Prison psychiatry Flashcards
1
Q
Mental health disorders
A
- 90% prisoners have a mental disorder
- 20-30% have substance missuse
2
Q
Personality disorders
A
- antisocial PD is most common in men
- second most common is paranoid personality disorder
3
Q
Psychosis in prison
A
- 52%
- 1/4th of all psychoses are attributable to psychoactive substances
4
Q
Suicide
A
- 8x higher in prison population than the general population
- majority occur within 6 months of imprisonment
- more life sentence prisoners
- remand prisoners, young offenders and those with a history of substance misuse and violent offences are at particular risk
5
Q
Serious violence in the severely mentally disordered
A
-probability is less than 1%
6
Q
Risk assessment
A
- can be clinical approach (subjective)
- actuarial- uses probabilities and is popular in forensics
- structured professional judgment (HCR-20)
7
Q
HCR 20
A
- popular tool for violence risk
- historical, clinical and risk
- 10 historic items
- 5 clinical items
- 5 risk management items
8
Q
Historical risk items in HCR20
A
- previous violence
- young age at first incident
- unstable relationships
- major mental illness
- substance use
- psychopathy
- employment issues
- personality disorder
- early maladjustment
- previous supervision failure
9
Q
Clinical items HCR-20
A
- negative attitudes to health services
- active symptoms
- impulsivity
- treatment unresponsiveness
- lack of insight
10
Q
Risk items in HCR-20
A
- management plan lacks feasibility
- exposure to destabilisers
- non-compliance
- stress
- lack of personal support
11
Q
SARA
A
- spousal assault risk assessment
- 20 item set of risk factors for use in the assessment of spousal assault
12
Q
SVR-20
A
- sexual violence risk 20 scale
- 20 item guide for assessing violence risk in sex offenders
13
Q
VRAG
A
- Violence risk appraisal guide is entirely reliant on historical factors
- validated in Canadian prisons
- made of 12 items and includes PCL_R as a subscale
14
Q
Items on VRAG
A
- PCL-R (diagnoses psychopathy)
- elementary school difficulties
- personality disorder
- younger age
- separated from parents before age of 16
- never married
- absence of schizophrenia
- victim injury
- alcohol abuse
- female victim
- failed conditional release
- history of non-violent offence
15
Q
Violence Risk Scale
A
-23 dynamic and 6 static variables
16
Q
PCL-R
A
- scale to diagnose psychopathy
- informs risk assessment and treatment decisions
- 0-40 score range
- 0-2 for each item
- 20 items in total
- cut off of 25 used to diagnose psychopathy
17
Q
The static 99
A
- ten item actuarial assessment instrument created by Hanson and Thornton
- used with adult male sex offenders who are at least 18 years of age at the time of release to the community
18
Q
SORAG
A
- sexual risk offender appraisal guide
- a 14 item actuarial instrument that incorporates the PCL-R
