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Changing characteristics of forensic psychiatric patients in Ontario: a population-based study from 1987 to 2012.

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Title:	Changing characteristics of forensic psychiatric patients in Ontario: a population-based study from 1987 to 2012.
Authors:	Penney, Stephanie R. (AUTHOR), Seto, Michael C. (AUTHOR), Crocker, Anne G. (AUTHOR), Nicholls, Tonia L. (AUTHOR), Grimbos, Teresa (AUTHOR), Darby, Padraig L. (AUTHOR), Simpson, Alexander I. F. (AUTHOR)
Source:	Social Psychiatry & Psychiatric Epidemiology. May2019, Vol. 54 Issue 5, p627-638. 12p.
Subjects:	Mental health services, Psychotherapy patients, Substance-induced disorders, Comorbidity, Substance abuse, Psychiatric diagnosis, Race, Affective neuroscience
Geographic Terms:	Ontario
Abstract:	Purpose: To quantify the demand for forensic psychiatric services in Ontario over the past 25 years and investigate whether the sociodemographic, clinical and offense-based characteristics of forensic patients have changed over time.Methods: We investigated all forensic admissions from 1987 to 2012 resulting in a disposition of Not Criminally Responsible on account of Mental Disorder (N = 2533). We present annual proportions of patients with specified sociodemographic, clinical and offense characteristics, and investigate whether the duration of forensic system tenure varies as a function of admission year, psychiatric diagnosis, or index offense.Results: There has been a steady increase in forensic admissions over this time period, particularly individuals with comorbid substance use disorders and individuals of non-Caucasian ethno-racial background. The proportion of persons committing severe violence has remained low and has decreased over time. Having a comorbid personality, neurological, or substance use disorder significantly increased forensic system tenure, as did committing a violent offense. Individuals who came into the system in earlier years had slower rates of discharge compared to more recent admissions.Conclusions: Defining the trends characterizing the growth of the forensic population has important policy implications, as forensic services are costly and involve a significant loss of liberty. The current results indicate that young, substance abusing individuals of diverse ethno-racial backgrounds and who commit relatively low-level violence comprise an increasing proportion of Ontario's forensic population, and suggest that treatment must be optimized to best serve the needs of these individuals. [ABSTRACT FROM AUTHOR]
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Database:	Psychology and Behavioral Sciences Collection
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