Cultural competency training for psychiatry residents and mental health professionals: A systematic review.

Introduction: Cultural competence is a prerequisite skill for a psychiatrist. There is a dearth of information on the methods used for training of cultural competence and their outcomes. This study aims to explore and determine the existing methods used for cultural competency training (CCT) for psychiatry residents and how useful these training methods are.

The attack on November 13, 2015: organisation of the medico-judicial unit of the Hôtel-Dieu Hospital in Paris.

The main aims of a medico-judicial unit are to ensure the examination of assault victims or persons in custody and to perform sampling necessary for investigations. Forensic examination is essential to describe the wounds and to evaluate the consequences of an assault by determining days of total incapacity for work (ITT). After the Paris attack on November 13, 2015, 121 victims were examined at the medico-judicial units of Paris.

Dignity and Transcultural Forensic Consultation.

We analyze and comment on a legal case (, 1989) from Barbados. We theorize that in this kind of case a forensic psychiatrist consultant could helpfully advise the principals regarding pitfalls to avoid in resolving their conflict. Use of the consultant has certain advantages over taking such disputes to courts of law.

Confidentiality and psychological treatment of moral injury: the elephant in the room.

Morally injurious incidents may present ethical or legal quandaries, yet how military or civilian clinicians should manage such disclosures is poorly understood. Individuals who experience moral injury may be reluctant to seek help due to concerns about the legal ramifications of disclosure. Guidance on breaching patient confidentiality differs by regulatory body but also by profession, geography and context.

Clozapine rechallenge and initiation despite neutropenia- a practical, step-by-step guide.

Clozapine remains the only drug treatment likely to benefit patients with treatment resistant schizophrenia. Its use is complicated by an increased risk of neutropenia and so there are stringent monitoring requirements and restrictions in those with previous neutropenia from any cause or from clozapine in particular. Despite these difficulties clozapine may yet be used following neutropenia, albeit with caution.

The Queensland mental health court: a unique model.

There is a longstanding but sometimes controversial belief that a person is not criminally responsible for a crime if they were suffering from a mental illness at the time of the offence. The Queensland Mental Health Court (QMHC) system, in which assisting clinicians have a central role, is underwritten by this belief. This paper describes the QMHC system.

European violence risk and mental disorders (EU-VIORMED): a multi-centre prospective cohort study protocol.

Background: The link between schizophrenia spectrum disorders (SSD) and violence is a core issue for most forensic psychiatric services. However, the drivers of violence in this population remain unclear, and, to date tools to predict violence risk have a range of limitations. Perhaps because of this uncertainty about the nature of violence risk, treatment programmes and care pathways for mentally disordered offenders vary substantially across the European Union, and differences in legal and policy frameworks are highly relevant.

Offenders with mental disorders in prison and the courts: links to rates of civil detentions and the number of psychiatric beds in England - longitudinal data from 1984 to 2016.

Background: The Mental Health Act in England and Wales allows for two types of detention in hospital: civil and forensic detentions. An association between the closure of mental illness beds and a rise in civil detentions has been reported.

Aims: To examine changes in the rate of court orders and transfer from prison to hospital for treatment, and explore associations with civil involuntary detentions, psychiatric bed numbers and the prison population.

Assessing the Risk of Inpatient Violence in Autism Spectrum Disorder.

The Historical Clinical and Risk Management scale (HCR-20) is a structured clinical judgment tool used to assess risk of violence in secure settings. But the scale does not account for difficulties typical of patients with autism spectrum disorder, which are thought to contribute to their engagement in violent behaviors. The present study is a preliminary investigation of the association between risk assessment and physical and verbal violence in patients with autism spectrum disorder in a secure psychiatric hospital.

Local radio to promote mental health awareness: a public health initiative.

Background: Public health strategies have focused largely on physical health. However, there is increasing recognition that raising mental health awareness and tackling stigma is crucial to reduce disease burden. National campaigns have had some success but tackling issues locally is particularly important.

A Case of Psychosis and Renal Failure Associated with Excessive Energy Drink Consumption.

Energy drinks are nonalcoholic beverages that are widely consumed in the general population, and worldwide usage is increasing. The main stimulant component of energy drinks is typically caffeine. Few case reports exist that link energy drink consumption to psychosis, and similarly few reports exist that associate energy drink consumption with acute renal failure.

Forensic patients, treating psychiatrist and the Mental Health Review Tribunal - An ethical question?

Objective: In inpatient forensic settings, a psychiatrist is expected to wear 'Two Hats', as a treating physician and as an expert to provide risk assessments and expert advice to the judicial authorities for leave and release decisions. Although dual roles have long been accepted as an inevitable part of independent forensic practice, there are additional ethical challenges for the treating psychiatrist to provide an expert opinion. This paper examines the specific ethical ambiguities for a treating psychiatrist at the interface of legal process related to leave and release decisions in the treatment of forensic patients.

Advance decision-making in mental health - Suggestions for legal reform in England and Wales.

This paper argues that existing English and Welsh mental health legislation (The Mental Health Act 1983 (MHA)) should be changed to make provision for advance decision-making (ADM) within statute and makes detailed recommendations as to what should constitute this statutory provision. The recommendations seek to enable a culture change in relation to written statements made with capacity such that they are developed within mental health services and involve joint working on mental health requests as well as potential refusals. In formulating our recommendations, we consider the historical background of ADM, similarities and differences between physical and mental health, a taxonomy of ADM, the evidence base for mental health ADM, the ethics of ADM, the necessity for statutory ADM and the possibility of capacity based 'fusion' law on ADM.

Prison healthcare services: the need for political courage.

SummaryPrisons in England and Wales have reached a low point in service delivery. Despite initial improvements after National Health Service transfer in 2006, it has deteriorated since 2010, with numerous reports giving cause for concern. Improvements are now urgently required, and political courage and a revised national programme of expenditure are necessary.