Michel Foucault’s analysis of psychiatry´s birth around 1800 is well known. The French philosopherreversed the myth of PhilippePinel and William Tuke asliberatorsof the mad in the New Era after the French revolution: instead of a starting liberation we should consider it a completed elimination. The exclusion of madness from the realm of Reason is fulfilled. Insanity is silenced. From this moment on ‘the life of unreason no longer manifests itself except in the lightningflash of works such as those of Hölderlin, of Nerval, of Nietzsche,or of Artaud’, Foucault writes. And: ‘Sade's calm, patient language also gathers up the final words of unreason and also gives them, for the future, a remoter meaning.’ LinkedIn: https://www.linkedin.com/in/bert-van-den-bergh-95476526/
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"Purpose – Despite the rising number of females in forensic psychiatry, research about their characteristics remains limited and is currently lacking in Belgium. Optimizing knowledge about the characteristics of these women will lead to a better understanding of this specific group. Therefore, the aim of the study was to gain insight into the characteristics of female forensic psychiatric patients in Flanders, Belgium. Design/methodology/approach – A case file study was carried out in the forensic psychiatric hospital Sint-Jan-Baptist in Zelzate, Belgium. The files of female patients admitted in the period 2006–2017 were analysed (N = 82) based on a checklist including sociodemographic, mental health care and offencerelated characteristics as well as historical risk factors. Findings – The study revealed that female patients have been confronted with a large number of adverse experiences during both childhood and adulthood, were frequently diagnosed with borderline personality disorder and usually had an extensive mental health treatment history with many drop-outs. The majority of the female patients had committed violent offences towards relatives. Practical implications – These findings are similar to those of other jurisdictions and highlight the importance of a gender-responsive treatment. This kind of treatment should include trauma-informed care, gender-sensitive risk-assessment and adapted versions of dialectical behavioural therapy and schema-focussed therapy. Additionally, treatment should focus on breaking the intergenerational transmission of violence andmental health problems by targeting parenting skills. Originality/value – To the best of the authors’ knowledge, this is the first study that scientifically scrutinized the detailed characteristics of female forensic psychiatric patients in Flanders, Belgium. Recommendations for gender-responsive treatment and directions for future research are discussed."
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Background: More knowledge about characteristics of children and adolescents who need intensive levels of psychiatric treatment is important to improve treatment approaches. These characteristics were investigated in those who need youth Assertive Community Treatment (youth-ACT). Method: A cross-sectional study among children/adolescents and their parents treated in either a regular outpatient clinic or a youth-ACT setting in a specialized mental health treatment center in the Netherlands. Results: Child, parent and family/social context factors were associated with treatment intensification from regular outpatient care to youth-ACT. The combination of the child, parent, and family/social context factors adds substantially to the predictive power of the model (Nagelkerke R2 increasing from 36 to 45% for the three domains separately, to 61% when all domains are combined). The strongest predictors are the severity of psychiatric disorders of the child, parental stress, and domestic violence. Conclusions: Using a wide variety of variables that are potentially associated with treatment intensification from regular outpatient clinic to youth-ACT, we constructed a regression model illustrating a relatively strong relation between the predictor variables and the outcome (Nagelkerke R2 = 0.61), with three strong predictors, i.e. severity of psychiatric disorders of the child, parental stress, and domestic violence. This emphasizes the importance of a system-oriented approach with primary attention for problem solving and stress reduction within the system, in addition to the psychiatric treatment of the child, and possibly also the parents. Auteurs: Vijverberg, R., Ferdinand, R., Beekman, A., & van Meijel B.
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Substance abuse is an important risk factor for offending, but is mostly studied in males. The aim of this multicentre study is to gain insight into possible gender differences in substance abuse history and offending behavior in forensic psychiatric patients. Files were analyzed of 275 women and 275 matched men who have been admitted between 1984 and 2014 to one of four Dutch gender-mixed forensic hospitals. Risk assessment ratings were related to registered violent incidents during treatment for both women and men and to official recidivism data after discharge for a subgroup of 78 women. Substance abuse history was coded as a risk factor for more than half of the women (56.7%), but significantly more often for men (68.4%). Men were more often diagnosed with substance dependence and more frequently committed the index-offense whilst intoxicated. Prediction of violent incidents during treatment was more accurate for men. A history of substance abuse was not a significant predictor for recidivism after discharge in the subgroup women. It is concluded that there are gender differences in substance abuse history and that the relationship with offending behavior seems stronger for men. These differences have implications for substance use treatment in forensic mental health services.
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Interview: Richard Vijverberg promoveerde op 31 januari 2022 aan de Vrije Universiteit op zijn proefschrift Care needs of children and adolescents in psychiatry. Steps towards personalized mental healthcare.
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Some patients in psychiatric treatment are considered extremely difficult to treat because of the disruptive nature of their relationships with treatment staff. In this paper, we describe and evaluate a specialist inpatient treatment program for these patients. Data were collected from medical records and daily reports of patients (n = 108). Pretest-posttest measurements were used to evaluate the treatment. The main treatment method consists of the provision of safety, structure, and cooperation. Treatment results show statistically significant changes from admittance to discharge. The collaborative and consistent manner in which nurses approach the patients is crucial for quality of care.
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The specific risks and mental health needs of women in forensic services and the relevance of gender-responsive treatment include gender differences in criminological and psychiatric characteristics; gender-sensitive risk assessment; and gender-sensitive management. Some recommendations are provided for practitioners working with women in forensic services.
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afstudeerscriptie van studente Psychologie Yasmin Gharavi gepubliceerd in BMC Psychiatry: Background: Family members who care for patients with severe mental illness experience emotional distress and report a higher incidence of mental illness than those in the general population. They report feeling inadequately prepared to provide the necessary practical and emotional support for these patients. The MAT training, an Interaction- Skills Training program (IST) for caregivers, was developed to meet those needs. This study used a single-arm pretestposttest design to examine the impact of the training on caregivers’ sense of competence (self-efficacy) and burden.
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"In high security forensic institutions, patients are sometimes placed on smallscale wards to be treated individually if their psychiatric condition and behaviour do not allow for them to live and interact more freely with other patients. On these so-called individual wards, there is little contact between patients and more security measures are in place, such as higher numbers of staff members per patient than on group wards. The present study investigated the experienced safety of staff members (n = 41) and patients (n = 21) of such individual wards, compared to staff members (n = 55) and patients (n = 55) of group wards with the Essen-CES. The mean item score on the scale experienced safety of the Essen-CES for the entire sample was 2.1 (SD = .9) with a range from 0 to 4 and higher scores reflecting a higher experienced safety. Staff on individual wards had a significantly lower experienced safety than patients on both ward types and staff on group wards. It is advised, therefore, to implement additional measures to support professionals who work on these individual wards. "
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