RESUMO
The Cal-DSH Diversion Guidelines provide 10 general guidelines that jurisdictions should consider when developing diversion programs for individuals with a serious mental illness (SMI) who become involved in the criminal justice system. Screening for SMI in a jail setting is reviewed. In addition, important treatment interventions for SMI and substance use disorders are highlighted with the need to address criminogenic risk factors highlighted.
Assuntos
Integração Comunitária/psicologia , Psiquiatria Legal/métodos , Guias de Prática Clínica como Assunto , California , Integração Comunitária/legislação & jurisprudência , Estabelecimentos Correcionais/estatística & dados numéricos , Psiquiatria Legal/normas , Humanos , Saúde Mental/legislação & jurisprudência , Saúde Mental/estatística & dados numéricosRESUMO
There is increasing interest in developing more nuanced methods for managing aggression and violence in long-term psychiatric inpatient settings. However, the dearth of controlled studies has, at times, hampered presentation of viable options. Following the publication of guidelines developed in the California State Hospital forensic system, the authors present a group of 7 cases illustrating different approaches to violence management, including pharmacological, psychotherapeutic, and environmental interventions.
Assuntos
Guias como Assunto , Hospitais Psiquiátricos/normas , Violência/psicologia , Adulto , Antipsicóticos/uso terapêutico , California , Feminino , Psiquiatria Legal/normas , Humanos , Masculino , Pessoa de Meia-Idade , Esquizofrenia/tratamento farmacológico , Esquizofrenia/terapia , Adulto JovemRESUMO
Here we provide comprehensive guidelines for the assessment and treatment of violence and aggression of various etiologies, including psychotic aggression and impulsive aggression due to schizophrenia, mood disorders, ADHD, or trauma, and predatory aggression due to psychopathy and other personality disorders. These guidelines have been developed from a collection of prescribing recommendations, clinical trial results, and years of clinical experience in treating patients who are persistently violent or aggressive in the California Department of State Hospital System. Many of the recommendations provided in these guidelines employ off-label prescribing practices; thus, sound clinical judgment based on individual patient needs and according to institution formularies must be considered when applying these guidelines in clinical practice.
Assuntos
Antipsicóticos/uso terapêutico , Transtorno da Personalidade Antissocial/terapia , Hospitais Estaduais , Transtornos Psicóticos/terapia , Esquizofrenia/terapia , Violência/prevenção & controle , Agressão/psicologia , Transtorno da Personalidade Antissocial/psicologia , California , Humanos , Comportamento Impulsivo , Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Transtornos do Humor/psicologia , Transtornos do Humor/terapia , Uso Off-Label , Transtornos Psicóticos/psicologia , Medição de Risco/métodos , Fatores de Risco , Psicologia do Esquizofrênico , Violência/psicologia , Violência/estatística & dados numéricosRESUMO
Here we provide comprehensive guidelines for the assessment and treatment of violence and aggression of various etiologies, including psychotic aggression and impulsive aggression due to schizophrenia, mood disorders, ADHD, or trauma, and predatory aggression due to psychopathy and other personality disorders. These guidelines have been developed from a collection of prescribing recommendations, clinical trial results, and years of clinical experience in treating patients who are persistently violent or aggressive in the California Department of State Hospital System. Many of the recommendations provided in these guidelines employ off-label prescribing practices; thus, sound clinical judgment based on individual patient needs and according to institution formularies must be considered when applying these guidelines in clinical practice.
RESUMO
Guidelines for treating various conditions can be helpful in setting practice standards, but the presence of several sets of guidelines from different countries, experts, and settings, written at different times, can also create confusion. Here we provide a "guideline of guidelines" for the treatment of schizophrenia, or "meta-guidelines, which not only reconcile the various existing standards but also update them to include the use of several newer agents, most of which were marketed following the publication of existing standards.