Psychosocial interventions in a forensic department

Background

Schizophrenia often entails difficulties in social and occupational functioning. Frequently the approach followed in the hospital wards is mainly pharmacological and different from that of the community-based service which is mainly psychosocial. The accumulating evidence on the active role of the person in his or her recovery has had a profound impact on our understanding and interventions in relation to that severe mental illness especially when is accompanied with violent behavior.

Materials and methods

At present there are 60 patients in our department. They have committed crimes and are under compulsory detention and treatment. Since 2000 a variety of psychosocial interventions began to be implemented in concert with medications to minimize symptoms and improve community adjustment in mentally disordered offenders hospitalized in the Forensic Unit of the Psychiatric Hospital of Thessaloniki.

Results

In order to motivate our patients and finally to strengthen their sense of purpose and self-confidence, a rehabilitation program including 20 patients started in 2000 co-sponsored by the European Union. Since 2005 only 12 patients participate in this program now funded from the Ministry of Health and Social Welfare. The program includes several working teams inside or outside the ward, still inside the hospital, leaving limited opportunities to use social skills.

Conclusions

It is the hope that these interventions, and in a larger scale, will allow people with mental illness and violent behavior to more speedily and effectively reintegrate into their families and community so that they may lead more satisfying lives. Although there is a lot that can be done towards rehabilitation, especially for this group of patients, it seems that regular work performance feedback and goal setting are especially important for reducing clinical and social morbidity.