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Biomedical subjects

G J Maier

Publications and source records attributed to G J Maier.

28 records · Page 2Linked to original sources
PubMed1987

Factors affecting the decision to prosecute mental patients for criminal behavior.

Several authors have argued that under certain circumstances it is both necessary and therapeutic to bring criminal charges against psychiatric patients who have committed assaults or manifested other criminal behavior. Others have argued that prosecution may impair therapeutic alliances and may lead to increased litigation by patients. In this paper the authors present four cases in which patients in the public mental health system were prosecuted, and they discuss factors that affect the decision to pursue prosecution. They argue that both clinicians and legal professionals need specific training to help them recognize the differences between behavior that a patient's illness prevents him from controlling and impulsive behavior, stemming from character pathology, that can appropriately be addressed by criminal sanctions.

Adult↗
PubMed1987

Patient access to medical records in a forensic center: a controlled study.

Several psychiatric facilities have opened their records partially or completely to patients. The authors report the results of a two-part study in which 20 patients on a minimum-security unit of a forensic center were allowed to read their records and later to write in them. Staff and patient attitudes toward granting patients access to their records were measured before and during the study and were compared with staff and patient attitudes on two units where patients were not granted access. Only eight study patients actually read their charts and none wrote in them, but the majority of both study and control patients felt that access had been helpful. No significant differences in patient behaviors were found on any of the units as a result of access. Staff attitudes toward access did not differ significantly before or after the study, and few differences were found in staff charting practices.

Attitude of Health Personnel↗
PubMed1987

A model for understanding and managing cycles of aggression among psychiatric inpatients.

A model developed at the Forensic Center of the Mendota Mental Health Institute for understanding and managing aggressive inpatients focuses on the dynamics of inpatient aggression and their impact on staff. Divided into cycles of physical and verbal aggression, the model incorporates staff responses to aggressive behaviors and outlines the responsibilities of the administration in helping staff deal with aggressive patients. It particularly addresses repetitive aggression and the importance of recognizing countertransference issues.

Aggression↗
PubMed1987

Preventive aggression devices (PADS): ambulatory restraints as an alternative to seclusion.

The authors introduce an ambulatory restraint procedure developed for a specialized inpatient unit with repetitively aggressive patients. Preventive Aggression Devices (PADS) reduce the length and frequency of seclusion and humanely foster a safer, more therapeutic environment for patients requiring a highly controlled environment. Indications and contraindications for PADS are listed, and criteria for their use are described.

Aggression↗
PubMed1987

Models of mental health service delivery to correctional institutions.

The mentally disordered offender falls into the "no man's land" between prison and mental health systems. A number of reasons are given to explain why mental health service to this special group is in crisis again, and to lay the base for understanding the advantages and disadvantages of five different models of service delivery. The authors conclude by favoring small psychiatric units attached to major prisons.

Commitment of Persons with Psychiatric Disorders↗
PubMed1986

Relationship security: the dynamics of keepers and kept.

Hiring, training and supervising treatment staff who work closely with forensic patients at all levels of security requires careful planning. In particular, staff must identify and share feelings like fear and anger that are always generated when patients threaten or attack staff. Approaches to dealing with staff countertransference to patients are suggested in this article, and aids to breaking the aggression cycle are discussed. Relationship security is a working through of dynamics that are always in operation where there are keepers and kept.

Adult↗
PubMed1985

The Munchausen patient in a forensic facility.

The many reports in the literature of chronic factitious illness (Munchausen's Syndrome) have emphasized the difficulty of treating these patients because of their propensity to leave medical facilities as soon as the factitious nature of their symptoms is discovered, and because of their disinclination to accept psychiatric help. The authors report on their treatment of such a patient who was incarcerated for over ten years under a criminal commitment, and discuss methods for overcoming resistances to treatment in Munchausen's patients.

Adult↗
PubMed1985

Miranda comes to the hospital: the right to remain silent in civil commitment.

One procedural protection that has not generally made the transition from the criminal justice system to involuntary civil commitment is the Fifth Amendment protection against self-incrimination. The authors present the results of a study of the implementation of the right to remain silent, which demonstrate that warning patients that anything they say may be used against them in the commitment hearing has little impact on their willingness to talk to staff or to cooperate with treatment. The authors discuss the possible reasons for their findings.

Adult↗