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Article
Publication date: 11 May 2015

VIRGININIA DUBE-MAWEREWERE

– The purpose of this paper is to develop a medico-judicial framework for rehabilitation of forensic psychiatric patients in Zimbabwe.

Abstract

Purpose

The purpose of this paper is to develop a medico-judicial framework for rehabilitation of forensic psychiatric patients in Zimbabwe.

Design/methodology/approach

Grounded theory of the Charmaz (2006, 2014) persuasion was used. An exploratory qualitative design was utilised. The theoretical framework that was used as a point of departure was Pierre Bourdieu’s conceptual canon. Participants were purposefully and theoretically sampled. These included the judiciary, patients, patients’ family, psychiatrists, nurses, social workers, experts in forensic psychiatric practice. They were 32 in total.

Findings

The findings reflected a need to realign the dislocation and dissonance between and within the fields of the prison system, medical system, and the judiciary. The realignment was done by co-constructing a therapeutic jurisprudent medico-judicial framework for rehabilitation of forensic psychiatric patients in Zimbabwe with participants who were stakeholders in forensic psychiatric rehabilitation.

Research limitations/implications

The study was focused on male forensic psychiatric patients rehabilitation and not on female forensic psychiatric patients because there were important variables in the two groups that were not homogenous. However, it is possible that including females in the study could have added perspective to the study. This also limits the generalisation of findings beyond the male forensic psychiatric participants. Services beyond the experience of participants translate to the notion that findings cannot be generalised beyond the parameters of the study. Future research and service evaluation and audit need to be considered. The study findings focused on the “psychiatric” aspect and did not emphasise the “forensic” aspect of the service delivery service. Future research may need to feature physical provisions and progression pathways with reference to “forensic” risk reduction as a parallel goal.

Practical implications

The study calls for the following: Transformation of the medico-judicial system, adjusting legislation and restructuring of the public service; changing of public attitudes to enable implementation of the medico-judicial framework; there is need for a step by step process in the implementation of the framework in which training needs of service staff, social workers, community leaders and key stakeholders will need to be addressed; the proposed changes presented by the model will require cultural, financial and infrastructural shifts.

Social implications

There is need for policy makers to re-enfranchise or rebrand forensic psychiatric rehabilitation services in Zimbabwe. This could positively involve the marketing of forensic psychiatric rehabilitation to the stakeholders and to the public. This is projected to counter the stigma, disinterest and disillusionment that run through both professionals and public alike. This will foster a therapeutic jurisprudence that upholds the dignity and rights of forensic psychiatric patients.

Originality/value

This work is an original contribution to forensic psychiatry in Zimbabwe. Research in that area is prohibitive because of the complexity of processes that are followed. This research is therefore ground breaking.

Details

Journal of Forensic Practice, vol. 17 no. 2
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 11 May 2015

VIRGININIA DUBE-MAWEREWERE

– The purpose of this paper is to explicate the lived experiences of nurses involved in rehabilitation of forensic psychiatric patients in special institutions in Zimbabwe.

Abstract

Purpose

The purpose of this paper is to explicate the lived experiences of nurses involved in rehabilitation of forensic psychiatric patients in special institutions in Zimbabwe.

Design/methodology/approach

The study used the grounded theory approach utilising a mixed sequential dominant status design (QUAL/Quant). Pierre Bourdieu’s conceptual canon of field, habitus and capital was used as a theoretical point of departure by the research study. Confirmatory retrospective document review of 119 patients’ files was also done to substantiate the nurses’ experiences. Theoretical sampling of relatives was also done.

