Markham Sarah
Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Front Psychiatry. 2021 Nov 8;12:789089. doi: 10.3389/fpsyt.2021.789089. eCollection 2021.
This evidence-based opinion piece explores the totalising risk averse nature of secure and forensic mental health services and associated iatrogenic harms in England and Wales. Drawing on the research literature I consider the various influences, both external and internal which impact on the provision of such services and how both the therapeutic alliance and recovery potential for patients may be improved. Especial attention is paid to the deployment of restrictive practise, practitioner attitudes, the potential for non-thinking, and how these may impact on decision-making and the care and treatment of mentally disordered offenders.
这篇基于证据的观点文章探讨了英格兰和威尔士安全及法医精神健康服务中普遍存在的规避风险的性质以及相关的医源性伤害。借鉴研究文献，我考虑了影响此类服务提供的各种内外部因素，以及如何改善治疗联盟和患者的康复潜力。特别关注了限制性措施的使用、从业者态度、不假思索的可能性，以及这些因素如何影响决策以及对精神错乱罪犯的护理和治疗。
