Law & Psychiatry Division, Department of Psychiatry, Yale School of Medicine, New Haven, CT, 06519, USA.
Harvey Cushing/John Hay Whitney Medical Library, Yale University, 333 Cedar St, New Haven, CT, 06520-8014, USA.
Behav Sci Law. 2020 Sep;38(5):426-440. doi: 10.1002/bsl.2484. Epub 2020 Sep 8.
After being found not guilty by reason of insanity (NGRI), individuals are typically admitted to a secure forensic hospital for evaluation and treatment. This patient population can pose a challenge to clinicians in the hospital setting due to significant violence risk, complex psychiatric presentations, and scrutiny from oversight boards and the public. This article reviews the scientific literature around several key aspects of hospital-based treatment of insanity acquittees, including the management of inpatient aggression, the provision of specific treatments to acquittees, the assessment of violence risk and readiness for release, and the process of community transition. The authors conclude that the existing literature is heavily weighted toward the study of risk assessment and recidivism, with relatively little attention paid to the study of therapeutic modalities and recovery-oriented care in this population.
被判定为精神失常无罪（NGRI）后，通常会将个人送进安全的法医医院进行评估和治疗。由于存在严重的暴力风险、复杂的精神疾病表现以及监督委员会和公众的审查，这类患者人群会给医院里的临床医生带来挑战。本文综述了有关在医院环境下治疗精神失常无罪释放者的几个关键方面的科学文献，包括住院患者攻击性的管理、向无罪释放者提供特定治疗、暴力风险评估和出院准备，以及社区过渡的过程。作者得出结论，现有文献主要侧重于风险评估和累犯的研究，而对该人群的治疗模式和以康复为导向的护理的研究相对较少。
