is useful to have an understanding of how factors have evolved overtime.Learning Objectives•Have an understanding of the evolution of general and forensic psychiatry in the UK over the past 200 years.•Comprehend the similarities and differences between general and forensic psychiatry.•Be aware of some of the roots of conflict between general and forensic psychiatry.
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Linehan, Sally A., Dearbhla M. Duffy, Helen O'Neill, Conor O'Neill, and Harry G. Kennedy. "Irish Travellers and forensic mental health." Irish Journal of Psychological Medicine 19, no. 3 (September 2002): 76–79. http://dx.doi.org/10.1017/s0790966700007102.

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AbstractObjectives: To determine whether Irish Travellers are over-represented amongst transfers from prison to psychiatric hospital. If so, to determine whether this represents an excess over the proportion of Irish Travellers committed to prison.Method: Irish Travellers admitted to the National Forensic Psychiatry service were identified from a case register over three years 1997-1999. New prison committals were sampled and interviewed as part of the routine committal screening to identify ethnicity.Results: Irish Travellers accounted for 3.4% of forensic psychiatric admissions compared to 0.38% of the adult population. Travellers transferred from prison to psychiatric hospital had more learning disability and less severe mental illness than other groups, while black and other ethnic minorities had a higher proportion of severe mental illness. Travellers accounted for 6% (95% CI 3-11) of 154 male committals and 4% (95% CI 2-12) of 70 female committals. The estimated annualised prison committal rate was 2.8% (95% CI 2.4-3.3) of all adult male Travellers in Ireland and 1% for female Travellers (95% CI 0.8-1.3). Male Travellers had a relative risk of imprisonment compared to the settled community of 17.4 (95% CI 2.3-131.4), the relative risk for female Travellers was 12.9 (95% CI 1.7-96.7). Imprisoned Travellers had greater rates of drugs and alcohol problems than other prisoners (Relative risk 1.46, 95% C11.11-1.90).Conclusion: There is gross over-representation of Travellers in forensic psychiatric admissions. This reflects the excess of Travellers amongst prison committals.
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O'Neill, Conor, Patrick Heffernan, Ray Goggins, Ciaran Corcoran, Sally Linehan, Dearbhla Duffy, Helen O'Neill, Charles Smith, and Harry G. Kennedy. "Long-stay forensic psychiatric inpatients in the Republic of Ireland: aggregated needs assessment." Irish Journal of Psychological Medicine 20, no. 4 (December 2003): 119–25. http://dx.doi.org/10.1017/s0790966700007916.

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AbstractObjectives:To profile the current cohort of forensic psychiatric inpatients in the Republic of Ireland, comparing psychiatric healthcare and placement needs of long-stay patients with those more recently admitted.Method:All forensic psychiatric inpatients in the Central Mental Hospital, Dundrum on a census date were included in the study. Patients and key worker were interviewed using a standardised schedule and validated research instruments. Static and dynamic risk factors for violence including demographic, diagnostic and legal characteristics were supplemented by detailed chart review. Standardised anonymised case vignettes were presented to panels of forensic and community psychiatric multidisciplinary teams who assessed current and future treatment and placement requirements for the cohort.Results:There were 88 forensic psychiatric inpatients on the census date. Forty-three had lengths of stay over two years (17 over 20 years). Both patient groups were predominantly males with severe mental illness and histories of violent offending. The majority of the long-stay group were receiving regular parole and this group had lower levels of positive symptoms and comorbid substance misuse disorders. Significant gaps in existing rehabilitation inputs were identified. Almost half the long-stay patients were inappropriately placed. Thirty per cent of long-stay patients could be safely transferred to lower levels of security within six months and 63% within three years.Conclusions:Holding patients in conditions of excessive security impedes rehabilitation and has considerable human rights implications. Almost half of long-stay forensic psychiatric patients in Ireland are inappropriately placed. Barriers to discharge include legislative inadequacies, lack of local low-secure facilities and under-resourcing of community psychiatric services. Such barriers lead to inappropriate utilisation of limited resources and limit access to secure facilities for higher-risk mentally disordered offenders. These findings are of particular relevance in the context of proposed new insanity legislation.
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Tong, K., A. Gibbons, O. Byrne, T. Conlon, H. Kennedy, and M. Davoren. "Zero violence or zero seclusion. Which is more acceptable in our hospitals?" European Psychiatry 65, S1 (June 2022): S601. http://dx.doi.org/10.1192/j.eurpsy.2022.1539.

