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MRCPSYCH_Paper B_MENTOR & More_Dr. ART > Forensics_SPMM_2 > Flashcards

Forensics_SPMM_2 Flashcards

1
Q

What are forensic institutions?

A

Forensic institutions include high secure and medium secure residential units for mentally disordered offenders (MDOs), Young Offender Institutes (YOIs) for young offenders, and secure children’s homes.

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2
Q

What is the age range for young offenders in YOIs?

A

Young offenders in YOIs are typically aged 12 to 16.

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3
Q

What is the age range for juvenile offenders?

A

Juvenile offenders are typically aged 15 to 17.

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4
Q

What is the difference between high secure and medium secure units?

A

High secure units are filled with MDOs who pose a grave risk, while medium secure units provide services for high-risk MDOs.

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5
Q

What do low secure units generally hold?

A

Low secure units generally hold mentally disordered offenders (MDOs) with limited violence or absconding risk.

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6
Q

What is the role of Community Forensic Teams?

A

Community Forensic Teams focus on reducing physical and procedural security while enhancing therapeutic care.

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7
Q

What is the Parallel Care Model?

A

The Parallel Care Model provides inpatient medium secure care and community care in parallel, ensuring continuous long-term community service.

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8
Q

What is the Integrated Care Model?

A

The Integrated Care Model involves general psychiatric services providing long-term rehabilitation after discharge from low/medium secure units.

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9
Q

What is the Hybrid Care Model?

A

The Hybrid Care Model includes a period of shared care after discharge, allowing forensic services to retain long-term care for high-risk offenders.

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10
Q

What does probation refer to?

A

Probation refers to serving a sentence in the community rather than in prison.

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11
Q

What percentage of supervised offenders in England & Wales are under probation when discharged from secure institutions?

A

Nearly 70% of supervised offenders are under probation when discharged.

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12
Q

What are some roles of a probation officer?

A

Roles include assessing offenders, monitoring progress, advising the parole board, supervising offenders on license, and providing local support.

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13
Q

What are prison inreach services?

A

Prison inreach services provide a link to primary care health services and are present in nearly 87% of UK prisons.

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14
Q

What is the National Offender Management Service (NOMS)?

A

NOMS connects prison and probation services and advises the UK government on strategies and policies.

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15
Q

What is the Multi-Agency Public Protection Arrangements (MAPPA)?

A

MAPPA is a framework for interagency collaboration to manage mentally disordered offenders convicted of specified sexual or violent offences.

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16
Q

What are the three main areas to consider for security in psychiatric hospitals?

A

The three areas are physical security, relational security, and procedural security.

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17
Q

What is the purpose of security level assessment in forensic settings?

A

Security levels are assessed to balance safety needs with therapeutic objectives.

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18
Q

What are the categories of observation levels?

A

Observation levels include general observation, intermittent observation, within eyesight observation, and within arms’ length observation.

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19
Q

What factors determine the decision for temporary leave from secure units?

A

Factors include stability of mental state, insight, rapport with staff, engagement with treatment, and past behavior on leave.

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20
Q

What is Section 17 leave?

A

Section 17 leave allows temporary absence from secure units and requires documentation of purpose and conditions.

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21
Q

What is the prevalence of mental disorders in prisons?

A

Over 90% of prisoners have a mental disorder.

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22
Q

What is the most significant cause of morbidity in prisons?

A

Mental health problems are the most significant cause of morbidity in prisons.

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23
Q

What is the suicide rate trend in prisons?

A

The suicide rate in prison has more than doubled from 1982 to 1998.

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24
Q

What is the most common method of suicide in prisons?

A

The most common method of suicide in prisons is hanging.

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25
Q

What is the likelihood of suicide in the prison population compared to the general population?

A

Suicide is nearly 8 times higher in the prison population than in the general population.

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26
Q

What is the definition of risk in the context of violence risk assessment?

A

Risk is the likelihood that harm will occur.

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27
Q

What does risk assessment involve?

A

Risk assessment involves calculating the likelihood of an adverse event and specifying what will happen, when, and by whom.

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28
Q

What term has been replaced with risk assessment and management?

A

The term is no longer used.

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29
Q

What is risk?

A

Risk is the likelihood that harm will occur.