Findings

Findings and results revealed that nurses seemed to experience infrahumanisation, a subtler form of dehumanisation. The infrahumanisation was embodied in the unpleasant context in which nurses were expected to perform their mandate of championing rehabilitation of forensic psychiatric patients. The guards who represented the prison system seemed to possess all forms of capital in the prison system (where special institutions are housed): the prison cultural capital, social capital and economic capital. This capital seemed to represent symbolic power over the disillusioned and voiceless nurses. Guards attended to and discussed patients and relatives issues instead of nurses. This form of misrecognition of the nurses culminated in dominance and reproduction of the interests of the prison system which underlined the established order of realities in the rehabilitation of forensic psychiatric patients in special institutions at the time of the study. The nurses’ lived experience was confirmed by theoretically sampled by relatives of forensic psychiatric patients who also participated in the research study. Nurses’ powerlessness was also reflected in the patients’ files in which in which care was largely not documented.

Research limitations/implications

The study focused on the nurses experiences related to rehabilitation of male forensic psychiatric patients and not on female forensic psychiatric patients because there were important variables in the two groups that were not homogenous. For the little documentation that was done, there was also a tendency nurses to document negative rather than positive events and trends. The documents/files of patients had therefore a negative bias which was a major limitation to this study.

Practical implications

There is a need for major revision of the revision of the role of the nurse in the forensic psychiatric setting. Collaboration as academia, practice, professional organisations and regulatory bodies would foster a nurse led therapeutic jurisprudence in the future of rehabilitation of forensic psychiatric patients in Zimbabwe.

Social implications

There is a need for major revision of the revision of the role of the nurse in the forensic psychiatric setting.

Originality/value

This is the first description of the position of nurses’ seconded to special institutions in Zimbabwe and will go a long way in realigning conflictual policy documents guiding care of forensic psychiatric patients in special institutions.

Details

Journal of Forensic Practice, vol. 17 no. 2
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 13 March 2019

Kerri Eagle, Trevor Ma and Barbara Sinclair

The purpose of this paper is to inform the development of an evidence-based and effective rehabilitation programme to address substance use disorders in a population of patients…

Abstract

Purpose

The purpose of this paper is to inform the development of an evidence-based and effective rehabilitation programme to address substance use disorders in a population of patients with severe mental illness and mental disorders detained in a secure forensic psychiatric facility. A clinical review identified a high prevalence of substance use disorders in the patient population at a secure forensic facility in Sydney, Australia with only a limited number of patients being assessed and offered interventions for substance use problems.

Design/methodology/approach

A literature review was undertaken specifically looking at articles between 2009 and 2017 that considered models of care or approaches to substance use rehabilitation in patients with co-morbid psychiatric disorders. Articles were considered based on their relevance to the purpose and the environment of a secure forensic facility.

Findings

The literature review emphasised the need for a cohesive model of care integrating substance use rehabilitation with mental health care. Comprehensive assessment and individualised approaches that incorporated patient choice and stages of change were considered essential components to any dual diagnosis rehabilitation programme.

Practical implications

The literature regarding rehabilitation approaches for those with severe mental illness and co-morbid substance use disorders was reasonably consistent with the models of care used in relation to criminal offenders and mental illness generally. Integrated and individualised rehabilitation approaches for dual diagnosis patients could play a significant role in forensic settings.

Originality/value

Limited robust evidence for substance use rehabilitation has been published. The authors consider the existing evidence base and the underlying theory behind substance use rehabilitation to propose a model for rehabilitation in secure forensic settings. This is the first known review of substance use rehabilitation involving mentally ill offenders with dual diagnoses in secure forensic settings. This paper is the original work of the authors.

Details

Journal of Forensic Practice, vol. 21 no. 1
Type: Research Article
ISSN: 2050-8794

Keywords

Article
Publication date: 28 December 2020

Lorenzo Pelizza, Ursula Zambelli, Enrico Rossi, Germana Verdoliva, Davide Maestri, Ilaria De Amicis, Cecilia Paraggio, Amir Zaimovic, Bruno Veneri, Beatrice Urbani, Diana Gran Dall'Olio, Adriana Adriani, Stefania Cutrino, Silvia Bertoli, Giuseppina Paulillo and Pietro Pellegrini

Mental health interventions for Italian prisoners with mental disorders remain a problematic issue, despite radical changes in general psychiatric care and a 2008 major government…

Abstract

Purpose

Mental health interventions for Italian prisoners with mental disorders remain a problematic issue, despite radical changes in general psychiatric care and a 2008 major government reform transferring mental health care in prison to the National Health Service. The aim of this study is to describe the mental health intervention model implemented since January 2020 for prisoners allocated in the Parma Penitentiary Institutes (PPI). This approach is specifically based on specialized, “person-centered” and “person-tailored” therapeutic-rehabilitation plans in line with psychiatric treatments usually provided in community mental health-care centers of the Parma Department of Mental Health.

