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Psychiatric in-patients and the criminal justice system: are there any downsides?

Published online by Cambridge University Press:  02 January 2018

Lin Sun Choong*
Affiliation:
Hadley Unit, Newtown Hospital, WorcesterWR5 1JG, email: steve.choong@hacw.nhs.uk
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Abstract

Type
Columns
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2012

The paper by Wilson et al Reference Wilson, Murray, Harris and Brown1 highlights the serious issue of in-patient violence. The potential benefits of involving the criminal justice system are well laid out and the suggested approach is likely to be useful in practice. Unfortunately, the paper fails to look at the possible downsides of such a practice.

Potential adverse outcomes include short- and long-term stigma for the individual patient and loss of therapeutic relationship between the patient and clinician. These are likely to result in poorer services and longer periods of detention. The critical step in deciding whether to refer a patient to the criminal justice system will be the clinician's judgement of non-trivial violence. Good training can reduce lack of consistency but long-term follow-up and critical examination of this practice will ensure that adverse outcomes are kept to a minimum as we juggle to find the ethical balance here.

References

1Wilson, S, Murray, K, Harris, M, Brown, M.Psychiatric in-patients, violence and the criminal justice system. Psychiatrist 2012; 36: 41–4.Google Scholar
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