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Chapter 11 - Forensic Psychiatry and Adult Inpatient Secure Settings

from Section 3 - Violence in Different Settings

Published online by Cambridge University Press:  09 May 2023

By
Elliott Carthy  and
Bradley Hillier
Edited by
Masum Khwaja  and
Peter Tyrer
Masum Khwaja
Affiliation:
Imperial College of Science, Technology and Medicine, London
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
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Summary

Forensic psychiatry is a medical discipline, developed from the foundations of the asylum era, which focuses on the assessment and treatment of offenders with mental disorders. The complexity of the patient cohort is arguable reflected in the complexity of their clinical pathways, which necessitates some understanding of the legal system that for most patients, works in parallel to that of health and social care. In this chapter, we briefly review the historical context through which modern forensic psychiatry has emerged within England and Wales. This includes some high-profile individual cases that led to the development of concepts such as fitness to plead and the psychiatric defence of not guilty by reason of insanity. We then provide an outline of how inpatient secure services are structured, the relevant criminal sections of the Mental Health Act at each stage of the trial process and some of the challenges associated with managing this complex cohort of individuals.

Keywords

Forensicinpatientmental illnesscourttherapeutic securitysecure
Type
Chapter
Information
The Prevention and Management of Violence
Guidance for Mental Healthcare Professionals
 , pp. 166 - 186
Publisher: Cambridge University Press
Print publication year: 2023

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