Forensic psychiatric/mental health nursing: responsive to social need

Alexithymia and Forgiveness Levels of Forensic Psychiatric Patients

The current cross-sectional study was performed to examine levels of alexithymia and forgiveness in forensic psychiatric patients. Data were collected between March 2022 and August 2022 at a high-security forensic psychiatric hospital affiliated with a city hospital in Turkey. A personal information form prepared by the researchers, the Toronto Alexithymia Scale, and the Heartland Forgiveness Scale were used to obtain data. Participants comprised 132 forensic psychiatric patients who agreed to participate in the study. A significant negative correlation was found between alexithymia and forgiveness levels of participants (p < 0.01, r = -0.259). In other words, as alexithymia levels increased, participants were found to be less forgiving. In addition, results suggest that forensic psychiatric patients are susceptible to alexithymia and higher levels of forgiveness. Determining forgiveness and alexithymia levels of forensic psychiatric patients will contribute to the structuring of care to be offered to these patients. [Journal of Psychosocial Nursing and Mental Health Services, 62(6), 27-35.].

The Nurse-Police Assistance Crisis Team (N-PACT): A new role for nursing

AIM

This study aimed to gain insights into forensic nurses' perspectives and approaches to behavioural crisis situations, comparing them to disciplines traditionally involved in first-line behavioural crisis response.

DESIGN

This study used a descriptive, qualitative exploratory design and was informed by Systems Theory.

METHODS

The study was carried in the United States, between 2022 and 2023. Data were gathered through four focus groups: police officers (n = 12), co-response (mental health) clinicians (n = 13), sexual assault nurse examiners (n = 6) and correctional nurses (n = 4). Thematic analysis was performed.

REPORTING METHOD

The Standards for Reporting Qualitative Research (SRQR) guidelines were used.

RESULTS

Findings revealed temporal themes in crisis response: (1) Searching for Historical Information; (2) Safety and Acting at the Present Scene; and (3) Future Strategies and Interventions. Common priorities (e.g. safety and de-escalation) were identified across groups. Notably, nurses demonstrated a comprehensive approach, addressing physical and mental health assessments, substance involvement, and physical injury evaluation.

CONCLUSION

This study proposes the creation of a novel nursing role within first-line multidisciplinary teams (MDTs) for crisis response-the Nurse-Police Assistance Crisis Team (N-PACT). Nurses bring expertise and comprehensive assessment skills to enhance crisis responses, particularly in cases involving mental health emergencies, medical crises, and drug-related incidents.

IMPLICATIONS

Forensic nurses, with their diverse competencies and comprehensive training, are highly valuable assets within MDTs. Their expertise extends to proficiently conducting mental and physical assessments, ensuring safety and adeptly navigating situations that intersect with the legal system.

IMPACT

The N-PACT concept can improve outcomes and streamline the allocation of resources, particularly considering the number of police calls involving behavioural crises.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Implementation of the Mental Health Nurse Practitioner Role in Forensic Settings: A Case Report

This is a case report about the implementation of the mental health nurse practitioner role in forensic psychiatric settings. We will present its implementation and issues encountered during this process, such as a lack of understanding of the role in staff teams, scope of practice limitations, tension stemming from the conflict between treatment and punishment approaches, and the risk of medicalization of nursing. This case report, based on the authors' experiences, represents an early contribution to research on advanced nursing practice in forensic psychiatry, an area that has yet to receive much attention in the literature.

Psychotherapy Experiences of Perpetrators of Child Sexual Abuse

Cynicism about treatment of sex offenders pervades both professional and lay literature. A Cochrane review of randomized controlled trials concluded there is no evidence to support any psychological intervention for sex offenders, but RCT design has limitations for evaluating sex offender treatment. Rarely has a qualitative approach been used to explore perceptions of offenders themselves about their psychotherapy experiences. The purpose of this study was to discover the meaning of therapy experiences to 11 community-dwelling perpetrators of child sexual abuse. They had received therapy during incarceration or after release, or both. Secondary analysis was conducted of phenomenological interviews about participants' early life, during which they spontaneously revealed insights gleaned during therapy in adulthood. Rigor of the analysis was enhanced by reading transcripts aloud and thematizing them in an interdisciplinary interpretive group. Five interrelated themes constituted a gestalt comprising the essence of the therapy experience: "This treatment, it's just totally changed my whole world." Themes included: "It just stripped away all the pretense, all the lies, all the manipulation;" "I didn't understand myself; I found out all about myself through this;" "Nobody knew any of my secrets; that (therapy) was the first time that I got to tell my story;" "The group has become a family for me;" and "I'm very ashamed of what I've done; this treatment has really helped me, gave me a second chance." These findings stand in contrast to cynicism about sex offender therapy and lend support to the increased optimism expressed by several contemporary scholars.

Psychiatric nurses' self-rated competence

This study explored the self-rated competence of 52 Swedish psychiatric nurses in three clinical environments: forensic psychiatry, general psychiatric inpatient care, and clinical non-residential psychiatric care. A questionnaire wtih 56 statements from nine areas of expertise was completed. Forensic nurses were more skilled in safety and quality and in dealing with violence and conflicts. Non-specialist nurses appreciated their skills more so than specialist nurses in health promotion and illness prevention and conduct, information, and education. Women were inclined to invite patients' relatives for education and information. Men attended to a patients' spiritual needs; they also coped with violence and managed conflicts.