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Introduction There is an established association between serious mental illness and violence. Secure forensic psychiatric services provide care and treatment to mentally disordered offenders. The majority of patients in forensic services suffer from severe mental illnesses such as schizophrenia, with co-morbid polysubstance abuse and maladaptive personality traits. Psychiatric services are under significant pressure to reduce the use of seclusion and restrictive practices, whilst mandated to provide safe environments for patients and staff. Objectives To determine the number and characteristics of violent incidents in a secure forensic hospital in Ireland. Methods A retrospective review of all incidents in Central Mental Hospital, Ireland between 1st March 2019 and 31st August 2021 was completed. Incidents were categorised into physical assaults and other violent incidents. Demographic measures and measures of violence risk (HCR-20), functioning (GAF), programme completion and recovery (DUNDRUM tool) were collated. Results A total of 321 incidents took place during the period examined, of which 47 (14.6%) involved physical assaults perpetrated by patients. Between March 2020 and August 2021, numbers of assaults increased by 50% and 78% compared to the preceding six-month period respectively. The majority of assaults were committed by a relatively small group of patients. Victims of assaults were more likely to be patients (n=27, 57.4%) and more likely to be males (n=43, 91.9%). Conclusions Physical assaults and other violent incidents happen in forensic and general psychiatric units. Restrictive practices, used in accordance with the law, are necessary at times to prevent serious harm to patients and staff in psychiatric hospitals. Disclosure No significant relationships.
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Kelly, Brendan D. "Folie à plusieurs: forensic cases from nineteenth-century Ireland." History of Psychiatry 20, no. 1 (March 2009): 47–60. http://dx.doi.org/10.1177/0957154x08094236.

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Campbell, Philip, and Keith Rix. "Fusion legislation and forensic psychiatry: the criminal justice provisions of the Mental Capacity Act (Northern Ireland) 2016." BJPsych Advances 24, no. 3 (April 25, 2018): 195–203. http://dx.doi.org/10.1192/bja.2017.9.

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SUMMARYFusion legislation is the latest in a long line of reforms in mental health law that have sought to increase patient autonomy. It has not been without controversy, having been proposed and rejected in various jurisdictions throughout the UK and internationally, while causing considerable debate in the academic literature. This article considers some of the history and debate, along with the criminal justice provisions of the first piece of fusion legislation internationally, the Mental Capacity Act (Northern Ireland) 2016, and their potential implications.LEARNING OBJECTIVES•Understand the history of fusion legislation in the UK and internationally•Understand the advantages and disadvantages of fusion legislation•Understand the Mental Capacity Act (Northern Ireland) 2016 criminal justice provisionsDECLARATION OF INTERESTNone.
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Murphy, F., A. Mcloughlin, A. Butler, M. Davoren, and H. Kennedy. "Frailty in Secure Forensic Mental Health Settings: A Study from Dundrum Hospital, Ireland." European Psychiatry 65, S1 (June 2022): S348—S349. http://dx.doi.org/10.1192/j.eurpsy.2022.885.

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Introduction Frailty is defined as a clinical syndrome that encompasses a combination of decreased physiological reserve and low resistance to stressors. There is an association between mental illness and frailty among elderly cohorts. Frailty is also associated with obesity and smoking. There are high rates of treatment resistant schizophrenia among patients in secure forensic services. Patients with schizophrenia have high rates of morbidity and early mortality. Objectives The primary aim of this study was to examine the rates of frailty present in a complete cohort of forensic in-patients. Methods An assessment using Fried Frailty criteria was offered to all in-patients (n=95) in Ireland’s National Forensic Service, which included measures of walking speed, grip strength, low physical activity and exhaustion. Demographic details and details pertaining to diagnoses and medications were also gathered. Results Of the 95 in-patients, 92 patients agreed to participate. The majority were male (89%). The most common diagnosis was schizophrenia (71.7%). Mean age was 44.7 years (SD 11.42), and 58.2% met criteria for obesity. Of the total group, 47 patients met criteria for ‘pre-frail’ and 10 met criteria for ‘frail’ using Fried criteria. Conclusions This is the first study examining frailty in a cohort of patients in secure forensic settings. We found high rates of patients meeting frailty criteria at very young ages. Rates of frailty in this group were comparable to those found amongst elders in community settings. We consider this demonstrates significant medical vulnerability in this patient group. Disclosure No significant relationships.
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Дисертації з теми "Forensic psychiatry – ireland"

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Kelly, Brendan D. "Custody, care and criminality : clinical aspects of forensic psychiatric institutionalisation in late nineteenth- and early twentieth-century Ireland." Thesis, University of Northampton, 2011. http://nectar.northampton.ac.uk/8866/.

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Книги з теми "Forensic psychiatry – ireland"

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Custody, care & criminality: Forensic psychiatry and law in 19th century Ireland. Dublin, Ireland: The History Press, 2014.

