Felthous Alan R, Bloom Joseph D
Dr. Felthous is Professor and Director, Forensic Psychiatry Division, Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, Saint Louis, MO. Dr. Bloom, Clinical Professor of Psychiatry, Department of Psychiatry, University of Arizona College of Medicine-Phoenix, Phoenix, AZ.
J Am Acad Psychiatry Law. 2018 Sep;46(3):364-372. doi: 10.29158/JAAPL.003772-18.
One of the most traditional, longstanding, and essential methods of providing the proper level of psychiatric treatment for severely disturbed jail inmates with serious mental illness has been hospital transfer. Transfer does not necessarily imply diversion from trial, but diversion from jail, at least while the detainee is in need of higher level care. Unfortunately, hospital transfer has become increasingly unavailable. Two responses to the unavailability of hospital care for pretrial detainees have been used as justification for maintaining this deficiency: the development of jail-based competency restoration programs and the acceptance of enforced medication of pretrial detainees in jail. The authors analyze each of these practices as inadequate responses to the state's failure to provide timely pretrial hospitalization to detainees who have a serious mental illness and are in need of this level of service.
为患有严重精神疾病的严重扰乱治安的监狱囚犯提供适当水平的精神科治疗，最传统、长期且必不可少的方法之一就是转院治疗。转院不一定意味着脱离审判程序，而是脱离监狱，至少在被拘留者需要更高水平护理期间是这样。不幸的是，转院治疗越来越难以实现。针对审前被拘留者无法获得医院护理的情况，有两种应对措施被用作维持这种不足状况的理由：开展基于监狱的能力恢复项目，以及接受在监狱中对审前被拘留者强制用药。作者分析了这些做法中的每一种，认为它们都是对该州未能及时为患有严重精神疾病且需要这种服务水平的被拘留者提供审前住院治疗的不充分应对措施。
