RESUMO
A shift within state psychiatric hospitals toward serving a predominantly forensic population has resulted in increased violent incidents within those settings. Thus, addressing criminogenic needs in addition to mental illness is an important paradigm shift. Relying on seclusion or restraint as the primary mechanisms to address violence interferes with the provision of effective care to patients struggling with aggressive behaviors. Implementing new treatment programs aimed at reducing violence in forensic inpatient settings is warranted. This article focuses on the step-by-step process of developing such a specialized treatment program within the California Department of State Hospitals. Leadership within this hospital system collaborated with labor unions and other stakeholders to obtain funding to create a novel treatment environment. This treatment program includes a ward design aimed to improve safety and delivers treatment based on the Risk Needs Responsivity Model. Treatment is guided by violence risk assessment and primarily focused on addressing criminogenic needs. The selection of treatments with a focus on violence reduction is discussed.
Assuntos
Controle Comportamental/métodos , Estabelecimentos Correcionais , Criminosos/psicologia , Violência/prevenção & controle , HumanosRESUMO
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
Traumatic brain injuries are one of the leading causes of deaths and disabilities in children and adolescents. There is a need for clinicians to quickly screen for disrupted cognitive functioning to appropriately refer to specialists. The Lebby-Asbell Neurocognitive Screening Examination for Children and Lebby-Asbell Neurocognitive Screening Examination for Adolescents were developed to fill a gap in available measures and create a screening tool to quickly identify impaired neurocognitive functioning. A series of statistical analyses were conducted to determine their clinical utility. A multivariate analysis of variance found a statistically significant difference between those with brain injury (n = 59) from noninjured (n = 190) on the combined dependent variables, F(14, 234) = 46.530, P < .001; Wilks Lambda = .264; partial η(2) = .763. The Lebby-Asbell Neurocognitive Screening Examinations for Children and Adolescents are effective neurocognitive screening measures for children and adolescents in identifying brain injury.