Design/methodology/approach

All the processes and procedures included in the PPI intervention model were first carefully illustrated, paying special attention to the service for newly admitted prisoners and each typology of specialized therapeutic-rehabilitation treatment potentially provided. Additionally, a preliminary descriptive process analysis of the first six months of clinical activity was also performed.

Findings

Since January 2020, 178 individuals entered the PPI service for newly admitted prisoners. In total, 83 (46.7%) of them were engaged in the services of the PPI mental health-care team (35 with pathological addiction and 48 with mental disorders): 56 prisoners were offered an integrated mental health intervention and 27 exclusively an individual psychological or psychiatric treatment.

Originality/value

The results support the potential applicability of an integrated mental health intervention in prison, planning a person-tailored rehabilitation in close collaboration with the prisoners, their families and the local mental health/social services.

Details

International Journal of Prisoner Health, vol. 17 no. 4
Type: Research Article
ISSN: 1744-9200

Keywords

Article
Publication date: 9 March 2015

Joanna Bredski, Kirsty Forsyth, Debbie Mountain, Michele Harrison, Linda Irvine and Donald Maciver

– The purpose of this paper is to present a qualitative analysis of the facilitators of recovery in in-patient psychiatric rehabilitation from the service users’ perspective.

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Abstract

Purpose

The purpose of this paper is to present a qualitative analysis of the facilitators of recovery in in-patient psychiatric rehabilitation from the service users’ perspective.

Design/methodology/approach

Interviews with 31 in-patients were coded and analysed thematically at an interpretive level using an inductive approach.

Findings

The dominant themes identified were hope, agency, relationships and opportunity. Totally, 20 subthemes were identified. Agency was more important to men than women and agency, hope and relationships were all more important to detained patients.

Research limitations/implications

Interview data were collected in writing rather than taped. The results may not be transferrable to patient populations with significantly different demographic or service factors.

Practical implications

Services need to target interventions at the areas identified by service users as important in their recovery. The findings suggest both environmental and relational aspects of care that may optimise recovery. Services also need to be able to measure the quality of the care they provide. A brief, culturally valid and psychometrically assessed instrument for measuring the recovery orientation of services is required.

Originality/value

As far as the authors are aware no qualitative work to date has examined the recovery experiences of psychiatric rehabilitation in-patient service users in order to understand what services require to do to enable recovery from their perspective. The conceptual framework identified in this paper can be used to develop a service user self-report measure of the recovery orientation of services.

Details

Mental Health Review Journal, vol. 20 no. 1
Type: Research Article
ISSN: 1361-9322

Keywords

Article
Publication date: 1 July 2002

Dan Noonan

The author, who works in the field of health care, identifies the development of an innovative best practices psychosocial rehabilitation principles template, which provides both…

716

Abstract

The author, who works in the field of health care, identifies the development of an innovative best practices psychosocial rehabilitation principles template, which provides both a conceptual framework and some core dimensions for rehabilitation practice and focused patient care. The steps and process in the development of the template are documented and reflect both staff and patient input in its formulation. There is an articulation, from an integrated perspective, of a patient‐centred, complementary, empowering and interdependent rehabilitation principles framework. There is also a delineation of the rationale for the template’s inception, literature review, conceptual composition, inherent challenges and potential applicability for enhancing rehabilitation care, outcomes and quality management.

