Jewell Michael, Pillai Krishna, Cavney James, Garrett Nick, McKenna Brian
Auckland Regional Forensic Psychiatry Services, Auckland, Aotearoa New Zealand.
Auckland University of Technology, Auckland, Aotearoa New Zealand.
Psychiatr Psychol Law. 2023 May 31;31(2):293-310. doi: 10.1080/13218719.2023.2192261. eCollection 2024.
The ceiling of therapeutic security in Aotearoa New Zealand is medium security. The aim of this study is to identify and characterise a putative cohort of high-secure patients at a medium-secure regional forensic mental health service. A retrospective review of all admissions to a specific service was conducted over 3.75 years. The Dangerousness Understanding, Recovery and Urgency Manual, Triage Security Scale (DUNDRUM-1) was used to identify patients with high-secure care needs. A multiple logistic regression analysis was used to identify the local needs of this cohort. We found a significant incidence (an admission every 55 days) and prevalence (11%) of mixed-gendered and culturally diverse patients with high-secure care needs. The cohort had a high prevalence of psychosis and violent offences, and relatively short length of stay. There is also an indication that the cohort was subject to more restrictive practice. A solution is proposed to meet the needs of this cohort.
在新西兰奥特亚罗瓦，治疗安全的上限是中等安全级别。本研究的目的是在一个中等安全级别的地区法医精神健康服务机构中识别并描述一个假定的高安全级别患者队列。对特定服务机构3.75年期间的所有入院病例进行了回顾性研究。使用《危险性理解、康复与紧急情况手册》分诊安全量表（DUNDRUM-1）来识别有高安全级别护理需求的患者。采用多元逻辑回归分析来确定该队列的当地需求。我们发现，有高安全级别护理需求的不同性别和文化背景的患者有显著的发病率（每55天有一例入院）和患病率（11%）。该队列中精神病和暴力犯罪的患病率很高，住院时间相对较短。还有迹象表明，该队列受到了更多的限制性措施。提出了一个满足该队列需求的解决方案。