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Adshead, Gwen, and Nigel Eastman. Forensic Psychiatry. Oxford University Press, 2012.

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Forensic Psychiatry. Oxford University Press, USA, 2012.

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Latham, Richard, Gwen Adshead, Nigel Eastman, Simone Fox, and Seán Whyte. Forensic Psychiatry. Oxford University Press, 2019.

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Kelly, Brendan. Custody, Care and Criminality: Forensic Psychiatry and Law in 19th Century Ireland. History Press Limited, The, 2014.

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Psychiatry and the Law. Blackhall Publishing, 2010.

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Psychiatry and the Law. Oak Tree Press, 1998.

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Semple, David, and Roger Smyth. Oxford Handbook of Psychiatry. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780198795551.001.0001.

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This fourth edition of what has become an indispensable pocket guide to general psychiatry and the subspecialties continues to provide portable reassurance to health professionals at all levels of experience when dealing with psychiatric issues. As well as a comprehensive overview of the common presentations in psychiatry, this handbook includes practical guidance on the principles of management for individual conditions. Subspecialties, including old age psychiatry, substance misuse, child and adolescent psychiatry, forensic psychiatry, intellectual disability, liaison psychiatry, and psychotherapy are covered in separate chapters, as are overarching considerations such as legal issues, cultural context, and therapeutics. As in previous editions, the handbook is indexed alphabetically, by ICD-10/DSM-5 codes, and by acute presentations for quick access to topics. The text is peppered with clinical observations, guidance, and commentary, reflecting the authors’ own experiences of working in psychiatry. This new edition has been thoroughly revised and updated to include the latest clinical guidelines, new licensed drug indications, changes to the legislature impacting on psychiatric practice across the United Kingdom and Ireland, the new DSM-5 classification system, and the anticipated ICD-11 changes to diagnostic coding.
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Частини книг з теми "Forensic psychiatry – ireland"

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Eastman, Nigel, Gwen Adshead, Simone Fox, Richard Latham, Seán Whyte, and Hannah Kate Williams. "Legal systems." In Forensic Psychiatry, edited by Nigel Eastman, Gwen Adshead, Simone Fox, Richard Latham, Seán Whyte, and Hannah Kate Williams, 361–96. 2nd ed. Oxford University PressOxford, 2023. http://dx.doi.org/10.1093/med/9780198825586.003.0014.

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Abstract This chapter begins with an overview of law in society, and then jurisprudence and legal interpretation. It goes on to explain sources of law, and the differences between civil law and common law systems. It goes on to explain the courts and tribunals of the UK, and Scotland. Judicial review, roles within the court, court procedures, and the burdens and standards of proof are all explained, alongside rules of evidence. The court systems within England, Wales, and Northern Ireland, the Republic of Ireland are all outlined, as well as a brief overview of systems in the EU and other countries. Finally, professional regulatory structures, inquests, and inquiries are all included.
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Taylor, Pamela J., Jackie Craissati, Pamela J. Taylor, Lindsay Thomson, Fred Browne, Harry Kennedy, Damian Mohan, et al. "Forensic mental health services in the United Kingdom and Ireland." In Forensic Psychiatry, 587–618. Routledge, 2014. http://dx.doi.org/10.1201/b15462-24.

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Dunn, Emma, Alan R. Felthous, Pierre Gagné, Tim Harding, Sean Kaliski, Peter Kramp, Per Lindqvist, et al. "Forensic psychiatry and its interfaces outside the UK and Ireland." In Forensic Psychiatry, edited by Pamela J. Taylor, 111–47. Routledge, 2014. http://dx.doi.org/10.1201/b15462-5.

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Doyle, David M., and Liam O’Callaghan. "Psychiatry, Criminal Responsibility and the Tempering of Punishment." In Capital Punishment in Independent Ireland, 171–200. Liverpool University Press, 2020. http://dx.doi.org/10.3828/liverpool/9781789620276.003.0006.

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This chapter, concerned mainly with the period between the last execution in Ireland in 1954 and the partial abolition of the death penalty in 1964, examines why hanging fell into disuse in this period. The chapter focuses on one phenomenon in particular: the development in Ireland and beyond of new ideas around criminal responsibility and psychiatry. The arrival, in Irish courtrooms, of the forensic psychiatrist meant that new expertise was brought to bear on judging the sanity otherwise of the accused. This, among other factors, led to an increase in the number of reprieves and called into question the desirability of mandatory death sentences. It was clear that the M’Naghten rules were now dated and that some murderers were of ‘diminished responsibility’ – a term given statutory definition in Britain. In Ireland, by the early 1960s, the commutation of death sentences was now routine and the way was clear for partial abolition of the death penalty.
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