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Results for “Commitment of Persons with Psychiatric Disorders”

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At least 145 records · Page 8Linked to original sources
PubMed1985

Psychotherapy of a murderer: excerpts.

The psychotherapy of a murderer adjudged not guilty by reason of insanity is presented through dated excerpts from twenty-six months of process material. The patient was treated in a maximum security facility. The murder is interpreted psychodynamically as an identification with the aggressor, the patient's mother. It is also understood as a pathetic appeal for help.

Adult↗
PubMed1986

Law versus clinical treatment: the case of L.C..

This paper defines certain conflicts between the clinical treatment process of borderline pathology in severely disturbed adolescents and the legal "patients rights" issues. It shows how these conflicts become part of the externalization of the internal splitting process in hospitalized borderline patients. It also demonstrates the sabotaging aspects of legal interventions in a treatment program that is structured for a locked inpatient unit. One case example is used to explicate these points.

Adolescent↗
PubMed1980

Strategic interventions with involuntary patients.

For successful treatment of involuntary patients who resist change, therapists from all schools of thought use numerous interventions. A variety of interventions, from the general strategic therapy approach to tactics for dealing with specific behavioral symptoms, are described. Strong emphasis in applying interventions is placed on the therapist's controlling the therapeutic relationship and establishing the patient's responsibility for his behaviors. Guidelines are also given for the effective use of interventions and the precautions in applying them.

Anger↗
PubMed1988

Court-mandated outpatient treatment for insanity acquittees: clinical philosophy and implementation.

Court-mandated outpatient treatment for offenders found not guilty by reason of insanity is an alternative form of treatment in which insanity acquittees may be released into the community after serving part of their commitment in a forensic hospital. Working with this difficult population requires a close liaison with the criminal justice system and a clearly articulated treatment philosophy. Essential elements include an emphasis on structure and supervision, recognition of the importance of neuroleptic medication, a reality-based approach to therapy and a focus on the problems of everyday living, and incorporation of the principles of case management. Treatment staff must be comfortable with giving support, enforcing limits, and recommending revocation of the patient's community status when necessary. Case illustrations of successful and unsuccessful community treatment for insanity acquittees are included.

Adult↗
PubMed1988

The insanity defense for sex offenders: jury decisions after repeal of Wisconsin's Sex Crimes Law.

After repeal of a Wisconsin statute permitting hospitalization of defendants convicted of sexual crimes, the authors noted an increase in the percentage of sex offenders among persons hospitalized after being found not guilty by reason of insanity. They also found that a greater proportion of hospitalized sex offenders than of other kinds of offenders were diagnosed as nonpsychotic. Illustrating with three case studies, the authors argue that despite trends away from the therapeutic model of corrections, juries continue to make decisions that provide treatment for defendants perceived to need it, even if the legal criteria for those decisions do not appear to be met.

Adult↗
PubMed1988

Involuntary outpatient commitment in Arizona: a retrospective study.

In July 1983 Arizona's commitment statutes were revised to allow the courts to order involuntary outpatient treatment for the mentally ill. Using retrospective data from medical and court records, patients at a county hospital in Tucson for whom involuntary commitment was sought before outpatient commitment was available were compared with similar groups of patients after outpatient commitment was instituted. Patients ordered to receive outpatient treatment did not differ significantly in diagnosis or reason for commitment from patients committed to inpatient treatment before the change in the law. However, shorter inpatient stays were reported after outpatient commitment became available. In addition, the percentage of patients who voluntarily maintained an active relationship with community treatment centers six months after commitment increased significantly after outpatient commitment was instituted.

Adult↗
PubMed1991

Effect of evaluations of competency to stand trial on the state hospital in an era of increased community services.

The authors studied court-ordered inpatient evaluations of competency to stand trial at two Massachusetts state hospitals for the period from 1972 to 1987, with particular attention to the effects of a 1978 federal court consent decree that created an extensive system of community-based services in the catchment area of one of the hospitals. The authors found that the broad array of community services developed under the consent decree did not reduce commitments to the state hospital for evaluation of competency to stand trial at the same rate as it reduced civil commitments, with the result that the composition of the patient population changed to include a significantly larger proportion of patients referred by the criminal justice system. This proportion was as high as 17.8 percent in 1985. These patients used a disproportionate share of the hospital's resources, staying in the hospital for a median of 28 days, compared with 12 days for all other patients.

Antisocial Personality Disorder↗
PubMed1992

Who commits matricide?

The authors studied sixteen men who committed matricide. Fifteen out of sixteen cases had a diagnosis of schizophrenia and the remaining patient had a diagnosis of schizophrenia with personality disorder. All were single at the time of the matricide. Data indicate an intense conflict-laden and ambivalent relationship between the majority of patients with their mothers. Thirteen out of sixteen cases described their mothers as quite domineering and demanding but the EMBU inventory revealed that the Matricidal group differed from the Control group in how tolerant they saw their parents. The sample as a whole saw mothers were more over-involved, overprotective, tolerant, affectionate, stimulating, performance-orientated and shaming. The matricidal group differed from the control group in the way they viewed the difference between mother and father on various scales, like over-involved, tolerant, affectionate and performance-orientated. The matricidal groups' mothers were found to be more over-involved, tolerant, affectionate, and fathers more abusive. Mothers in the control group were more performance-orientated.

Adult↗
PubMed1999

The Bournewood judgment: a way forward?

In this article we provide a commentary on the various reasonings behind the Law Lords' unanimous judgements in their recent decision (25 June 1998) in Regina v. Bournewood Community and Mental Health NHS Trust, Ex parte L. After summarizing the judgment and commenting on its important implications, we suggest a way forward. The 1995 Law Commission incapacity proposals, on which the 1997 consultation paper Who Decides? was based, do afford a mechanism which could resolve much of the practical difficulty which practitioners feared from the Appeal Court decision, whilst at the same time affording the sorts of rights which the House of Lords decision denies.

Adult↗