ABSTRACT
Social responses to sex-offending behaviors have included criminal sanctions and clinical interventions that have evolved over time. These developments have created various challenges for mental health professionals charged with providing care to offenders, particularly when legislative expectations have exceeded available treatments. A summary is provided of recent clinical developments in assessments, therapies, and pharmacology. The usefulness of SRIs, in particular, may prompt the involvement of more psychiatrists in this treatment. Other implications for future practice of these clinical and legal developments are also discussed.
Subject(s)
Disruptive, Impulse Control, and Conduct Disorders/therapy , Hospitalization/legislation & jurisprudence , Paraphilic Disorders/therapy , Personality Disorders/therapy , Psychiatry/trends , Sex Offenses/legislation & jurisprudence , Androgen Antagonists/therapeutic use , Cognitive Behavioral Therapy , Disruptive, Impulse Control, and Conduct Disorders/complications , Female , Humans , Imagery, Psychotherapy , Male , Paraphilic Disorders/complications , Personality Disorders/complications , Psychiatry/legislation & jurisprudence , Recurrence , Referral and Consultation , Selective Serotonin Reuptake Inhibitors/therapeutic use , United StatesABSTRACT
For many reasons, inpatient psychiatric units are increasingly faced with treatment and management of violent individuals. This fosters a need to consider potential institutional responses to patient violence. This paper focuses on one response--prosecution of these persons. The existing literature on this topic is reviewed. In addition, the case history of a difficult but successful prosecution of an assaultive patient is presented. This case highlighted the development of guidelines, which are outlined herein, for determining the appropriateness of seeking legal action against patients. The paper concludes with an assessment of the benefits and risks associated with patient prosecution.
