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What do experts believe is the increase of admissions in state psychiatric hospitals in the U.S between 2002-2005?
They believe it may be related to increase of forensic admission and residents.
-Lack if community resources for individuals with mental health has led to an increase in individuals becoming involved with court system.
-Community reintergration following incarceration or forensic hospitalization is a complex journey
-Occupational Therapy practitioners are well suited to support this process, but relatively few practice in this area.
Examining the System: The Process
Clients in the criminal justice system come in contact with the mental health system in several ways
-Defendants,pre- trial, or undergoing evlauation phase
-Inmates, post conviction phase at jails and prisons
-Insanity aquitees- (those aquitted based on an insanity defense). Insanity aquitees.. typically have mental illness and often also have an additional diagnosis such as mental retardation or substance abuse.
Court System
-Another of different court systems are possible depending on the specific change
-Defendants found guilty enter the criminal justice system to serve their sentence
-Defendants/ clients adjudicated through insanity defense could be transferred to a court designated facility for further forensic evaluation or treatment to restore competency to stand trial
-Another verdict, "guilty but mentally ill" (GBMI), exists in some states
Why were specialty courts developed?
Specialty courts were developed to assist defendants who have social or behavioral issues in addition to criminal history
Mental Health Court processes vary by state jurisdiction. Most:
Work with persons with mental illness whose offenses vary- usually misdemeanors, but may include serious violent felonies.
-Divert persons with mental illness away from the criminal justice system, into the community with court-ordered mental health treatment and support
Criminal Justice System
-Access to mental health care varies based on how the person enters the criminal justice system and/or the forensic mental health system
-Defendants found guilty in court may get sentenced to jail or prison time
-Once incarcerated, if the inmate discloses mental illness or exhibits signs of mental illness, he may have access to limited psychiatric services
- If the inmate demonstrates exacerbated illness, he may be removed from the general population and transferred to a correctional mental health hospital for further assessment and treatment.
Forensic Mental Health System
Maximum security hospital provide treatment and rehabilitation to those accused of serious violent felonies (e.g., murder, arson, rape)
These hospital treat:
-Clients in states that have insanity plea
-Individuals who have been adjudicated Not Competent to Stand Trial, or Not Criminally Responsible (NCR)
Some states have integrated criminal justice and forensic mental health services. These facilities provide security and minimal treatment, but their primary concern is punishment
-These facilities are not typically accredited by the Joint Commission of Center for Medicare and Medicaid Services
Routes to community reintegration
-The path to community reintegration varies depending upon the original court finding and disposition
Defendant/Inmate
-Placement or release into the community is complex
-Individuals can be released by the court from a mental health court, jail, prison, or correctional mental health system
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