Forsenic Mental Health Nursing Flashcards
Fitness to plead
If a mental illness prevents a person from understanding the proceedings, instruction from his/her lawyer or understanding the nature of the charge then the court may not go ahead with the proceedings
Not guilty by reason of insanity
If they were unwell at the time of the offence and did not understand the nature and quality of the act or did not know it was wrong
Demographic characteristics
The forensic mental health population tends to be young, male, never married, of low socioeconomic status, unemployed, with poor educational achievement, prior to conviction. However, the number of imprisoned women is increasing and therefore the female forensic consumer population is growing
There is an over-representation of Indigenous peoples in forensic mental health services. Due to colonisation immigrant populations are required to adapt to the social reality of the dominant culture. Social adjustments place considerable pressure on disadvantaged groups. These pressures are reflected in social indicators, such as poor educational achievement, high unemployment rates, high crime rates and poor health statistics.
Cognitive and social skills
When a person’s ability to think clearly is compromised by mental illness, the likelihood of antisocial behaviour, including violence and offending, is enhanced. Compromised cognitive and social ability can relate to diminished learning opportunities in the context of the family and environment, inconsistent parenting, delinquent peer associations or brain injury. The development of cognitive and social skills is a recovery requirement of forensic mental health services.
Social disadvantage
Assessing the needs of forensic mental health consumers, nurses must also consider the consumer’s sociocultural context. The influences of cultural disadvantage and low socioeconomic status are especially important. Forensic mental health consumers are more at risk of victimisation compared with the general population. Victimisation includes being subjected to violence, intimidation, sexual exploitation and financial exploitation. Violence may be the reality of high-crime neighbourhoods where people experiencing mental illness often live. There is an indication that people experiencing mental illness move into, or fail to move out of a low socioeconomic locations because of the impact of the social stigma attached to the illness.
Substance use
Substance abuse is common in forensic mental health consumers the major driver of violence in people (with and without a mental illness) is substance misuse. Forensic consumers have high rates of substance abuse and these coexisting conditions have a link to offending and risk of violence. Having a substance use disorder can also present a number of challenges for consumers, including the ability to successfully transition into the community.
According to the Criminal Procedures (Mentally Impaired Persons) Act 2003, what is a special patient?
Provide that a defendant found unfit to stand trial for an offence must be the subject of an inquiry to determine whether the evidence against the defendant is sufficient to establish that the defendant caused the act or omission that forms the basis of the offence
Read the learning resource “Forensic Mental Health’ on Moodle. There are 3 major barriers to recovery that forensic clients identified what are they?
- The stigma associated with being an offender
- Having a major mental illness
- Cramped and overcrowded conditions
Discuss how we (as nurses) can support the recovery process when choice, autonomy and freedom is limited by legislation and the environment.
We need to listen to our clients carefully to fulfil what need they feel are important to support their recovery process.
Identify the risk factors considered in the main forensic risk assessment tools used
Adherence with mediation
Marital resources
Antisocial attitudes
Mental state
Antisocial patterns of behaviour Occupation
Barriers to release
Personal support
Barriers to release
Personality disorder
Case-specific factors
Plans
Companions/peers
Previous violence
Coping skills
Recreation
Criminal history
Relationships
Education
Responsiveness to treatment
Early maladjustment
Rule adherence
Emotional state
Self-care
Exposure to destabilisers
Social skills
Impulsivity
Social support
External triggers
Stress
Family/martial
Substance use
Insight
Young age at first violent incident
Medication adherence
Prior supervision failure
Leisure/recreation
Prison experience institutional factors
