Forensic hospitals are responsible for both the custody and treatment of patients, including treatment that will minimize the risk of future violence to the community. This study examined factors that affected length of stay (LOS) in Maryland’s only maximum-security forensic hospital for mentally ill patients who were adjudicated not criminally responsible (NCR) for serious violent crimes. The current study focused on the combined effects of demo-graphic, legal, and clinical variables on LOS in NCR patients who had been approved for transfer to a less restrictive environment to determine what, if any, variables should be targeted for services during hospitalization. The results of the study indicated that, in addition to gender, history of employment prior to the offense was the strongest predictor of LOS. Three other variables contributed less significantly to the prediction model. These findings have pro-grammatic implications for forensic psychiatric facilities treating the seriously mentally ill.
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References
1.
Addington, D., & Holley, H. (1989). A comparison of voluntary with remanded schizophrenics. Canadian Journal of Psychiatry, 34(2), 89-93.
2.
Bachrach, L. L. (1986). The future of state mental hospitals. Hospital and Community Psychiatry, 37(5), 467-474.
3.
Bachrach, L. L. (1996). The state of the state mental hospital in 1996. Psychiatric Services, 47(10), 1071-1078.
4.
Binder, R. L., & McNeil, D. E. (1990). The relationship of gender to violent behavior in acutely disturbed psychiatric patients. Journal of Clinical Psychiatry, 51(3), 110-114.
5.
Bloom, J. D., & Williams, M. H. (1992). Oregon’s experience with insanity acquittees. Psychiatric Annals, 22(11), 579-583.
6.
Cooke, G., & Sikorski, C. R. (1974). Factors affecting length of hospitalization in persons adjudicated not guilty by reason of insanity. Bulletin of the Academy of Psychiatry and Law, 2(4), 251-261.
7.
Cuneo, D. J., Brelje, T. B., Randolph, J. J., & Taliana, L. E. (1982). Seriousness of charge and length of hospitalization for the unfit defendant. Journal of Psychiatry and Law, 10(2), 163-171.
8.
Gelberg, L., Linn, L. S., & Leake, B. D. (1988). Mental health, alcohol and drug use and criminal history among homeless adults. American Journal of Psychiatry, 145(2), 191-196.
9.
Grob, G. (1994). The mad among us. New York: Free Press.
10.
Harding, C. M. (1995). The interaction of biopsychosocial factors, time and course of schizophrenia. In C. L. Shriqui & H. A. Nasrallah (Eds.), Contemporary issues in the treatment of schizophrenia (pp. 653-681). Washington, DC: American Psychiatric Press.
11.
Harding, C. M., Strauss, J. S., Hafez, H., & Lieberman, P. B. (1996). Work and mental illness: Toward an integration of treatment and rehabilitation. In S. G. Holliday, R. J. Ancill, & G. W. MacEwan (Eds.), Schizophrenia: Breaking down the barriers (pp. 39-61). New York: Wiley.
12.
Hart, S. D., Hare, R. D., & Forth, A. E. (1994). Psychopathy as a risk marker for violence: Development and validation of a screening version of the Revised Psychopathy Checklist. In J. Monahan & H. J. Steadman (Eds.), Violence and mental disorder: Developments in risk assessment (pp.81-98). Chicago: University of Chicago Press.
13.
Hollingshead, A. B. (1965). Two factor index of social position. New Haven, CT: Yale University Press.
14.
Huntley, D. A., Cho, D. W., Christman, J., & Csernansky, J. G. (1998). Predicting length of stay in an acute psychiatric hospital. Psychiatric Services, 49(8), 1049-1053.
15.
Jemelka, R., Trupin, E., & Chiles, J. A. (1989). The mentally ill in prisons: A review. Hospital and Community Psychiatry, 40(5), 481-491.
16.
Jones, M. (1978). State mental hospitals: Demoralized, forgotten? [letter]. Hospital and Community Psychiatry, 29, 610-610
17.
Mesch, G. S., & Fishman, G. (1994). First re-admission of the mentally ill: An event history analysis. Social Science Research, 23(4), 295-314.
18.
Mortimer, J. T., & Finch, M. D. (1986). The development of self-esteem in the early work career. Work and Occupations, 13(2), 217-239.
19.
Psychiatric Security Review Board. (1994). A model for management and treatment of insanity acquittees. Hospital and Community Psychiatry, 45(11), 1127-1131.
20.
Quinsey, V. L., Harris, G. T., Rice, M. E., & Cormier, C. A. (1998). Violent offenders: Appraising and managing risk. Washington, DC: American Psychological Association.
21.
Rodenhauser, P., & Khamis, H. J. (1988a). Relationships between legal and clinical factors among forensic hospital patients. Bulletin of the Academy of Psychiatry and the Law, 16(4), 321-332.
22.
Rodenhauser, P., & Khamis, H. J. (1988b). Predictors of improvement in maximum security forensic hospital patients. Behavioral Sciences and the Law, 6(4), 531-542.
23.
Strick, S. E. (1989). A demographic study of 100 admissions to a female forensic center: Incidences of multiple charges and multiple diagnoses. Journal of Psychiatry and Law, 17(3), 435-448.
24.
Swanson, J. W. (1994). Mental disorder, substance abuse and community violence: An epidemiological approach. In J. Monahan & H. J. Steadman (Eds.), Violence and mental disorder: Developments in risk assessment (pp.101-136). Chicago: University of Chicago Press.
25.
Thompson, J. W., Belcher, J. R., DeForge, B. R., Myers, C. P., & Rosenstein, M. J. (1993). Changing characteristics of schizophrenic patients admitted to state hospitals. Hospital and Community Psychiatry, 44(3), 231-235.
26.
Torrey, E. F. (1995). Jails and prisons: America’s new mental hospital. American Journal of Public Health, 85(12), 1611-1613.
