Adminstrative issues in the follow-up treatment of insanity acquittees

Stuart B. Silver, Christiane Tellefsen

Research output: Contribution to journalArticlepeer-review

Abstract

This paper discusses issues in the community-based management of forensic patients. Community acceptance and safety demand a careful system of follow-up treatment for insanity acquittees. Many studies have examined the recidivism of this population, but few have dealt with administrative strategies to manage their care as outpatients. In this paper, we discuss our experiences in developing systems for follow-up care as outpatients. In this paper, we discuss our experiences in developing systems for follow-up care of insanity acquittees in the state of Maryland. Central to this work is the balancing of clinical, judicial and community concerns. The decision for outpatient care or movement of the patient to a non-forensic (regional) hospital is a significant turning point in the forensic patient's care. One of the major challenges faced by forensic mental health services is to develop consistency of practice throughout a state. A centralized system is easier to manage, but costly. A system embedded in community mental health centers is less duplicative, but requires major and ongoing educational support. A private practice model is flexible, but administratively challenging. The authors believe Maryland possesses well-developed approaches for the evaluation, treatment and conditional release of insanity acquittees. The state continues to study and redesign its systems toward increased effectiveness and efficiency.

Original languageEnglish (US)
Pages (from-to)242-252
Number of pages11
JournalThe Journal of Mental Health Administration
Volume18
Issue number3
DOIs
StatePublished - Sep 1991
Externally publishedYes

ASJC Scopus subject areas

  • Leadership and Management
  • Psychiatry and Mental health

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