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Table of Contents
Intro; Contents; 1: Introduction; 1.1 Detention of Mentally Disordered Offenders; 1.2 How Long Is (Too) Long?; 1.3 Factors Associated with Length of Stay; 1.4 This Book; References; Part I: The Context; 2: Asylums and Deinstitutionalization: The Penrose Hypothesis in the Twenty-First Century; 2.1 Enlightenment Split and the Rise of Lunatic Asylums in the Nineteenth Century; 2.2 A Century of Psychiatric Bed Removals; 2.3 The Penrose Hypothesis in the Twenty-First Century; References; 3: Challenges in Comparing Health-Care Systems Across Different Countries
3.1 The Inter-sectoral Perspective3.1.1 Issues to Address; 3.1.2 Assessment Methods; 3.2 Legal Frameworks, Basic Philosophies and Key Concepts; 3.2.1 Forensic-Psychiatric Assessment; 3.2.2 Service Provision; 3.2.3 Outpatient and Forensic-Psychiatric Aftercare; 3.3 Overlap with Prison Sector; 3.4 Outcomes and Effectiveness; 3.5 Cost and Cost-Effectiveness; 3.6 Conclusion; References; 4: Long Stay in Europe: A Systems-Oriented Approach; 4.1 The Dynamics Between Systems: Long-Stay and Long-Term Forensics Psychiatry as Part of a Larger System; 4.2 Prison Services
4.3 Forensic Psychiatric Services4.4 Factors Affecting Length of Stay; 4.4.1 Inadequate Treatment Principles; 4.4.2 Patient Characteristics; 4.4.3 Unmet Needs, Lack of Treatment Resources and Lack of Adequate Facilities; 4.4.4 Aftercare; 4.4.5 Legislative Barriers; 4.5 Long-Term Forensic Care; 4.6 Conclusion; References; 5: Ethical Aspects of Long-Stay Forensic Psychiatric Care; 5.1 Introduction; 5.2 Ethics in Forensic Psychiatry; 5.3 Respect for Justice; 5.3.1 Case Studies; 5.3.1.1 Case 1; 5.3.1.2 Case 2
5.3.2 Application of the Principle "Respect of Justice" to Forensic Psychiatry5.4 Respect for Autonomy; 5.4.1 Case Studies; 5.4.1.1 Case 3; 5.4.1.2 Case 4; 5.4.2 Application of the Principle "Respect of Autonomy" to Forensic Psychiatry; 5.4.2.1 The Classical Concept of Autonomy; 5.4.2.2 Decisional Autonomy; 5.4.2.3 Relational Autonomy; 5.5 Conclusion; References; 6: Prevalence and Characteristics of Long-Stay Patients: Results from a Study in England; 6.1 Introduction; 6.1.1 Detention of Mentally Disordered Offenders in England and Wales; 6.1.2 Aims and Overview of This Study
6.2 Methods6.2.1 Defining 'Long-Stay'; 6.2.2 Sampling Units; 6.2.3 Data Collection; 6.3 Results; 6.3.1 Prevalence of Long-Stay; 6.3.2 Extrapolation of Long-Stay Numbers; 6.3.3 Comparisons Between Long-Stayers and Non-long-Stayers; 6.3.4 Characteristics and Pathways of Long-Stay Patients; 6.3.4.1 Sociodemographic Characteristics; 6.3.4.2 Length of Stay and Pathways; 6.3.4.3 Psychiatric History, Diagnoses and Treatment; 6.3.4.4 Offending History; 6.3.4.5 Institutional Behaviour and Risk; 6.3.4.6 Family Contact; 6.3.4.7 Future Placement Needs; 6.4 Discussion; References
3.1 The Inter-sectoral Perspective3.1.1 Issues to Address; 3.1.2 Assessment Methods; 3.2 Legal Frameworks, Basic Philosophies and Key Concepts; 3.2.1 Forensic-Psychiatric Assessment; 3.2.2 Service Provision; 3.2.3 Outpatient and Forensic-Psychiatric Aftercare; 3.3 Overlap with Prison Sector; 3.4 Outcomes and Effectiveness; 3.5 Cost and Cost-Effectiveness; 3.6 Conclusion; References; 4: Long Stay in Europe: A Systems-Oriented Approach; 4.1 The Dynamics Between Systems: Long-Stay and Long-Term Forensics Psychiatry as Part of a Larger System; 4.2 Prison Services
4.3 Forensic Psychiatric Services4.4 Factors Affecting Length of Stay; 4.4.1 Inadequate Treatment Principles; 4.4.2 Patient Characteristics; 4.4.3 Unmet Needs, Lack of Treatment Resources and Lack of Adequate Facilities; 4.4.4 Aftercare; 4.4.5 Legislative Barriers; 4.5 Long-Term Forensic Care; 4.6 Conclusion; References; 5: Ethical Aspects of Long-Stay Forensic Psychiatric Care; 5.1 Introduction; 5.2 Ethics in Forensic Psychiatry; 5.3 Respect for Justice; 5.3.1 Case Studies; 5.3.1.1 Case 1; 5.3.1.2 Case 2
5.3.2 Application of the Principle "Respect of Justice" to Forensic Psychiatry5.4 Respect for Autonomy; 5.4.1 Case Studies; 5.4.1.1 Case 3; 5.4.1.2 Case 4; 5.4.2 Application of the Principle "Respect of Autonomy" to Forensic Psychiatry; 5.4.2.1 The Classical Concept of Autonomy; 5.4.2.2 Decisional Autonomy; 5.4.2.3 Relational Autonomy; 5.5 Conclusion; References; 6: Prevalence and Characteristics of Long-Stay Patients: Results from a Study in England; 6.1 Introduction; 6.1.1 Detention of Mentally Disordered Offenders in England and Wales; 6.1.2 Aims and Overview of This Study
6.2 Methods6.2.1 Defining 'Long-Stay'; 6.2.2 Sampling Units; 6.2.3 Data Collection; 6.3 Results; 6.3.1 Prevalence of Long-Stay; 6.3.2 Extrapolation of Long-Stay Numbers; 6.3.3 Comparisons Between Long-Stayers and Non-long-Stayers; 6.3.4 Characteristics and Pathways of Long-Stay Patients; 6.3.4.1 Sociodemographic Characteristics; 6.3.4.2 Length of Stay and Pathways; 6.3.4.3 Psychiatric History, Diagnoses and Treatment; 6.3.4.4 Offending History; 6.3.4.5 Institutional Behaviour and Risk; 6.3.4.6 Family Contact; 6.3.4.7 Future Placement Needs; 6.4 Discussion; References