Hospital design for inpatient psychiatry: A realistic umbrella review.

The evaluation of the effects of architecture and design in psychiatric hospitals primarily focuses on final outcomes, such as disease progression, and is made from the perspective of evidence-based medicine. Meanwhile, the evidence-informed, realist approach addresses how the intervention works. Understanding the underlying action mechanisms of the intervention is needed to facilitate its scaling-up and adaptation in new environments.

Aggressive behaviors in first-episode psychosis: Distinction between the premorbid phase and the onset of psychosis.

Background: There is a well-established, although complex, association between aggression and psychosis, particularly in the early stages of illness. Some persons display aggressive behaviors even prior to psychosis onset. However, factors associated with aggressive behaviors prior to and at first-episode psychosis (FEP) onset remain underdocumented.

Risk factors for homelessness and housing instability in the first episode of mental illness: Initial findings from the AMONT study.

Aim: People living with mental illness are more likely than the general population to experience adverse housing outcomes, including homelessness. The aim of the current study is to examine residential status when participants have their first contact with mental health services, and the correlates of residential status at that moment.

Methods: First-time mental health service users were recruited from seven clinical sites across Québec.

Community treatment orders: A qualitative study of stakeholder perspectives.

Introduction: For people with a serious mental disorder, a community treatment order (CTO) is a legal response that requires them to undergo psychiatric treatment unwillingly under certain conditions. Qualitative studies have explored the perspectives of individuals involved in CTOs, including persons with lived experiences of a CTO, family members and mental health care providers, who are directly involved in these procedures. However, few studies have integrated their different perspectives.

Exploring the nature and prevalence of targeted violence perpetrated by persons found not criminally responsible on account of mental disorder.

Although mental illness has a demonstrated link with violence, the prevalence of targeted (planned and goal-directed) violence perpetrated by individuals with mental illness and its association with psychiatric symptoms is relatively unexplored. File information was compared for all 293 individuals found not criminally responsible due to mental illness in British Columbia between 2001 and 2005, of whom 19% had committed targeted violence. Most individuals with targeted offenses displayed at least one warning behavior before their offense (93%); all displayed delusions and approximately one third exhibited hallucinations.

Women experiencing homelessness and mental illness in a Housing First multi-site trial: Looking beyond housing to social outcomes and well-being.

Objective: There is scant research on the effectiveness of permanent supportive housing for homeless women with mental illness. This study examines the effectiveness of Housing First with an unprecedentedly large sample of homeless women from five Canadian cities, and explore baseline risk factors that predict social, health and well-being outcomes over a 24 month-period.

Methods: The At Home/Chez Soi multi-site randomized controlled Housing First trial recruited over 600 women between October 2009 and July 2011.

[Overview of the Organisation of Forensic Mental Health Services Internationally: Towards a Balanced Care Model].

Objective The objective of this paper is to provide an overview of the provision and organization of forensic mental health services around the world. In particular, we attempt to address the following question: What system-level characteristics are important to consider in relation to the organization and structure of forensic mental health services? Methods To do so, we synthesize publicly accessible information, identified through Academic Search Complete (EBSCO), ProQuest Central, Scopus, PsycInfo, Google Scholar and Google, to describe how forensic systems are organized throughout the world. We examine the fundamental principles in the organization of services and examine potential quality indicators.

[Methods and Current Issues Related to Risk Assessment of Other-Directed Violence].

Objectives This article provides an overview of the approaches and instruments used to assess the risk of other-directed violence, with particular focus on risk formulation. Issues pertaining to the development and implementation of these instruments are briefly reviewed. Method A critical analysis of the literature pertaining to the methods and current issues related to risk assessment of other-directed violence is proposed.

[Beyond Housing: The Heterogenous Effect of Housing First on Criminal Justice Outcomes Among Homeless People With Mental Illness].

Background Housing First does not, on average, reduce criminal justice involvement. This analysis aims to test whether the overall absence of an impact is due to intervention effect heterogeneity as a function of the pattern of lifetime criminal justice involvement, identified through latent class analysis conducted through earlier work. Methods This analysis relied on data from the Montréal, Toronto and Vancouver sites of the Canadian At Home/Chez Soi randomized controlled trial, merged with administrative records of lifetime criminal charges (N = 1,321).

[Complex Trauma and Forensic Mental Health Services: Towards Trauma-informed Care].

Objectives Exposure to repeated traumatic events during childhood and adolescence is associated with high prevalences of mental illness, addictions, physical health conditions, and psychosocial difficulties (Felitti et al., 2019). The most common consequence of exposure to trauma is violence towards self and others (Hughes et al.

Barriers and facilitators of access and utilization of mental health services among forensic service users along the care pathway.

Background: The verdict of Not Criminally Responsible on account of a Mental Disorder (NCRMD) is increasingly used to access specialized mental health services in Canada and elsewhere. This situation highlights the importance of ensuring timely access to services in the community to prevent violence and justice involvement. The objective of the present study is to identify individual and contextual barriers and facilitators of access to mental health services during the period preceding an offense leading to a verdict of NCRMD.

[Not Available].

Introduction: While governments have focused efforts on implementing health measures such as physical distancing and confinement to protect communities from the spread of COVID-19, some researchers focused on the significant impact of these measures on mental health and well-being. Persons with mental disorders who are both institutionalized and justice-involved in psychiatric and forensic hospitals find themselves more vulnerable to these measures and more limited in their movements and activities.

