Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
18 Cards in this Set
- Front
- Back
|
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 |
|
|
Who would be considered as forensic clients?
|
-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) |
|
|
Forensic Mental Health System |
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 |
|
|
Routes to community Reintegration |
Adjudicated Not Criminally Responsible -In some states, patients/defendants who are adjudicated as not criminally responsible continue to reside in a maximum security state hospital but no longer need that level of supervision -If initial offense was heinous and highly publicized, community agencies hesitate to accept the client directly from maximum security hospitals -An occupational therapy practitioner may contribute to a team who plan and consider conditional release requests-especially when specific to community living needs and aftercare |
|
|
Roles & Necessary Skills of an Occupational Therapy Practitioner Working in the Community |
-A thorough knowledge of general occupational therapy, mental health and illness, community systems, and the criminal justice system -Learning about individual client legal issues and synthesizing information about mental health diagnosis are skill fostered by on the job training and experience |
|
|
Challenges to Community Intervention: Public Safety |
Occupational therapy practitioners must -Be well versed with legal, psychiatric, and public safety issues -Be aware of how this might affect their therapeutic use of self -Understand probation and parole criteria and state laws regarding victim notification, as well as reporting requirements |
|
|
Cultural Dynamics of the Criminal Justice & Mental Health Contexts: Transition and community reintegration also can be affected by..... |
-Transition and community reintegration also can be affected by: -Barriers to reintegration -Contextual features -Cultural dynamics -Interactions of multiple systems |
|
|
Cultural Dynamics of the Criminal Justice & Forensic Mental Health Contexts: Institutional/Jail/ Maximum Security Hospital... |
-Most penal systems focus on the implementation of punishment as the primary objective -Mental health or substance abuse treatment is secondary -Opportunity to engage in any occupation is often necessarily controlled or limited |
|
|
Cultural Dynamics of the Criminal Justice & Forensic Mental Health Contexts: The Person.... |
-Clients who have been incarcerated for a lengthy period may fear the "unknown" context of the community -Individuals who have had non experience with new technologies may demonstrate fear and reluctance to leave the familiarity -Once released the dual stigma of a mental illness and criminal history affects all aspects of life from employment to securing housing |
|
|
Cultural Dynamics of the Criminal Justice and Forensic Mental Health Contexts: Community Agency Context.... |
Community agencies who assist with reintegration should be prepared to support the common requirements of programs and housing units including: -Client must be completely independent in ADLs and able to structure his or her free time -Housing agency staff often requires caregiver training regarding potential for behavioral exacerbations or symptom increases |
|
|
Mental Health Recovery Movement |
-Occupational therapy fits well with the principles of the recovery movement because of its client-centered perspective -It is important to remember that encouraging self-determination and empowerment in forensic clients is a delicate balance and must consider judicial mandates that dictate community participation |
