Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting

ObjectivesForensic psychiatric care has two, often contradictory, aims—the treatment of mentally ill offenders and the isolation of the perpetrators to ensure public safety. It is essential to ensure that any periods of liberty deprivation do not last longer than necessary to provide appropriate tre...

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Main Authors: Paweł Gosek, Justyna Kotowska, Elżbieta Rowińska-Garbień, Dariusz Bartczak, Janusz Heitzman
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-08-01
Series:Frontiers in Psychiatry
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fpsyt.2020.00810/full
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author Paweł Gosek
Justyna Kotowska
Justyna Kotowska
Elżbieta Rowińska-Garbień
Dariusz Bartczak
Janusz Heitzman
author_facet Paweł Gosek
Justyna Kotowska
Justyna Kotowska
Elżbieta Rowińska-Garbień
Dariusz Bartczak
Janusz Heitzman
author_sort Paweł Gosek
collection DOAJ
description ObjectivesForensic psychiatric care has two, often contradictory, aims—the treatment of mentally ill offenders and the isolation of the perpetrators to ensure public safety. It is essential to ensure that any periods of liberty deprivation do not last longer than necessary to provide appropriate treatment. Therefore, identifying the factors affecting the length of stay (LoS) is one of the most important research areas in the forensic psychiatry. The literature on this subject is scarce and to date there no data available on LoS for patients in Eastern or Central European patients.MethodsWe conducted a retrospective analysis of data for 150 inpatients in a medium secure unit. Based on a literature review and clinical experience, variables potentially influencing LoS were identified and included in the analysis.ResultsThe variables that were significantly associated with LoS included duration of mental illness; severity of index offense; whether a crime was committed as a result of hallucinations or during drug treatment discontinuation; if the index offenses was a continuous crime (crimes committed over an extended period of time); persistent psychosis; multiple antipsychotic treatments; as well as a diagnosis of schizophrenia and schizoaffective disorder.ConclusionsOur findings are highly consistent with observations made by other researchers. However, contrary the majority of previous studies our project incorporates data concerning the clinical presentation of patients. For example, we demonstrate that variables measuring treatment resistance might be one of the crucial determinants of LoS, which is a novel research finding.
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spelling doaj.art-b91bd05be9f64d5382682aa1be4300b12022-12-21T23:56:34ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402020-08-011110.3389/fpsyt.2020.00810497594Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure SettingPaweł Gosek0Justyna Kotowska1Justyna Kotowska2Elżbieta Rowińska-Garbień3Dariusz Bartczak4Janusz Heitzman5Department of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, PolandDepartment of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, PolandChair of Psychiatry, Medical College, Jagiellonian University, Krakow, PolandSexological Clinic and Pathology of Intercourse, The Nowowiejski Hospital, Warsaw, PolandDepartment of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, PolandDepartment of Forensic Psychiatry, Institute of Psychiatry and Neurology, Warsaw, PolandObjectivesForensic psychiatric care has two, often contradictory, aims—the treatment of mentally ill offenders and the isolation of the perpetrators to ensure public safety. It is essential to ensure that any periods of liberty deprivation do not last longer than necessary to provide appropriate treatment. Therefore, identifying the factors affecting the length of stay (LoS) is one of the most important research areas in the forensic psychiatry. The literature on this subject is scarce and to date there no data available on LoS for patients in Eastern or Central European patients.MethodsWe conducted a retrospective analysis of data for 150 inpatients in a medium secure unit. Based on a literature review and clinical experience, variables potentially influencing LoS were identified and included in the analysis.ResultsThe variables that were significantly associated with LoS included duration of mental illness; severity of index offense; whether a crime was committed as a result of hallucinations or during drug treatment discontinuation; if the index offenses was a continuous crime (crimes committed over an extended period of time); persistent psychosis; multiple antipsychotic treatments; as well as a diagnosis of schizophrenia and schizoaffective disorder.ConclusionsOur findings are highly consistent with observations made by other researchers. However, contrary the majority of previous studies our project incorporates data concerning the clinical presentation of patients. For example, we demonstrate that variables measuring treatment resistance might be one of the crucial determinants of LoS, which is a novel research finding.https://www.frontiersin.org/article/10.3389/fpsyt.2020.00810/fullforensic psychiatryviolencelength of staytreatment resistanceforensic treatment
spellingShingle Paweł Gosek
Justyna Kotowska
Justyna Kotowska
Elżbieta Rowińska-Garbień
Dariusz Bartczak
Janusz Heitzman
Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
Frontiers in Psychiatry
forensic psychiatry
violence
length of stay
treatment resistance
forensic treatment
title Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
title_full Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
title_fullStr Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
title_full_unstemmed Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
title_short Factors Influencing Length of Stay of Forensic Patients: Impact of Clinical and Psychosocial Variables in Medium Secure Setting
title_sort factors influencing length of stay of forensic patients impact of clinical and psychosocial variables in medium secure setting
topic forensic psychiatry
violence
length of stay
treatment resistance
forensic treatment
url https://www.frontiersin.org/article/10.3389/fpsyt.2020.00810/full
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