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8 recordsLinked to original sources
PubMed1993

Double jeopardy: suicide rates in forensic hospitals.

While a number of studies have described high and increasing rates of completed suicide among psychiatric patients, the suicide risk of forensic hospital patients is virtually unknown. This paper reports on the suicides that have taken place in the country's oldest continually operating institution housing persons formerly labeled "criminally insane," the Bridgewater State Hospital. The results show considerable variation in the suicide rate by historical period, with suicide prior to 1968 a considerably more infrequent event. By contrast, the post-'68 rate of 232 per 100,000 is comparable to data reported in a series of studies of psychiatric suicides, and significantly higher than that found in U.S. studies of correctional populations. These differences are discussed. The results strongly suggest that forensic hospital populations have suicide rates broadly comparable to other psychiatric populations.

Dangerous Behavior↗
PubMed1987

An evaluation of procedures for assessing competency to stand trial.

In a field experiment involving 120 defendants at Bridgewater State Hospital in Massachusetts, the authors evaluated three instruments for assessing competency to stand trial: the Competency Screening Test (CST), Competency Assessment Instrument (CAI), and Interdisciplinary Fitness Interview (IFI). The CST (a paper-and-pencil test) was administered by a research assistant and scored by trained graduate students. Lawyers, psychologists, and social workers were recruited and trained in the use of the other instruments, then assigned as individuals (CAI) or teams (IFI) to conduct interviews and assess subjects. The performance of the project interviewers was compared against two yardsticks: (1) actual decisions reached by the regular Bridgewater staff, and (2) a consensus of two nationally respected experts who reviewed the cases and formed independent competency judgments. Both the CAI and IFI performed well under these conditions, indicating that one-time interviews by well-trained persons can lead to accurate competency decisions in the majority of cases. The authors conclude that hospitalization for competency assessment is rarely necessary.

Forensic Psychiatry↗
PubMed1993

Comparative suicide rates in different types of involuntary confinement.

In the past decade especially, a number of studies have appeared on suicide among court-involved persons, chiefly in jail and prison remand settings, and to a lesser degree among longer-term prisoners. Confinement is not everywhere equally suicidogenic, and the types of people who find themselves confined do not represent uniformly high risk groups. This article reports on rates of completed suicides over long periods of time in two very different US institutions operated by the Massachusetts Department of Correction: the Addiction Centre and its antecedent facilities (1886-1990); and the Defective Delinquent Department (1922-1971). For perspective, the paper compares suicide rates among its two populations to rates for other very distinctive institutions operated by the Massachusetts Department of Correction, the Bridgewater State Hospital and the Massachusetts Treatment Centre for Sexually Dangerous Persons. The results are remarkable for the rarity of suicide in three distinct populations--the Addiction Center, the Defective Delinquent Department and the Treatment Center for Sexually Dangerous Persons--but considerably higher rates in the State Hospital, a population often dismissed as 'criminally insane.' The possible significance of these results for debates about 'importation' versus 'deprivation' explanations of custodial suicide is discussed.

Female↗
PubMed1987

Medicine court: Rogers in practice.

The authors conducted a prospective study of the impact of the Rogers decision involving patients' right to refuse treatment during the first year (1983-1984) of its implementation in the Massachusetts facility for the criminally insane. They learned that of the 98 cases submitted to the probate court, only 39 were heard. The court found that 35 (90%) of the 39 patients whose cases were heard lacked competence to make treatment decisions. Hearings occurred 2-7 months after petitions were signed by treating physicians. In arriving at the decisions the court appeared to rely more on reports of violent incidents than on evidence of mental illness or testimony about competence.

Commitment of Persons with Psychiatric Disorders↗
PubMed1996

Learning opportunities for internal medicine residents: comparison of a tertiary care setting and a regional setting.

PURPOSE: To compare the learning opportunities for internal medicine residents in tertiary care and community hospital settings. METHOD: Two sites were studied: Victoria General Hospital, a teaching hospital affiliated with the Dalhousie University Faculty of Medicine, staffed by five general internists and serving Halifax County (population of 420,000); and South Shore Regional Hospital, serving the community of Bridgewater (with a catchment area of 50,000) and staffed by three general internists. All in- and outpatients seen in the two settings over a one-year period (1993) were described in accordance with the Canadian Institute for Health Information's major clinical categories, as well as a case mixture recommended as providing appropriate learning experiences for internal medicine clerks. Over a one-month period (August 1993), consecutive patients were interviewed, completing a health status questionnaire, the Medical Outcome Study Short Form 36 (SF-36). RESULTS: Data were collected from the records of 2,763 patients, and the SF-36 questionnaire was administered to 406 patients. The data indicate that the settings were relatively similar except that there was more case variety in the tertiary care setting, and that more patients with cardiovascular disease and no patient with acquired immune deficiency syndrome were seen in the regional setting. Quality-of-life scores showed similarities to norms in the United States and United Kingdom, except that the ambulatory patients in the regional setting had rather lower scores. CONCLUSION: Overall, the patients' problems in the regional and tertiary care settings offered similar learning opportunities.

Aged↗