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Grubbe F, Wagner E, Pogarell O, Dudeck M, Hasan A. [Inpatient Treatment of Mentally Ill Prisoners in General Psychiatric Departments and Hospitals]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2024; 92:128-134. [PMID: 36720233 DOI: 10.1055/a-1981-2883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Inpatient psychiatric treatment of prisoners is organized differently in Germany, depending on the structural conditions of the federal state and prison. There are very few findings on the different possibilities of treatment and the view of the hospitals on this issue. OBJECTIVES Our aim was to gain an up-to-date picture of inpatient treatment of prisoners in general psychiatric departments and hospitals and the challenges these institutions face. METHODS We conducted an anonymous online survey of the frequency, extent, and challenges of inpatient treatment of prisoners. Approximately 460 chief physicians of German general psychiatric departments and hospitals were invited to participate in this survey. In addition to descriptive statistics, we calculated group differences by type of hospital and by subjective responsibility for inpatient care of prisoners. RESULTS A total of 74 chief physicians surveyed participated; 51.4% of the surveyed hospitals provided psychiatric inpatient treatment to prisoners in 2020. Group differences between the different types of hospitals were found only for the presence of anticipated anxiety among regular inpatients. Various differences were found between responsible and non-responsible hospitals, especially with regard to organizational aspects. DISCUSSION For the treatment of mentally ill prisoners, various organizational challenges as well as fears of hospital staff and fellow patients were mentioned by the participants. The type of hospital appears to play a subordinate role here, whereas the responsibility of the hospital for the inpatient treatment of mentally ill prisoners might be more decisive for anticipated concerns and barriers.
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Affiliation(s)
- Felix Grubbe
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg
| | - Elias Wagner
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, LMU München
| | - Oliver Pogarell
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, LMU München
| | - Manuela Dudeck
- Klinik für Forensische Psychiatrie und Psychotherapie der Universität Ulm am BKH Günzburg
| | - Alkomiet Hasan
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Medizinische Fakultät, Universität Augsburg, Bezirkskrankenhaus Augsburg
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Fovet T, Scouflaire T, Belet B, Demeulemeester E, Paindavoine M, Gibour C, Claeyman V, Ghislain L, Narguet C, El Qaoubii O, Martignène N, Wathelet M, Védère M, Moncany AH, Bouchard JP. Soins psychiatriques et sortie de prison : des équipes mobiles transitionnelles pour atténuer le « choc post-carcéral » ? ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2023. [DOI: 10.1016/j.amp.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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Fovet T, Villa C, Belet B, Carton F, Bauer T, Buyle-Bodin S, D’Hondt F, Bouchard JP. Le psychotraumatisme en milieu pénitentiaire. ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Eck M, Simonet J, Vincent C, Thomas P, Wathelet M, Fovet T. Examen psychiatrique des personnes placées en garde à vue en France : une enquête nationale auprès d’un échantillon de psychiatres. ANNALES MÉDICO-PSYCHOLOGIQUES, REVUE PSYCHIATRIQUE 2022. [DOI: 10.1016/j.amp.2022.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Fovet T, Chan-Chee C, Baillet M, Horn M, Wathelet M, D'Hondt F, Thomas P, Amad A, Lamer A. Psychiatric hospitalisations for people who are incarcerated, 2009-2019: An 11-year retrospective longitudinal study in France. EClinicalMedicine 2022; 46:101374. [PMID: 35434587 PMCID: PMC9011007 DOI: 10.1016/j.eclinm.2022.101374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/16/2022] [Accepted: 03/21/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Despite the poor mental health status of people who are incarcerated, few studies have examined the number of psychiatric hospitalisations in this population. Since 2010, France has progressively opened nine full-time inpatient psychiatric wards exclusively for people who are incarcerated, called "specially adapted hospital units" (unités hospitalières spécialement aménagées, UHSAs, 440 beds). This study aimed to present the annual rates of psychiatric hospitalisations and primary psychiatric diagnoses among people who are incarcerated in France from 2009 to 2019. METHODS We used discharge reports from the French national hospital database to describe longitudinal retrospective administrative data of psychiatric hospitalisations for people in jail and prison between 2009 and 2019, the age, sex, and principal diagnoses of these patients, the proportion of voluntary versus involuntary care, and the interactions between UHSAs and other facilities. FINDINGS Between Jan 1, 2009, and Dec 31, 2019, 32,228 (92.2% men, n = 29,721; 7.8% women, n = 2 507) incarcerated people were hospitalised for psychiatric care (64,481 stays). The main diagnoses were psychotic disorders (27.4%), personality disorders (23.2%), and stress-related disorders (20.2%). The annual number of incarcerated people hospitalised in psychiatric care increased from 3263 in 2009 to 4914 in 2019. The gradual increase in the activity of UHSAs (300 hospitalisations in 2010 versus 3252 in 2019) was not associated with a reduction in the rate of hospitalisation of incarcerated people in local psychiatric hospitals. INTERPRETATION The creation of psychiatric hospitals specifically dedicated to the prison population has not stopped the hospitalisation of people who are incarcerated at psychiatric hospitals. These findings suggest that access to psychiatric hospitalisation remains problematic for people who are incarcerated in France. FUNDING There was no funding source for this study.