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30
Q

What is risk assessment?

A

Risk assessment is a process of scientific calculation of the likelihood of an adverse event, including specifying: 1. What will happen? 2. When will this happen? 3. By whom will this happen? 4. How will this happen?

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31
Q

What is the role of risk management in risk assessment?

A

Risk management is integral to assessment; it is a dynamic process specific to the event of importance.

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32
Q

Can risk be eliminated?

A

No, risk cannot be eliminated but only reduced.

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33
Q

What did the Ritchie report identify?

A

The Ritchie report identified failures of risk assessment and management by individual practitioners.

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34
Q

What is a problem with predicting risk?

A

Low base rate: The events of interest are usually very rare, leading to low predictive value.

35
Q

What are the categories of risk factors for untoward incidents?

A

Risk factors can be categorized as static, stable, and dynamic.

36
Q

What are static risk factors?

A

Static risk factors are fixed and historical, such as family history of suicide.

37
Q

What are stable risk factors?

A

Stable risk factors are long-term, enduring issues that are modifiable to some extent, such as a diagnosis of personality disorder.

38
Q

What are dynamic risk factors?

A

Dynamic risk factors fluctuate in both duration and intensity, such as the presence of acute anxiety symptoms.

39
Q

What should a comprehensive risk assessment consider?

A

It should consider static, stable, dynamic, and future risk factors.

40
Q

What are some problems identified in homicide inquiries?

A

Problems include failure to take carers’ views into consideration and undue emphasis on civil liberties of patients.

41
Q

What is the clinical approach to risk assessment?

A

The clinical approach uses a clinician’s subjective judgment informed by experience to estimate risk.

42
Q

What is the actuarial approach to risk assessment?

A

The actuarial approach uses formal, algorithmic procedures for quantifying risk as a numerical probability.

43
Q

What are the problems with actuarial tools?

A

Problems include high false positive rates and insensitivity to change.

44
Q

What is structured professional judgment?

A

Structured professional judgment combines evidence for risk factors with individual clinical assessment.

45
Q

What are the stages in risk assessment according to Bouch & Marshall?

A

Stages include identifying the need for assessment, assessing risk factors, and developing a management plan.

46
Q

What is HCR-20?

A

HCR-20 is a structured clinical assessment tool for violence risk, showing good inter-rater reliability.

47
Q

What is SARA?

A

SARA is a 20-item set of risk factors for assessing spousal assault.

48
Q

What is the Static-99?

A

Static-99 is a ten-item actuarial assessment instrument for adult male sexual offenders.

49
Q

What does actus reus refer to?

A

Actus reus refers to the act of crime.

50
Q

What does mens rea refer to?

A

Mens rea refers to the intent of crime.

51
Q

What is the age of criminal responsibility in England & Wales?

A

The age of criminal responsibility is over 10 years.

52
Q

What are the psychiatric defences used during a trial?

A

Defences include not guilty by reason of insanity and diminished responsibility.

53
Q

What is fitness to plead?

A

Fitness to plead relates to the mental abilities to participate in a trial.

54
Q

What are the common trial defences?

A

Not guilty by reason of insanity, infanticide, automatism, diminished responsibility.

55
Q

What does fitness to plead relate to?

A

Fitness to plead relates to the mental abilities to comply with trial proceedings.

56
Q

What physical conditions may affect fitness to plead?

A

Physical conditions such as deafness or muteness may result in unfitness to plead.

57
Q

What is the presumption regarding fitness to plead?

A

There is a presumption of fitness and tests of cognitive ability are conducted.

58
Q

What are the R v Pritchard criteria for unfitness to plead?

A

An individual is unfit to plead if found incapable of understanding the charge, deciding whether to plead guilty or not, exercising the right to challenge jurors, instructing solicitors and counsel, following the course of proceedings, or giving evidence in their own defence.

59
Q

What is the burden of proof for fitness to plead?

A

If raised by prosecution, it must be proven beyond reasonable doubt; if raised by defence, it must be proven on the balance of probabilities.

60
Q

What happens if a person is found unfit to plead?

A

A trial can still occur, but it is limited to a trial of facts.

61
Q

What are the components of the McNaughten Rules?

