J Psychiatr Pract. 2022 Sep 1;28(5):396-403. doi: 10.1097/PRA.0000000000000652.
Rates of psychiatric diagnosis, medical morbidity, and suicide risk are notably high among incarcerated individuals. However, engaging these individuals in community-based health care settings can be a challenge. Among justice-involved individuals who do access services, community-based health care settings may lack available resources to effectively conduct comprehensive assessments that inform evidence-based conceptualization. We propose forensic mental health assessment (FMHA) as a critical opportunity to enhance service delivery for this at-risk population. In particular, within the scope of their role, forensic mental health evaluators are able to conduct a comprehensive review of records across health (eg, inpatient and outpatient health care settings), social (eg, homeless shelter), and correctional (eg, jail or prison) settings. Moreover, FMHA often includes specialized batteries that are able to assess and differentially diagnose myriad clinical presentations that may have overlapping symptomatology. We present 2 case vignettes to illustrate the utility of FMHA for enhancing service delivery. Finally, we conclude by noting challenges to integrating FMHA into conceptualization and necessary next steps in research and programing.
在监禁人员中，精神科诊断、医疗发病率和自杀风险的比率显著较高。然而，让这些人参与社区医疗保健环境可能是一个挑战。在确实获得服务的涉及司法的人员中，社区医疗保健环境可能缺乏有效进行全面评估的可用资源，而这些评估可以为基于证据的概念化提供信息。我们提出法医心理健康评估 (FMHA) 作为增强这一高危人群服务的重要机会。特别是，在其职责范围内，法医心理健康评估员能够对健康（例如，住院和门诊医疗保健环境）、社会（例如，无家可归者收容所）和矫正（例如，监狱或拘留所）环境中的记录进行全面审查。此外，FMHA 通常包括能够评估和区分诊断多种临床表现的专门电池，这些临床表现可能具有重叠的症状。我们提出了 2 个案例示例来说明 FMHA 增强服务的效用。最后，我们在研究和项目规划中指出了将 FMHA 纳入概念化的挑战和必要的下一步。
