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Experiences of restrictiveness in forensic psychiatric care: Systematic review and concept analysis.
Tomlin, Jack; Bartlett, Peter; Völlm, Birgit.
Afiliação
  • Tomlin J; Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham Innovation Park, Jubilee Campus, Triumph Road, Nottingham NG7 2TU, UK. Electronic address: jack.tomlin@nottingham.ac.uk.
  • Bartlett P; School of Law, Law and Social Sciences Building, University Park, Nottingham, NG7 2RD, UK.
  • Völlm B; Division of Psychiatry and Applied Psychology, School of Medicine, Institute of Mental Health, University of Nottingham Innovation Park, Jubilee Campus, Triumph Road, Nottingham NG7 2TU, UK.
Int J Law Psychiatry ; 57: 31-41, 2018.
Article em En | MEDLINE | ID: mdl-29548502
ABSTRACT
Mentally disordered offenders may be sent to secure psychiatric hospitals. These settings can resemble carceral spaces, employing high levels of security restricting resident autonomy, expression and social interaction. However, research exploring the restrictiveness of forensic settings is sparse. A systematic review was therefore undertaken to conceptualize this restrictiveness. Eight databases were searched for papers that address restrictive elements of secure forensic care in a non-cursory way. Fifty sources (empirical articles and policy documents) were included and subject to thematic analysis to identify 1) antecedent conditions to, 2) characteristic attributes, 3) consequences and 4) 'deviant' cases of the developing concept. The restrictiveness of forensic care was experienced across three levels individual, institutional and systemic. Restrictiveness was subjective and included such disparate elements as limited leave and grounds access, ownership of personal belongings and staff attitudes. The manner and extent to which these are experienced as restrictive was influenced by two antecedent conditions; whether the purpose of forensic care was to be more caring or custodial and the extent to which residents were perceived to be risky. We argue that there must be a reflexivity from stakeholders between the level of restrictiveness needed to safely provide care in a therapeutic milieu and enable the maximum amount of resident autonomy.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Psiquiatria Legal / Internação Compulsória de Doente Mental / Pessoas Mentalmente Doentes / Transtornos Mentais Tipo de estudo: Diagnostic_studies / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Revista: Int J Law Psychiatry Ano de publicação: 2018 Tipo de documento: Article

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Psiquiatria Legal / Internação Compulsória de Doente Mental / Pessoas Mentalmente Doentes / Transtornos Mentais Tipo de estudo: Diagnostic_studies / Prognostic_studies / Systematic_reviews Limite: Humans Idioma: En Revista: Int J Law Psychiatry Ano de publicação: 2018 Tipo de documento: Article