A Residential Psychiatric Approach for Forensic Patients: The Experience of “Tiziano” Facility

Abstract

Introduction

Italian forensic mental hospitals closed on March 31st, 2014 and offenders sentenced to need a psychiatric care are restrained in facilities. Since 2002, the residential psychiatric facility “Tiziano” (Aulla, Massa-Carrara) hosts forensic patients, on appointment with national health system and compulsorily admitted by the justice system.

Methods

This descriptional and prospective study provides a thorough report on the main epidemiological, clinical, and criminological features of 60 mentally ill offenders hosted in the “Tiziano” facility between 2002 and June 2016.

Results

Most forensic patients were male (90%, n = 54; average age: 33 years). Sixty percent of subjects (n = 36) had a clinical diagnosis of psychosis (19.4% affective psychosis, 72.2% non-affective psychosis, 8.4% organic psychosis), and about one third of them (31.6%, n = 19) had a personality disorder (63.1%, n = 12, antisocial personality disorder, 42.1%, n = 8, borderline personality disorder, 21.0%, n = 4 other personality disorders). Mental insufficiency was diagnosed in 11.6% (n = 7) of subjects, while substance use disorder affected 35.0% (n = 21) and alcohol use disorder 26.6% (n = 16). Forty-nine patients (81.7%) had committed serious crimes against people; 15% (n = 9) were murderers or attempted murderers, and 46.7% (n = 28) had committed more crimes. The average length of stay is 22 months.

Conclusions

To date, there are no data about long-term follow-up and clinical outcome of mentally ill offenders restrained in Italian psychiatric facilities. Additional studies are needed to assess psychopathology and differentiate treatment according to diagnosis, and to identify risk factors of relapse for criminal behavior relapse.

Disclosure of interest

The authors have not supplied their declaration of competing interest.