1 / 11

Scottish Head Injury Forum Head injury and offending

Scottish Head Injury Forum Head injury and offending. Dr Derek Chiswick Consultant Forensic Psychiatrist The Orchard Clinic Royal Edinburgh Hospital Derek.Chiswick@lpct.scot.nhs.uk. Head injury and offending: why?. personality change +/- cognitive impairment pre-injury features

storm
Télécharger la présentation

Scottish Head Injury Forum Head injury and offending

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Scottish Head Injury ForumHead injury and offending Dr Derek Chiswick Consultant Forensic Psychiatrist The Orchard Clinic Royal Edinburgh Hospital Derek.Chiswick@lpct.scot.nhs.uk

  2. Head injury and offending: why? • personality change +/- cognitive impairment • pre-injury features • maladaptive behaviour patterns • impulsivity, self-centredness • sexual disinhibition • carer interactions • alcohol, drugs • secondary mental illness

  3. The head injured person in the criminal justice system • criminal justice system is not a treatment agency • but some offenders with mental disorders only obtain treatment through the criminal justice system

  4. What sort of offence? • any! • breach of peace and minor assaults • damage to property • crimes of dishonesty • more serious assaults • sexual offences • fire-raising • homicide

  5. Arrest • police action, discretion, arrest • police station • questioning, appropriate adult, charge • custody • medical examination • psychiatric assessment • fitness to be detained

  6. Court • representation • plea • bail • remand in custody • remand in hospital (where?) • psychiatric report: procurator fiscal • psychiatric report: solicitor

  7. Trial • fitness to plead • mental responsibility • diminished responsibility (murder only)

  8. Sentence • penal: e.g. prison, probation, CSO, fine, SD • treatment: e.g. condition of probation • hospital treatment: compulsory? security? conditions of detention?

  9. Problems: prison • not a treatment environment • nature of regimens • difficulty/ease of adaptation • victimisation • health care • epilepsy • visiting

  10. Problems: hospital • criteria for detention under MH(S)A 1984 • appropriate treatment • appropriate environment • staff skills • likelihood of improvement • unavailability of continuing care • community provision

  11. Summary • small group within a small group of offenders • problem or deficit may be missed • existing facilities usually unsuitable • few professionals with necessary experience • requirement for continuing (lifelong) care poorly provided (or acknowledged) in today’s NHS

More Related