Issues in the provision and evaluation of forensic services

Publisher Website
Google Scholar
Abstract
A brief history is given of how the forensic psychiatric services have arrived at their current form. These services provide care for patients in a range of settings, from the maximum security of Special Hospitals to the developing community services, and including a network of regional medium secure units. They differ from the rest of the mental health services in that their treatments are expected to be associated with a reduction in dangerousness in their patients. A judgement of the probability of reoffending is an important factor in determining the timing of release. It is argued that estimates of recidivism are of greater importance in the assessment of the effectiveness of the forensic psychiatric services than clinical relapse. Discharge from and transfer from and within the forensic psychiatric services are processes of great clinical and administrative complexity. The issues relevant to an audit of forensic psychiatric services functions are: (1) standard of care; (2) cost; (3) public safety. The design problems of studies to assess the functions of forensic psychiatric services are discussed and two areas of importance for evaluation are identified.