A
  1. A defect of reason due to a disease of mind. 2. Leading to loss of appreciation of the nature and quality of an act. 3. The accused did not realize what they were doing was wrong.
62
Q

What does diminished responsibility defence do?

A

It reduces the charge of murder to manslaughter by demonstrating the absence of mens rea.

63
Q

What is the legal classification of automatism?

A

Automatism can be classified as sane automatism (one-off acts) or insane automatism (likely to recur).

64
Q

What is sane automatism?

A

Sane automatism is a complete defence where the defendant is deemed not to be blameworthy for their actions.

65
Q

What are the features that support sleepwalking as an automatism defence?

A

Family history of sleepwalking, occurring within 2 hours of sleep onset, inappropriate behaviour with confusion, presence of trigger factors, substantial amnesia, no attempts to conceal crime.

66
Q

What is culpable homicide?

A

Culpable homicide lies between manslaughter and homicide, lacking specific intent to kill but resulting in death.

67
Q

What is the distinction between voluntary and involuntary intoxication?

A

Involuntary intoxication can be a valid defence, while voluntary self-induced intoxication is not.

68
Q

What are mitigating factors in a legal context?

A

Factors that can reduce the culpability of the defendant, such as being provoked, age, mental disorder, involuntary intoxication, showing remorse, or having a limited role in the offence.

69
Q

What does amnesia indicate in legal terms?

A

Amnesia may indicate an abnormality at the time of the offence, but it has no legal implications in the absence of automatism.

70
Q

What issue may occur if the defense does not consider support of an expert witness?

A

An issue of credibility may occur.

This is particularly relevant to fitness to plead, fitness to be interviewed, and reliability, especially in cases of amnesic syndrome.

71
Q

Does amnesia around the offense render someone unfit to plead?

A

No, amnesia around the offense does not render someone unfit to plead.

72
Q

What concerns can occur regarding witnesses’ fitness to give evidence?

A

Concerns can occur that the witnesses are unfit or unreliable, especially if they are at the extremes of age, suffer from psychiatric disorder, or have learning disabilities.

73
Q

What is the commonly used test for fitness to give evidence derived from?

A

The test is derived from case law and includes understanding the question, applying their mind to answering them, and conveying the answers intelligibly to the jury.

74
Q

What are the three types of false confessions?

A

The three types are: voluntary false confession, coerced-compliant confession, and coerced-internalised confession.

75
Q

What factors influence false confessions?

A

Factors include situational factors (effects of custody/isolation, e.g., police interrogation) and individual factors (including mental disorder and incapacity).

76
Q

What are the important tasks of a psychiatrist within the criminal justice pathway?

A

Important tasks include assessing suspects who may be mentally ill, advising on mental health diversion, advising on fitness to be interviewed, advising on fitness to plead and stand trial, arranging transfer to hospital while on remand, and providing advice regarding sentencing options.

77
Q

What is good medical practice in writing psychiatric reports?

A

You must be honest and trustworthy, ensure documents are not false or misleading, complete or sign documents without unreasonable delay, and be honest in all statements while clarifying the limits of your knowledge or competence.

78
Q

What are the three types of witnesses in court?

A
  1. An ordinary witness (witness to fact, not opinion). 2. A professional witness (comments on clinical state with some involvement). 3. An expert witness (writes reports or statements regarding mental disorder or a specific issue).
79
Q

What types of expertise do expert witnesses provide?

A

Expert witnesses provide advisory, actuarial, clinical, and experimental evidence.

80
Q

What is the role of the ECHR in UK and EU law?

A

The ECHR is enshrined in domestic law and includes several articles, some of which are weighted differently.

81
Q

What does Article 2 of the ECHR state?

A

Article 2 states the right to life, imposing a positive duty on the state to safeguard prisoners and others in custody.

82
Q

What does Article 3 of the ECHR prohibit?

A

Article 3 prohibits torture and degrading treatment.

83
Q

What does Article 5 of the ECHR authorize?

A

Article 5 authorizes the detention of persons of ‘unsound mind’ and led to the creation of deprivation of liberty safeguards.

84
Q

What does Article 8 of the ECHR protect?

A

Article 8 protects the right to private and family life, with a wide interpretation.

MRCPSYCH_Paper B_MENTOR & More_Dr. ART (62 decks)

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