Mentally Disordered Offenders in Forensic Rather Than Hospital

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Assess the care for sentencing mentally disordered offenders to prison rather than a forensic psychiatric hospital setting. The 19th Century saw many efforts to remove mentally ill offenders from the prison system. Bethlam Hospital in London opened a new wing for the criminal offenders who were diagnosed with a mental illness. Shortly after, Broadmoor hospital was opened. However, this did not end the detention of the mentally ill offenders in prison; although more special provision was being created within the prison system for those who were not able to be transferred to a mental hospital. There have been a number of cases highlighted that large numbers of mentally ill offenders are finding themselves in the prison system. There is, however, only a small minority of prisoners who are experiencing severe mental disorders, which under the mental health legislation warrants detention. The majority of offenders with mental health problems combined with substance abuse continue to remain in the prison system. The report of the Gladstone Committee in 1985 recommended that all prison officers with medical expertise be experienced or trained in the subject of mental illness, further acknowledging the fact that there is a significant presence of the mentally disordered offenders in prison. In assessing the case for sentencing mentally disordered offenders to prison rather than a forensic psychiatry hospital; it is necessary to look at the issues related to the interface between the prison service and the mental health services with regards to the way in which prisoners with mental health problems are managed. In 1988, the American Psychiatric Association's Council of Psychiatry and Law clearly approved the use of mental hospitals as prisons. The Council affirmed that psychiatric patients who no longer needed active psychiatric treatment or those who were deemed to be untreatable could still be managed in a psychiatric setting. Those who were acquitted and were unable to be discharged to an outpatient status were to remain under psychiatric care in the hospital setting. Psychiatrists are confronted with the realisation that the mental hospital is a prison and that the psychiatrist who works there is a ‘jailer’, they deceive themselves, just as much as they deceive the public, with the expression of ‘care.’ It is clear that as long as law, psychiatry, and society define particular behaviours as mental disorders, assign the responsibility to control those who display such behaviours to psychiatrists, who eagerly embrace that responsibility, i.e. seclusion and restraint; in other terms psychiatric coercion will remain a key characteristic of psychiatric practice. (Szasz, 2006) The criminal courts have the ability to make a determination about the correlation between someone’s mental health and their degree of responsibility for the crime they have committed; particularly with regards to serious offences such as homicide. However, it is somewhat recently that that the criminal courts became concerned with the significance of someone’s mental health and their liability for a crime. According to Bluglass and Bowden (1991) roughly 20 Acts of Parliament were passed that were associated with the care of mentally ill offenders in particular institutions. Legislation regarding the involuntary hospitalisation of mentally disordered offenders has progressed significantly since such law of this type was passed in the eighteenth century. At that particular time, the law was aimed at vagrants via a number of Vagrancy Acts. These acts gave way to the Criminal Lunatics Act (1800). Furthermore, the County Asylums Act (1808) lay down the path for the increase of local asylums that made up most of the psychiatric care system. (Jones, 1993, pp. 36-37) It is evident from the Act names that originally, mental health legislation was designed to care for those that were less fortunate. Local asylums were segregated from other institutions and...
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