- Community
-
Programs
- Schools
-
Careers
- RN Specialties
- Best RN Jobs and Salaries
- Aesthetic Nurse
- Nursing Informatics
- Nurse Case Manager
- NICU Nurse
- Forensic Nurse
- Labor and Delivery Nurse
- Psychiatric Nurse
- Pediatric Nurse
- Travel Nurse
- Telemetry Nurse
- Dermatology Nurse
- Nurse Practitioner
- Best NP Jobs and Salaries
- Family NP (FNP)
- Pediatric NP
- Neonatal NP
- Oncology NP
- Acute Care NP
- Aesthetic NP
- Women's Health NP
- Adult-Gerontology NP
- Orthopedic NP
- Emergency NP
- Psychiatric-Mental Health NP (PMHNP)
- APRN
- Nurse Educator
- Nurse Administrator
- Certified Nurse Midwife (CNM)
- Clinical Nurse Specialist (CNS)
- Certified Registered Nurse Anesthetist (CRNA)
- Resources
- Education
shambley
3 Posts
This case, and other cases in many states, are not, in my opinion, handled appropriately. With the history to harm herself or others, her case would be better handled by those who deal with patients who commit criminal offenses-in forensic psychiatric facilities.
I was under the impression that prior to this latest case, her case had been handled by civil facilities-public or private. In my opinion, civil facilities are not staffed or prepared for forensic clients and furthermore, these patients should not be foisted onto patients and staff in civil facilities. Civil admissions do not need court orders from criminal courts for admissions regarding criminal offenses. These forensic patients usually have a history of violent behavior.
Typically these criminal pre-trial committed patients are admitted for a period of four to eight weeks to determine competency and/or productivity (whether or not they committed the offense as a result of their mental status). Forensic staff are adept in assessing sociopathic or psychopathic personality disorders, or more often, the paranoid schizophrenic cases.
Very few states have comprehensive forensic psychiatric hospitals. This is a problem because then when civil facilities try to handle these cases, there is a problem in assessing potential for future violence. It is also a problem when the forensic patient is removed from the supervision of the criminal courts.
There is a tendency in civil facilities to release such prisoner-patients before they have worked their way through the system--from a status of mentally incompetent or maximum security, to medium security, to minimum security and finally to be considered for conditional release.
In my opinion, the court system should continue to supervise those who are committed for treatment. Their sentences should be indeterminate. The Judges should supervise their cases and it should be up to the prisoner-patient to prove to the court that their treatment has advanced so that they can be considered for movement to the next privilege level. Moving from one level to another typically takes several years-if not decades.
Even while in a conditional release status, the court maintains jurisdiction over the case. Failure to adhere to the out-patient appointments or failure to adhere to therapeutic medication levels is interpreted as a breach of the conditional release and the court can issue a bench warrant for arrest and return to the criminal justice system.
The above described system has been employed in Washington, DC since the assasination of President Garfield! DC has rarely had a premature release. The Judges of the DC Superior Court and the US District Court are aware that prior behavior is the best predictor of future behavior. The Judges are ever mindfull of those in the community. Our civilian population should be able to live without fear that forensic patients can be released too early. Indeed when bench warrents are obtained, they are served by the US Marshals!
Personnel who work in forensic facilities should be considered a part of the law enforcement system and thus should have law enforcement retirement systems. Indeed these personnel are responsible for the continued confinement at the forensic facility or otherwise under their care for other medical care (for example, intermittent visits to such facilities’ as Dr. Berlin's clinic at Johns Hopkins for sexual psychopaths, etc.). Forensic psychiatric personnel are able to retire after 20 years of service. Take my word for it-you don't want to stay employed in this field after age 55-57. New admissions are often less than 40 years old and continue violent patterns while they remain in confinement.
In this case, I was aware that she was seen by Park Dietz, MD, PhD, but he saw her for the prosecution and not for any visits prior to the offense in question.
As health care personnel, we should make our legislators aware that each state needs and deserves forensic psychiatric facilities so that mentally ill offenders can receive the care they deserve, and the public can be better protected from premature releases of forensic clients. We as health care personnel also need to be afforded better resources and status when we work with mentally ill criminals.
This is not a field for beginners! Nursing personnel who enter this field as a
career may also receive advanced preparation in such fields as administrative law, criminal law, physical and chemical restraints, substance abuse and corrections. Indeed several of the forensic psychiatrists also obtain a law degree.
US Govt.-Ret.