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Affiliation(s)
- Thomas Fovet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience and Cognition, Lille F-59000, France
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille F-59000, France
- Corresponding author at: Unité hospitalière spécialement aménagée, Chemin du Bois de l'Hôpital, 59113 Seclin, France.
| | - Christine Chan-Chee
- National Public Health Agency (Santé Publique France), Saint-Maurice F-94415, France
| | - Maëlle Baillet
- Univ. Lille, Faculté Ingénierie et Management de la Santé, Lille F-59000, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et Des Pratiques Médicales, Lille F-59000, France
| | - Mathilde Horn
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience and Cognition, Lille F-59000, France
| | - Marielle Wathelet
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience and Cognition, Lille F-59000, France
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille F-59000, France
- Fédération Régionale de Recherche en Santé Mentale et Psychiatrie, Hauts-de-France, France
| | - Fabien D'Hondt
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience and Cognition, Lille F-59000, France
- Centre National de Ressources et de Résilience Lille-Paris (CN2R), Lille F-59000, France
| | - Pierre Thomas
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience and Cognition, Lille F-59000, France
| | - Ali Amad
- Univ. Lille, Inserm, CHU Lille, U1172 - Lille Neuroscience and Cognition, Lille F-59000, France
| | - Antoine Lamer
- Univ. Lille, Faculté Ingénierie et Management de la Santé, Lille F-59000, France
- Univ. Lille, CHU Lille, ULR 2694 - METRICS: Évaluation des Technologies de Santé et Des Pratiques Médicales, Lille F-59000, France
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[Involuntary psychiatric care for incarcerated people: a descriptive study of 73 consecutive judge-ordered discharges from psychiatric hospitalisation in France]. Encephale 2021; 48:480-483. [PMID: 34538621 DOI: 10.1016/j.encep.2021.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/15/2021] [Accepted: 04/30/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The procedure of involuntary psychiatric hospitalization has been recently modified in France. Indeed, since 2011, a liberty and custody judge is appointed for each measure, to guarantee the rights of psychiatric inpatients and to prevent abusive hospitalizations. As a result, if procedural errors are noted, the liberty and custody judge may order the immediate ending of the psychiatric hospitalization. To date, only two studies described the reasons for judiciary discharge from involuntary psychiatric hospitalizations, but no study has been conducted in forensic psychiatric units for incarcerated people. The objective of the current study was to describe the main reasons judges use to decide on the irregularity of the hospitalization (against the opinion of psychiatrists) for detained patients, and to compare these reasons with those for patients in the community psychiatric unit. METHODS We included all the discharges ordered between 2011 and 2018 in two units of the same hospital: a forensic psychiatric unit for incarcerated people and a community involuntary psychiatric unit. We extracted sociodemographic characteristics and judiciary information such as date of discharge, resason fordischarge, presence of the patient at the hearing. We analyzed the judge-ordered discharge rate (corresponding to the number of discharges divided by the number of involuntary psychiatric hospitalizations) for each year. Then, we examined the reason of discharge for each measure. RESULTS One hundred and forty-seven discharges were analyzed: 73 in the psychiatric forensic unit and 73 in the community psychiatric unit. Rates of discharges were 6.7% and 8.8% for the forensic unit and the general psychiatric unit, respectively. Several reasons for the discharges were common for the two units (failure to inform the patient, lack of physical examination), but others were specific to the forensic unit, such as the impossibility for the patients to communicate with their lawyer, or the lack of immediate dangerousness for the person or for the others. CONCLUSION This study highlights the specific aspects of involuntary psychiatric hospitalizations for people in prison in France. Future studies are needed to assess the impact of these judge-ordered discharge on patient's mental health, particularly for incarcerated patients.
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