269 research outputs found
Does the Insanity Defence lead to an Abuse of Human Rights?
No Abstract - Forensic Foru
Reinstitutionalization by stealth: The Forensic Mental Health Service is the new chronic system
No Abstract
Forensic telepsychiatry : a possible solution for South Africa?
Objective: South Africa has a shortage of facilities and psychiatrists to assess adjudicative competence of prisoners awaiting assessment under sections 77 to 79 of the Criminal Procedures Act of 1977. Various solutions have been proposed by the Department of Health. The recent linking of a Magistrate’s court and a prison by videoconferencing offers the opportunity to implement a forensic telepsychiatry service. The literature on forensic telepsychiatry for assessment of adjudicative competence was reviewed. Method: The electronic databases, PubMed, Scopus, Cinahl and Google Scholar were searched for papers on forensic telepsychiatry. The inclusion criterion was papers reporting the use of videoconferencing for assessment of adjudicative competence or for assessment for referral out of the judicial system, by psychiatrists or psychologists. Results: 411 papers were found of which 13, published between 1997 and 2008 were relevant. The use of videoconferencing for forensic psychiatric assessment was reported from four countries. The courts in those jurisdictions have accepted the use of videoconferencing for assessment and no successful appeals have been mounted on the basis of the use of videoconferencing for assessment. User satisfaction has not been reported for assessing adjudicative competence. Forensic telepsychiatry has been found to be cost effective, improve access to scarce specialist skills and reduce transport of prisoners under guard to hospitals or psychiatrists to prisons. Conclusion: There is nothing in the literature to suggest that a forensic telepsychiatry service is not feasible in South Africa and a pilot project is being planned.Keywords: Videoconferencing; Telemedicine; Forensic psychiatry; South Afric
Patients with severe mental illness: A new approach to testing for HIV
Background. The prevalence of HIV infection in South Africa
is approaching 20% of young adults. In severely mentally ill
people it is probably higher. Testing for infection is subject
to stringent ethical principles. Undiagnosed HIV infection in
people with severe mental illness increases costs and morbidity.
Since effective treatments are available, it is imperative to
diagnose HIV infection early in this high-risk population.
Methods. A literature review established the prevalence of HIV
infection in inpatient populations with HIV infection. The
pattern of testing for HIV over 3 years at a major psychiatric
hospital was investigated. We surveyed public sector
psychiatrists in the Western Cape to establish their attitudes to
HIV in their patients.
Results. The reported HIV seroprevalence in psychiatric
inpatients ranges from 0 to 59.3%, with a mean of 10%. Data
show a clear trend towards an increase in prevalence: before
1996 the mean HIV seroprevalence was 7.4%, while after 1996
the mean was 15%. State psychiatrists in the Western Cape do
not test routinely for HIV infection, mainly owing to ethical
constraints: 14.6% of patients at Lentegeur Hospital were tested
in 2006.
Conclusions. The high prevalence of HIV infection in South
Africa, which is probably higher in patients with severe mental
illness (most of whom are not competent to provide informed
consent), and the availability of effective treatment require
debate and a clear policy regarding testing for HIV infection
to be implemented. We recommend a new approach to HIV
testing in these patients. South African Medical Journal Vol. 98 (3) 2008: pp. 213-21
Does the Insanity Defence lead to an Abuse of Human Rights?
Every day convicted murderers, rapists, and other violent offenders are released by the prisons into the community. Most have not even completed their sentences, as they earned remittances for good behaviour. No one seems to worry that statistically many of these former prisoners remain dangerous, and will probably harm others sometime in the future. 1 In fact, there are criminologists who argue persuasively that fewer offenders should be imprisoned, for the good of their families and communities. This may reflect the confusion about what the actual purpose of imprisonment is, ranging from urges for retribution to achieving rehabilitation. Nevertheless, we are satisfied that when an offender ‘has repaid his debt to society’ he is free to re-enter ordinary life, albeit for a while under the sometimes wavering, watchful supervision of a parole officer
Forensic psychiatry in Africa: prospects and challenges
Forensic Psychiatry has a history that dates back almost two thousand years, and has evolved into a recognised discipline with a robust background of scientific enquiry, mostly because mental health care has always had an important interface with the law. 1 Nevertheless, even in the developed world there are differences between countries with respect to the extent forensic mental health services have developed. This has been exacerbated by the differences in legal systems, resources and priorities in each country. Consequently comparisons and cooperation between forensic psychiatrists internationally has been difficult. 2-4 In Africa, which is the second largest and most populous continent and containing an immense diversity of languages, religious traditions, ethnic groups and sociopolitical systems forensic psychiatry has largely remained underdeveloped within the context of a pervasive neglect in the provision of mental health services. 5 The situation is compounded by the dearth of information about forensic services on the continent. As described by an eminent African psychiatrist, “the practice of forensic psychiatry in Africa is shrouded in both mystery and confusion”. 6 In addition to the lack of appropriate facilities, most countries in Africa have, on average, one psychiatrist per one million inhabitants. Moreover many psychiatrists have migrated to developed countries, leaving a small number of mental health professionals burdened with large numbers of patients. 6 In most countries there are few coordinated initiatives to involve all stakeholders, such as the police, departments of justice, prisons and hospitals, in the development of forensic mental health services
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