What is forensics

Forensic psychiatry

English: Forensic psychiatry

1 definition

The forensic psychiatry is a branch of psychiatry and deals with the assessment and therapy of mentally ill law breakers or with patients who have committed a criminal offense under the influence of drugs.

2 tasks

The tasks of forensic psychiatry include the expert assessment of the culpability or partial culpability of a lawbreaker, as well as the placement of the same in the penal system. The length of stay in the penal system depends on the readiness for therapy, the therapy ability and ultimately on the expert opinion or assessment of the treating psychiatrist and the nursing staff as well as the decision of the judge.

3 legal framework

  • § 126a STPO - remand detention: If a mentally ill or addict commits a crime under the influence of drugs, it remains in the forensic psychiatry until the court hearing
  • Section 63 StGB - Here, forensic placement takes place on the legal basis that the patient has committed a crime as part of his mental illness. It is not possible to stop forensic therapy.
  • Section 64 of the Criminal Code - It records patients with a drug-related offense who are also treated forensically. All patients who are accommodated in accordance with Section 64 can apply for a "discontinuation of therapy" and instead begin their corresponding prison sentence. Here the motto "Therapy instead of punishment" stands in the background. If a lawbreaker with addiction does not want to be treated, the punishment takes the form of imprisonment.
  • Section 66 of the Criminal Code - Preventive Detention. In the case of serious offenses or repeated serious offenses, preventive detention can be ordered during the court hearing. However, this can no longer be awarded in retrospect, only directly in the main court hearing, as some of those affected complained against it and the Constitutional Court ruled that preventive detention is no longer possible afterwards.

4 clinical pictures in the context of forensic psychiatry

4.1 Schizophrenia

4.2 Personality Disorders

4.3 Addictions

5 forms of therapy

6 Forensic ward routine

In the high-security wing of a forensic-psychiatric ward, the focus is on the safety of employees. As a rule, the nursing staff receives special training courses in order to be prepared for day-to-day work in the ward. Every employee carries a personal emergency call system (PNA) with which an alarm can be triggered. The forensic security service and nurses from the neighboring stations can quickly come to the rescue.

Members of the nursing staff can attend a briefing from the police as the first speaker in order to be able to bridge critical situations (e.g. a hostage-taking) until the security forces arrive.

The ward and courtyards of the forensic psychiatry department are monitored by cameras. There are often markings in front of the actual walls and in front of areas that patients are not allowed to enter. If these are violated, an immediate alarm is sent to the gate and the staff. Some rooms, so-called crisis intervention rooms (KIR) or areas (KIB), are also provided with locks. The forensic psychiatry is one of the few places where the nursing staff is allowed to use handcuffs to secure things, e.g. to accompany the patient to a consultation or when they are outside.

In spite of the strict safety measures, care is taken to build trust and motivate patients to undergo therapy. Ensuring regular use of psychotropic drugs is just as much a part of care as protecting the therapist and any visitors (including judges).

7 Continuing Education

Psychiatrists can use the specialization "Forensic Psychiatry" if they meet the conditions prescribed by the Medical Association. The further training period for this is 36 months, of which up to 12 months can be completed during the specialist training.

Nurses can qualify as forensic nurses through a two-year advanced training course.

8 length of stay

The length of stay depends, among other things, on the clinical picture, the crime and the psychiatric prognosis.

In the case of a patient who is addicted to rehab in accordance with Section 64 of the Criminal Code, the duration of treatment is limited to a maximum of two years. The length of stay in the penal system can, however, be postponed or extended by calculating the maximum period.

Criminal offenders who are incapable of guilt or who are less capable of guilt, who are dangerous to the general public due to their illness and who are expected to commit further serious criminal offenses (e.g. violent offenses or sexual offenses), are accommodated in a psychiatric hospital for an indefinite period in accordance with Section 63 StGB.

This is differentiated from the temporary placement according to §126a StPO, which has the status of pre-trial detention for the mentally ill.

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