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forensic psychiatry Flashcards

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1
Q

forensic patient locations

A
  1. prison
  2. inpatients - central mental
  3. general adult psych
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2
Q

how are people admitted to the central mental

A
  1. from prison/court under the criminal law act 2006

2. from psych hospitals under mental health act 2001

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3
Q

remand prisoner

A

awaiting trial that is not convicted and not released on bail

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4
Q

sentenced prisoner

A

tried and guilty and serving

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5
Q

prisoner gender

A

m»>f

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6
Q

mentally ill prisoners + violence

A

most offences minor and non violent - should get bail but because mental illness don’t eg. homeless/no money/no family to vouch for them

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7
Q

rate of mental illness in prisons?

A

higher than community

6 month prevalence of psychosis in male remand prisoners is 10x that of community

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8
Q

why is there a high rate mental illness in irish remand centres?

A
  1. no formal court diversion mechanism
  2. no mental health court
  3. not enough investment in community services
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9
Q

what is court diversion?

A

transfer people with mental illness from criminal justice system to psych hosp

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10
Q

when are people with mental illness identified in legal system?

A
  1. point of arrest
  2. court appearance
  3. remand centres
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11
Q

when are patients sent to CMH?

A

major mental illness + major offence

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12
Q

when are patients sent to local psych service?

A

major mental illness, minor offence

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13
Q

when are patients treated in prison?

A

major offence, minor illness

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14
Q

when OPD tx by local psych service?

A

minor mental illness, minor offence

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15
Q

what specific mental illnesses are more common in the male prisoner population?

A

antisocial PD

personality disorder

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16
Q

what meds are high currency value in prison?

A
  1. benzos
  2. hypnotics
  3. mirtazapine
  4. olanzapine

intimidate staff and other inmates

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17
Q

what is the book of evidence?

A
  1. charge sheet
  2. transcript of interview after arrest
  3. statements from witnesses and victim
  4. list of exhibits for trial
  5. a copy is given to the accused, prosecutors, defencers, psychiatrist
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18
Q

psychiatric court report features

A
  1. impartial regardless of who comissions it
  2. detailed
  3. duty is to the court
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19
Q

which courts have juries?

A

circuit and central criminal

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20
Q

what is a summary offence?

A
  1. less serious than indictable
  2. hear in district court
  3. max sentence of one month for one offence
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21
Q

what is an indictable offence?

A
  1. circuit or central criminal
  2. up to life in prison
  3. sometimes special criminal
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22
Q

fitness to be tried means?

A

capacity at time of trial not at time of offence

23
Q

when is someone unfit to be tried?

A

can’t:

  1. plead to charge
  2. instruct legal representative
  3. can’t elect for trial by jury
  4. can’t challenge a juror
  5. can’t understand the evidence
24
Q

what if someone is unfit to be tried?

A

postpones trial

25
Q

what is the insanity plea?

A

actus rea without mens rea

26
Q

criteria for not guilty by reason of insanity?

A
  1. suffering at the time of the offence
  2. cannot be held responsible because:

a. did not know the nature of the act
b. did not know the act was wrong
c. could not stop from committing the act

27
Q

if NGRI?

A

CMH

28
Q

diminished responsibility vs NGRI?

A

NGRI can be any charge, DR only murder

29
Q

criteria of DR?

A
  1. person did the act alleged
  2. was suffering from a mental disorder at the time
  3. mental disorder substantially diminished the responsibility for the act
30
Q

what happens if DR?

A

murder = automatic life sentence, but if DR then reduced to manslaughter - can sentence for any time

31
Q

what is the mental health review board?

A

reviews CMH patients who have been referred by criminal law act 2006 by court if unfit to stand trial or NGRI

max interval 6 months

32
Q

members of mental health review board?

A

chair - solicitor/barrister
consultant psych
lay person

33
Q

drugs/alcohol - offence?

A

theft
driving
violence

34
Q

SCZ - offence?

A

minor public order

rarely violence!

35
Q

depression- offence?

A

shoplifting

suicide + homicide

36
Q

LD - offence?

A

sexual

arson

37
Q

mania - offence?

A

fraud

sexual

38
Q

dementia - offence?

A

minor

exhibition

39
Q

morbid jealousy - offence?

A

rape
homicide
directed at partner of affected individual
children - may think are product of extra-marital relationship
love rivals

40
Q

dissocial PD - offence?

A

10x risk homicide

41
Q

epilepsy - offence?

A

controversial association

doesn’t seem to be a link

42
Q

manslaughter vs murder?

A

murder - killing with malice

manslaughter- killing without malice

43
Q

characteristics of rape offenders?

A
  1. M>F

2. usually

44
Q

characteristics of rape victims?

A
  1. females>males
  2. CSA = higher risk
  3. alcohol by offender or victim
  4. more in summer, first half of night, weekends
45
Q

when are kids most vulnerable to CSA?

A

8-12 yrs

f>m

46
Q

men who abuse boys orientation

A

usually say heterosexual

47
Q

how long average CSA abuse relationship last?

A

4 years

48
Q

RFs for NAI?

A
  1. ill child
  2. premature
  3. first born
  4. single parent
  5. young mother
  6. parents suffered abuse
  7. low income
  8. substances
49
Q

categories of CA?

A

neglect
emotional
physical
sexual

50
Q

children first guidelines?

A

anyone who suspects must report to health board - HB will get SW on the case

if emergency - gardai

51
Q

stalking + mental health problems?

A 
personality disorder
delusional disorder
abused substances
SCZ
BPAD/anxiety
52
Q

how do we know the risk of violence posed by those with mental illnesses?

A

HCR-20 risk assessment

53
Q

what is the HCR 20 RA?

A 
1. risk factor checklist
H - historical factors
C - clinical factors
R -risk management issues
20 - 20 items altogether

Psych (23 decks)

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