310315: Mentally Ill Disabled Offenders_2
This question was submitted by Federal Ministry of Justice Austria, Austria on 22/01/2016
Ministry of Justice, Administration and Local Government: Prison Administration (HR) (Croatia)
How are the units/departments carrying out these measures of prevention and rehabilitation for mentally ill/disabled offenders organized?
Reduced responsibility mentally ill prisoners in the prison system in Rep. Croatia Criminal Code provides that reduced responsibility perpetrator can get along with imprisonment and security measure of compulsory psychiatric treatment, which is carried out in the prison system (fixed in the prison hospital and outpatient Prison / Penitentiary) while the execution of sentence; measures lasts as long as a punishment, a court reviewing it once a year. In the prison hospital, which has the status of a penitentiary measure of psychiatric treatment is carried out on a separate Department for forensic prisoners, in a stationary form, and the simultaneous implementation of medication and with treatment through individual and group therapy, according to the rules for the treatment of mental patients. Civilian Psychiatric Hospital (health care) Mentally incompetent criminal offenders Criminal Court ruling determined that the perpetrator was insane because of mental illness, which includes judgment compulsory psychiatric treatment in civilian psychiatric hospital in the forensic department, outside the prison system, and the enforcement of applicable special Law on Protection of Persons with Mental Disorders.
What kind of staff and how many of the different staff categories are working there?
The prison system In the prison hospital treatment and the treatment of mentally ill prisoners deal with medical specialists - psychiatrists and other medical, treatment and security staff. Psychiatric Hospital In prisons and jails, the treatment of mentally ill prisoners is performed outpatient, and carried out by a doctor psychiatrist and treatment team conducted and officers treatments and officers insurance. Mentally incompetent criminal offenders are placed in psychiatric hospitals on a special department for forensic prisoners, and department leads the doctor psychiatrist and other medical staff.
Which occupational groups are holding management functions and which ones?
The prison system In the prison hospital head of a special department for forensic prisoners leading doctor - a psychiatrist forensic and treatment team conducted and officers treatments and officers insurance, because a measure of psychiatric treatment simultaneously executed and imprisonment (occupational therapy). In penitentiaries and prisons departments treatment water treatment officers (psychologists, social workers, social pedagogues, a measure of psychiatric treatment in an outpatient implemented and monitored by doctors and psychiatrists judge oversees the execution. The treatment of mentally ill prisoners team conducted a doctor, treatment officers and officers insurance, because along with a measure of psychiatric treatment simultaneously executed and imprisonment (occupational therapy). Psychiatric Hospital Departments manage psychiatrists, who along with other medical staff carried out the treatment and working therapy forensic prisoners.
Ministry of Justice: Department of Prison Administration (IT) (Italy)
With reference to the question indicated in the subject matter, we inform you that with effect from April 1, 2015 the measures of prevention and rehabilitation of mentally ill/disable offenders are performed in special institutions called "Homes for the enforcement of Security Measu res" whose management is entrusted to the National Health Services.
Dutch Custodial Institutions Agency (NL) (Netherlands)
Measures of prevention and rehabilitation for offenders with mental disorders and/or intellectually challenged individuals within this population can be imposed by criminal courts. Civil measures are not part of this enquiry, but are not irrelevant as diversion from the criminal justice system to the general mental health services is possible without further criminal prosecution even when criminal responsibility can be presupposed. There are no measures of prevention and rehabilitation available for offenders who are fully criminally responsible for their actions. Other conditions (e.g. traffic safety courses) remain possible. When adjudicating offenders with mental disorders and/or intellectually challenged offenders 1. The court may find the defendant not criminally responsible (ontoerekenbaar). In those cases no punishment is possible under law. Available measures are a. compulsory admission in a mental hospital which may have specialist forensic features rendering it suitable for the treatmant of individuals which pose a danger to their environment and b. Ter beschikking stelling (Tbs, see below). All hospitals under a. are part of an organisation within the private not for profit sector. Treatment is funded by the state. 2. The court may find the defendant partially criminally responsible. All treatment options available in civil society can be made a condition in sentencing. In certain cases (see under 3.) the measure of Ter beschikking stelling (Tbs) can be imposed. 3. All offenders with a. mental disorders and/or an intellectual challenge found b. guilty of serious crimes against persons and c. judged to be dangerous can be detained at the government's pleasure. This sanction, which is known as Ter beschikking stelling (Tbs) is imposed under the Dutch Entrustment Act for the duration of two years. however, it can be consecutively extended for one or two years by the court, in rare cases even indefinitely as long as dangerousness persists. Tbs clinics are specialist forensic mental hospitals. Two are in the hands of the state, the others are (as their generalist counterparts) privately owned by institutions within the civil non profit sector. There are four Penitentiary Psychiatric Centres (PPC's) within the prison system that offer specialist psychiatric treatment for incarcerated offenders who, for whatever reason, can not be placed in a general or forenisc mental hostipal or in a tbs clinic.
