Hilton N Zoe, Ham Elke, Kim Soyeon
Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, Ontario, Canada.
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
Behav Sci Law. 2022 May;40(3):467-479. doi: 10.1002/bsl.2569. Epub 2022 Apr 10.
The demand for forensic psychiatric beds is increasing, while many individuals are "stuck" in the system. Index offense severity and other legal considerations are associated with longer forensic stays but factors amenable to change such as symptoms of mental illness and aggression may also influence forensic decisions. We examined forensic review board decisions over time among 89 men admitted to a high-security forensic hospital. Almost half received a disposition to remain at their first hearing. Overall, dispositions were not associated with violence risk. The odds of a disposition to remain were higher for men with more in-hospital assaults and higher scores on a measure of clinical factors. Dispositions changed over time and this change was sensitive to clinical factors. We conclude that decisions were consistent with a cascading system of loosening security over time. Further longitudinal research following large samples through the forensic system is recommended.
法医精神病床位的需求不断增加，而许多人却“被困”在该系统中。索引犯罪的严重程度和其他法律考量因素与更长的法医住院时间相关，但诸如精神疾病症状和攻击性等可改变的因素也可能影响法医决策。我们研究了89名被收治到一所高度戒备法医医院的男性患者随时间推移的法医审查委员会决策情况。近一半的人在首次听证时就被决定留院。总体而言，决策与暴力风险无关。在医院内发生更多攻击行为且临床因素测量得分较高的男性，被决定留院的几率更高。决策随时间而变化，且这种变化对临床因素敏感。我们得出结论，随着时间的推移，决策与安全措施逐步放宽的级联系统是一致的。建议对通过法医系统的大样本进行进一步的纵向研究。
