Geheran B, Kumar S, Ma'u E
Psychiatry, Auckland District Health Board, Auckland, New Zealand.
Forensic MHS, Waikato District Health Board, Hamilton, New Zealand.
Psychiatr Psychol Law. 2022 Jun 15;30(4):553-564. doi: 10.1080/13218719.2022.2059030. eCollection 2023.
On entering forensic mental health services (FMHS) patients progress along forensic care pathways (FCP) that aim to maximise well-being and reduce risk of reoffending. They progress through high-, medium-, and low-secure psychiatric units with changing care and security needs. There is minimal literature examining FCP or their efficacy. This retrospective study describes the characteristics of patients admitted to an acute FMHS and explores the clinical, sociodemographic, and legal factors that influence FCP progression. Most patients were referred from prison (65.1%) and presented with violent index offending (62.4%) and psychotic disorder (80.6%). Young Maori men with psychosis predominated the forensic population. Logistic regression revealed violent index offending and diagnosis were determinants of following FCP, while violent offending and longer duration of stay were predictive of FCP progression. This study found no reduction in re-hospitalisation rates or inpatient length of stay over a three year follow-up for patients that completed the FCP.
进入法医精神卫生服务机构（FMHS）的患者会沿着法医护理路径（FCP）发展，这些路径旨在使幸福感最大化并降低再次犯罪的风险。他们会在高、中、低安全级别的精神科病房中接受治疗，其护理和安全需求会不断变化。关于FCP及其疗效的文献极少。这项回顾性研究描述了入住急性FMHS的患者的特征，并探讨了影响FCP进展的临床、社会人口统计学和法律因素。大多数患者是从监狱转来的（65.1%），表现出暴力指数犯罪（62.4%）和精神障碍（80.6%）。患有精神病的年轻毛利男性在法医群体中占主导地位。逻辑回归显示，暴力指数犯罪和诊断是遵循FCP的决定因素，而暴力犯罪和住院时间较长则可预测FCP的进展。该研究发现，对于完成FCP的患者，在三年随访期间，再住院率或住院时间并未降低。
