THE BENEFITS OF OPENING FORENSIC MENTAL HEALTH SERVICES IN N. MACEDONIA
Keywords:
forensics, criminogenic factor, forensic mental health centersAbstract
The benefits of opening forensic mental health services in North Macedonia are enormous. Their establishment will provide assessment and treatment for individuals with mental disorders who have a history of criminal behavior, or those at risk of committing a crime. The services will be available to support individuals who have committed a crime and are mentally ill, as well as those at risk of committing a crime. The staff working in the forensic mental health services will receive training and focus on mental illnesses and the offending behavior of the clients. They will include psychiatrists, psychologists, nurses, occupational therapists, and social workers. All of them will be professionals, but they must also complete training in risk and safety management, i.e., appropriate training. Treatment will be pharmacological, socio-psychological, and occupational. These therapies are essential for patients to achieve good adjustment before leaving the community.
Objectives:
1. To determine the significance of the differences between the frequencies of hospitalized patients.
2. To examine the significance of the differences between the criminogenic behavior of patients and the frequency of committed crimes. The study group consists of the total number of subjects hospitalized over a two-year period with criminal behavior treated in the Forensic Department of the Psychiatric Hospital in Demir Hisar, and for whom psychiatric expert opinions were requested by the court. These are patients with criminal behavior (patients who committed a crime: murder, grievous bodily harm, violent behavior, rape, domestic violence, theft, disruption of public safety and public order and peace, and forgery). The patients were diagnosed according to the ICD-10 classification.
The control group consists of subjects who were treated in the Psychiatric Hospital in Demir Hisar and who were hospitalized during the same period without criminal behavior, with corresponding demographic and clinical data as the subjects in the study group.
The study group consisted of 158 patients with criminal behavior, of whom 144 (91.1%) were men and 14 (8.9%) were women.
The largest number of 44 (27.85%) patients committed murder, and the smallest number of 6 (3.79%) patients committed rape.
The control group consisted of 158 patients who did not commit a crime, of whom 144 (91.1%) were men and 14 (8.9%) were women. In the presented distribution of diagnoses, for h2 = 16.29 and p < 0.05, the difference between the frequencies of hospitalized patients is significant.
Regarding the issue of criminogenic treatment of patients, there is a significant difference between the frequencies of crimes committed for h2 = 87.16 and p < 0.001, with murder and theft dominating over other crimes.
The prevalence of criminogenic behavior among psychiatric entities has significantly higher values in the male population. The largest number of patients had diagnoses of schizophrenia, addiction disorders, and psychopathy, and the most common crimes were murders and thefts, committed by paranoid and psychasthenic individuals. More forensic patients were aggressive.
Suggested measures would include: Prevention of homicide, crime, aggression and violence, therapeutic methods, use of public information media, inclusion of mental health services, respect for the rights of people with mental disorders, as well as preparing individuals for resocialization after hospital treatment with subsequent continuous treatment of such individuals in mental health centers.
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