Just Like a Woman: Gender Role Stereotypes in Forensic Psychiatry.

The relationship between violence, gender and mental health is a complex one which is yet to be fully understood. Gender role stereotypes are social constructs that can powerfully influence and regulate human behaviour, including violence; and so it is likely that they also influence the nexus of violence management and mental health which is at the core of forensic psychiatry. In this article, we examine how gender role stereotypes might influence the practice of forensic psychiatry: specifically, in relation to women as violent offenders, as patients in secure psychiatric care and as clinicians working in forensic settings.

Impact of homicide by a psychiatric patient on forensic psychiatrists: national survey.

Aims And Method: To explore the experiences and support needs of consultant forensic psychiatrists, whose patients had committed homicide while under their care. We circulated a survey to all forensic psychiatrists in the UK, through the Royal College of Psychiatrists, asking about their experiences of a homicide by a patient under their care. Respondents were invited to discuss their experiences further in a structured telephone interview and themes were identified from these discussions.

COVID-19 Vaccination in those with mental health difficulties: A guide to assist decision-making in England, Scotland, and Wales.

There is currently no specific guidance addressing vaccine hesitancy in those with mental health difficulties in the United Kingdom. This is particularly problematic when one considers that individuals with serious mental illnesses are at greater risk of infection and have poorer health outcomes for a range of reasons. There are also many individual and system level barriers to vaccination in this group.

Montgomery and shared decision-making: implications for good psychiatric practice.

The 2015 Supreme Court judgment in Montgomery v Lanarkshire Health Board [2015] UKSC 11 established that consent to medical treatment requires shared decision-making based on dialogue between the clinician and patient. In this editorial, we examine what Montgomery means for standards of good psychiatric practice, and argue that it represents an opportunity for delivering best practice in psychiatric care.Declaration of interestNone.

Security of mind: 20 years of attachment theory and its relevance to psychiatry.

In this editorial, I suggest that no psychiatrist should be without a working knowledge of attachment theory, and it is a capability that all trainees should cover in the proposed new curriculum. I have focused on three domains of research to argue that attachment theory is relevant to practicing psychiatrists.Declaration of interestNone.

Motherhood and Apple Pie: A UK Perspective on Mothers Who Misuse Drugs.

In this commentary, I explore two questions raised by Angelotta and Appelbaum's study. First, I offer an English legal perspective on the protection of children from their mothers, looking at both civil (family) and criminal law. Second, I discuss the idealization of motherhood that is implied by the prosecution of pregnant women; the denigration of those who fail this ideal; and the way that idealization and denigration contribute to injustice for women.

Everything moves on: referral trends to a leavers' group in a high secure hospital and trial leave progress of group graduates.

Background: Moving on from high secure psychiatric care can be a complex and potentially stressful experience, which may hinder progression. A leavers' group in a UK high secure hospital is offered to support patients with this transition.

Aims: The aims of this study are to investigate characteristics of patients referred for the leavers' group and compare outcomes for leavers' group graduates with those for patients who never attended a leavers' group for any reason.

Commentary: Stories and histories in forensic psychiatry.

In this commentary, I reflect on the narratives of offending that are generated in the courtroom and those that are generated in the therapeutic space between an offender patient and his or her therapist. I discuss the similarities and differences between these different stories and explore the role of the psychiatrist in both cases.

Violence risk assessment as a medical intervention: ethical tensions.

Risk assessment differs from other medical interventions in that the welfare of the patient is not the immediate object of the intervention. However, improving the risk assessment process may reduce the chance of risk assessment itself being unjust. We explore the ethical arguments in relation to risk assessment as a medical intervention, drawing analogies, where applicable, with ethical arguments raised by general medical investigations.

Locks, keys, and security of mind: psychodynamic approaches to forensic psychiatry.

In this article, we discuss psychological approaches to the understanding of acts of violence and, specifically, psychodynamic approaches to both formulation and treatment. We suggest that the key theoretical paradigm of a psychodynamic approach involves the exploration and elaboration of the meaning of a violent act for the offender and describe the relevance of this approach for both legal assessments and clinical services in secure residential care. We argue that a psychodynamic approach can improve the quality of assessments of both psychopathology and risk and inform effective therapeutic interventions in hard-to-treat patients.

Commentary: Thereby hangs a tale--the creation of tragic narratives in forensic psychiatry.

In my commentary, I suggest that the criminal court is a place where justice examines tragedy, as described by Aristotle in his Poetics. I suggest that there are strong parallels with Aristotle's account of tragic narratives and the concepts of representation and performance of forensic expert testimony, as described by Griffith and Baranoski-especially in relation to the creation of voice. On this account, the forensic expert's psychiatric court report acts as a tragic narrative that makes defendants come alive as people.

Becoming a caregiver: attachment theory and poorly performing doctors.

Context: In this paper, I review a theoretical paradigm (attachment theory) which facilitates an understanding of how human care-giving and care-eliciting behaviours develop and are maintained over the lifespan. I argue that this paradigm has particular utility in: (i) the training of doctors; (ii) understanding why some doctors and medical students experience high levels of stress, and (iii) developing interventions to help those who struggle to manage high levels of work-related stress.

Methods: I carried out a review of key texts and previously published studies of attachment styles in caregivers.

Whose DNA is it anyway? European court, junk DNA, and the problem with prediction.

In this article, we discuss the implications of a recent European Court of Human Rights (ECHR) decision about the use of retained DNA profiles in criminal cases. Met with polar but equal passion from both the privacy lobby and law enforcement, this case has opened concerns regarding ethics in the nascent science of DNA profiling. Although the technology is touted as the most exciting breakthrough since fingerprinting in crime solving, there are questions regarding its use.

Commentary: till we have faces--on humiliation.

My commentary takes up two points raised by Drs. Torres and Bergner: first, the social context in which humiliation takes place and the way such behavior is normalized; and second, the question of face, and in this context, the loss of face and its impact on identity. For me, the key concern in relation to humiliation is not so much loss of entitlement status, but a loss of identity.

Commentary: on walking and talking.

I welcome Dr. Kapoor's reflections on psychotherapy with offender patients. In this commentary, I will discuss the value of psychodynamic psychotherapy in the treatment of forensic patients and some of the technical competencies required.

Violence and gun crime.

Protecting children and reducing social exclusion are the priorities

Ethical dilemmas in forensic psychiatry: two illustrative cases.

One approach to the analysis of ethical dilemmas in medical practice uses the "four principles plus scope" approach. These principles are: respect for autonomy, beneficence, non-maleficence and justice, along with concern for their scope of application. However, conflicts between the different principles are commonplace in psychiatric practice, especially in forensic psychiatry, where duties to patients often conflict with duties to third parties such as the public.