Aims: The purpose of this paper is to examine the changes in practice in response to the pandemic and their potential impact on individuals in institutional settings.

Care Pathways, Health Service Use Patterns and Opportunities for Justice Involvement Prevention Among Forensic Mental Health Clients.

Objectives: The objective of the present study is to describe the patterns of health service use and of prescription claims in the year preceding an offense leading to a verdict of not criminally responsible on account of a mental disorder (NCRMD).

Methods: Provincial health administrative databases were used to identify medical services, hospitalizations, and ambulatory prescription claims among 1,014 individuals found NCRMD in Québec. Contacts in the year preceding the offense were analyzed using descriptive analyses and latent class analysis.

Not a "Get Out of Jail Free Card": Comparing the Legal Supervision of Persons Found Not Criminally Responsible on Account of Mental Disorder and Convicted Offenders.

Background: The public often perceives the insanity defense as a "get out of jail free card". Conversely, several studies demonstrate the substantial control imposed upon these defendants. This study compares Review Boards decisions regarding people found not criminally responsible on account of mental disorder (NCRMD) to criminal courts decisions regarding convicted offenders for similar offenses in Canada.

Examining the Relationships between Cumulative Childhood Adversity and the Risk of Criminal Justice Involvement and Victimization among Homeless Adults with Mental Illnesses after Receiving Housing First Intervention.

Objectives: Exposure to adverse childhood experiences (ACEs) is associated with increased risk of criminal justice involvement and repeated victimization among homeless individuals. This study aimed to (1) examine whether the relationship between cumulative ACE score and odds of experiencing criminal justice involvement and victimization remains significant over time after receiving the Housing First (HF) intervention and (2) investigate the moderating effect of cumulative ACE score on the effectiveness of the HF intervention on the likelihood of experiencing these outcomes among homeless individuals with mental illnesses.

Methods: We used longitudinal data over the 2-year follow-up period from the At Home/ demonstration project that provided HF versus treatment as usual (TAU) to homeless adults with mental illness in five Canadian cities (N = 1,888).

Pathways to Recovery among Homeless People with Mental Illness: Is Impulsiveness Getting in the Way?

Objective: This study investigates the association between impulsiveness and six dimensions of recovery among homeless people with mental illness.

Method: The sample was composed of 418 participants of a randomized controlled trial of Housing First, a recovery-oriented program that provides immediate access to permanent housing. The reliable change index method was used to provide an estimate of the statistical and clinical significance of the change from baseline to 24 months (i.

The Impact of Housing First on Criminal Justice Outcomes among Homeless People with Mental Illness: A Systematic Review.

Objective: Housing First is increasingly put forward as an important component of a pragmatic plan to end homelessness. The literature evaluating the impact of Housing First on criminal justice involvement has not yet been systematically examined. The objective of this systematic review is to examine the impact of Housing First on criminal justice outcomes among homeless people with mental illness.

Changing characteristics of forensic psychiatric patients in Ontario: a population-based study from 1987 to 2012.

Purpose: To quantify the demand for forensic psychiatric services in Ontario over the past 25 years and investigate whether the sociodemographic, clinical and offense-based characteristics of forensic patients have changed over time.

Methods: We investigated all forensic admissions from 1987 to 2012 resulting in a disposition of Not Criminally Responsible on account of Mental Disorder (N = 2533). We present annual proportions of patients with specified sociodemographic, clinical and offense characteristics, and investigate whether the duration of forensic system tenure varies as a function of admission year, psychiatric diagnosis, or index offense.

Mental Health Screening and Differences in Access to Care among Prisoners.

Objective: Disparities in mental health care exist between regional and demographic groups. While screening is recommended as part of a correctional mental health strategy, little work has been done to explore whether it can narrow regional and demographic disparities in access to care. We compared treatment access rates by sex, race, age, and region in relation to screening results.

Decision curve analysis as a framework to estimate the potential value of screening or other decision-making aids.

Objectives: There is an increasing debate about the impact of mental health screening. We illustrate the use of a decision making framework that can be applied when there is no sufficient data to support a traditional cost-benefit analysis.

Methods: We conducted secondary analyses of data from 459 male prisoners who were screened upon intake.

Mental health treatment patterns following screening at intake to prison.

Objective: While there is general consensus about the need to increase access to mental health treatment, it is debated whether screening is an effective solution. We examined treatment use by inmates in a prison system that offers universal mental health screening.

Method: We conducted an observational study of 7,965 consecutive admissions to Canadian prisons.

Expanding the early and late starter model of criminal justice involvement for forensic mental health clients.

The early and late starter model provides one of the most enduring frameworks for understanding the developmental course and severity of violence and criminality among individuals with severe mental illness. We expanded the model to account for differences in the age of onset of criminal behavior and added a group with no prior contact with the justice or mental health systems. We sampled 1,800 men and women found Not Criminally Responsible on account of Mental Disorder in 3 Canadian provinces.

Adverse Childhood Experiences and the Risk of Criminal Justice Involvement and Victimization Among Homeless Adults With Mental Illness.

Objective: Exposure to adverse childhood experiences (ACEs) is highly prevalent among homeless individuals and is associated with negative consequences during homelessness. This study examined the effect of ACEs on the risk of criminal justice involvement and victimization among homeless individuals with mental illness.

Methods: The study used baseline data from a demonstration project (At Home/Chez Soi) that provided Housing First and recovery-oriented services to homeless adults with mental illness.