Apart from janitorial, housekeeping and general medical and nursing staff the curative workload is mainly carried by mental health nurses and institutional workers educated at EQF level 5 or 6 working in the units. Specialist therapists, both psychotherapists and craft specialists function outside of the housing unit system. Treatment planning and coordination is in the hands of psychologists and psychiatrists at master or doctorate level (EQF 7 to 8). They also report to internal and external committee charged with granting of leave to inmates and to the courts when a decision on extension of the imposed measure is due. Taking part-time contracts and duty rosters into consideration, the ratio patient - staff approaches 1:1 in tbs clinics. Medical specialists in the field of psychiatry educated at the consultant level beyond their EQF 8 basic medical education are quite rare, perhaps 3 to 4 FTE per clinic. Psychologists come at 3 levels: academic master level (without health care registration), health care registered psychologists completing 2 years postgraduate education and consultant level clinical psychologists, who have had 4 more years of specialization after health regiostration. Specialist forensic qualifications do not exist either in psychology or psychiatry. Many staff members hold specialist psychotherapeutic qualifications.
Management of tbs clinics and of most clinics in general society consists of a general director who has overall responsibility (is the administrative head of the clinic) and a treatment director. Civil clinics are almost without exception part of larger mental health organisations of the size of a NHS Mental Health Trust (UK) and may have different structures. The PPC's form part of larger penitentiary complexes. The general directors have differing backgrounds and experience either in hospital management or the running of Youth facilities or penitentiaries. They generally have quite extensive management qualifications up to MBA / MHA. The treatment director is also Chief Medical Officer when qualified as a psychiatrist. If he/ she is a psychologist, one of the psychiatrists is designated as such.
Answers have been provided by the psychiatric advisor.
The care of those with mental ill health in prison custody is multidisciplinary and those who present with symptoms of mental ill health are managed on an individual basis and have access to support from a range of professionals. Training for staff continues in mental health awareness to provide staff with a better understanding of the impact that mental illness can have on prisoner management. Prisoners with mental health problems transferred to secure hospital facilities are managed by NHS Scotland.
The Multi-Disciplinary Mental Health Team (MDMHT) in prison custody comprises of the SPS Deputy Governor, Residential First Line Manager, Chaplain, Social Work, NHS Health Care Manager, Mental Health Nurse, Psychiatrist and General Practitioner. The primary remit of the MDMHT is to consider referrals from a range of sources for those with suspected mental health needs to co-ordinate assessment and provide appropriate intervention.
The responsibility for the provision of healthcare services to prisoners and associated clinical resources is the responsibility of NHS Scotland. SPS is responsible for the provision of all other services e.g. prison officers, forensic psychologists, chaplaincy and social work services in accordance with our general duty of care.​​​
Swedish Prison and Probation Service (SE) (Sweden)
The Swedish Prison and Probation Service has no special units/departments for mentally ill/disabled offenders. Offenders with severe psychiatric disorder are sentenced to Forensic psychiatric care provided by counties who are responsible for all health care in Sweden, including this category of offenders. All other offenders follow the same procedure through an assessment by the Evaluation & Placement Unit for identification of the most suitable prison facility and allocation thereby.