Details

International Journal of Health Care Quality Assurance, vol. 15 no. 4
Type: Research Article
ISSN: 0952-6862

Keywords

Article
Publication date: 1 November 1998

Christiane Haerlin and Alfred Meier

This paper was presented to the 6th European Congress on Research in Rehabilitation, 31 May‐4 June 1998 in Berlin. It reflects the fact that, in Germany, there is a more…

Abstract

This paper was presented to the 6th European Congress on Research in Rehabilitation, 31 May‐4 June 1998 in Berlin. It reflects the fact that, in Germany, there is a more structured and research‐based approach to moving people into employment than we are used to in the UK ‐ one of the many cultural differences which we can learn from in our partnerships with European colleagues. It should also be remembered that the Germans regard Douglas Bennett as the source of many of their ideas and that there are nearly 2000 people with mental health problems working in German social firms as a result of their systematic approach.

Details

A Life in the Day, vol. 2 no. 4
Type: Research Article
ISSN: 1366-6282

Article
Publication date: 13 February 2017

Matthew John Gill and Samantha Brookes

The purpose of this paper is to develop a psychological outcome tool which reflects the relationship between clusters of items on the Short Term Assessment of Risk and…

Abstract

Purpose

The purpose of this paper is to develop a psychological outcome tool which reflects the relationship between clusters of items on the Short Term Assessment of Risk and Treatability (START) risk assessment and different categories of psychological progress in male inpatient psychiatric services.

Design/methodology/approach

A principal component analysis (PCA) was conducted on data from 135 male psychiatric rehabilitation patients’ START risk assessments.

Findings

PCA identified four strength psychology quadrants which were explained by a five-factor structure and four vulnerability quadrants which were explained by a four-factor structure. The development of the psychology quadrant, its usefulness in establishing a treatment pathway and areas of future research are also discussed.

Originality/value

Developing accessible, transparent outcome measures using evidence-based practice is highly relevant within the field of mental health rehabilitation.

Details

Journal of Forensic Practice, vol. 19 no. 1
Type: Research Article
ISSN: 2050-8794

Keywords

Book part
Publication date: 4 June 2019

Nikos Drosos and Menelaos Theodoroulakis

Although work has a fundamental role in the individual’s psychological well-being, the vast majority of mental health service users are not in employment. This is the result of…

Abstract

Although work has a fundamental role in the individual’s psychological well-being, the vast majority of mental health service users are not in employment. This is the result of various barriers that impede their work re-integration process despite their desire to work. Apart from the illness’ symptoms, these barriers are strongly associated with the negative effects of long-term unemployment, the negative stereotypes and attitudes towards mental health service users and the fear of losing disability benefits. There are several occupational intervention models aiming at vocational rehabilitation of mental health service users. Arguably, the Individual Placement and Support (IPS) model of supported employment has proved to be more effective compared to other models. This chapter presents an innovative career counselling approach that combines elements from the IPS model and from the newly emerged career theories that have been developed to address today’s world of work challenges. This model was developed by the Pan-Hellenic Association for Psychosocial Rehabilitation and Work Integration (PEPSAEE) in Greece during the recent major economic crisis. Further implications of the model’s implementation regarding vocational rehabilitation of mental health users as means for social inclusion are discussed.

Book part
Publication date: 17 December 2004

Alexis D. Henry

The last several decades have brought about a paradigm shift in the conceptualization of disability (Fougeyrollas & Beauregard, 2001; Williams, 2001). The traditional medical…

Abstract

The last several decades have brought about a paradigm shift in the conceptualization of disability (Fougeyrollas & Beauregard, 2001; Williams, 2001). The traditional medical model considers disability to be a characteristic of the person, situated within the body. In the medical model view, disability, or difficulty functioning in major life domains, results from bodily impairments associated with a medical diagnosis or disorder, and a medical intervention or treatment is required to “correct” the problem of the individual. Alternatively, contemporary social models argue that disability is a social construction. In the social model view, disability is created by social policies, stigma and other barriers within the social and physical environment. Changes in attitudes and policies and the removal of barriers are needed to “correct” these environmental problems.

Details

Research on Employment for Persons with Severe Mental Illness
Type: Book
ISBN: 978-1-84950-286-3

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