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forensic psychiatry Flashcards

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
what is the insanity plea?
actus rea without mens rea
26
criteria for not guilty by reason of insanity?
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
if NGRI?
CMH
28
diminished responsibility vs NGRI?
NGRI can be any charge, DR only murder
29
criteria of DR?
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
what happens if DR?
murder = automatic life sentence, but if DR then reduced to manslaughter - can sentence for any time
31
what is the mental health review board?
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
members of mental health review board?
chair - solicitor/barrister consultant psych lay person
33
drugs/alcohol - offence?
theft driving violence
34
SCZ - offence?
minor public order | rarely violence!
35
depression- offence?
shoplifting | suicide + homicide
36
LD - offence?
sexual | arson
37
mania - offence?
fraud | sexual
38
dementia - offence?
minor | exhibition
39
morbid jealousy - offence?
rape homicide directed at partner of affected individual children - may think are product of extra-marital relationship love rivals
40
dissocial PD - offence?
10x risk homicide
41
epilepsy - offence?
controversial association doesn't seem to be a link
42
manslaughter vs murder?
murder - killing with malice manslaughter- killing without malice
43
characteristics of rape offenders?
1. M>F | 2. usually
44
characteristics of rape victims?
1. females>males 2. CSA = higher risk 3. alcohol by offender or victim 4. more in summer, first half of night, weekends
45
when are kids most vulnerable to CSA?
8-12 yrs | f>m
46
men who abuse boys orientation
usually say heterosexual
47
how long average CSA abuse relationship last?
4 years
48
RFs for NAI?
1. ill child 2. premature 3. first born 4. single parent 5. young mother 6. parents suffered abuse 7. low income 8. substances
49
categories of CA?
neglect emotional physical sexual
50
children first guidelines?
anyone who suspects must report to health board - HB will get SW on the case if emergency - gardai
51
stalking + mental health problems?
``` personality disorder delusional disorder abused substances SCZ BPAD/anxiety ```
52
how do we know the risk of violence posed by those with mental illnesses?
HCR-20 risk assessment
53
what is the HCR 20 RA?
``` 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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