Seclusion should only be used as a last resort to prevent pending harm. It should never be used for punishment nor staff convenience. Although seclusion is sometimes clinically needed, the frequency, length, and administration of seclusion — and the trauma it often causes — are not aligned with a patient-centred system of mental health care.
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Program Shows Promise for Treating Substance Misuse in Forensic Psychiatric Setting
Substance misuse is common among patients in the forensic mental health system, and this complicates their recovery and community reintegration.
A semi-structured manualized treatment program (SSMTP) is showing promise for treating patients who misuse drugs and alcohol and have multiple mental disorders in a forensic mental health setting. Research has found that SSMTP increased recognition of a problem and steps taken toward substance use cessation in this population. However, the program may be more effective for some substances than others.
Read moreHelping Patients in Forensic Mental Health Feel Motivated and Ready for Treatment
A lack of motivation to change is one of the main barriers to successful treatment for individuals involved in the criminal justice and forensic mental health systems. A two-month group therapy program helped patients in a forensic mental health hospital feel more motivated and ready for treatment. While such preparation programs have been studied in other settings, a recent study is the first in forensic mental health.
Read moreSelf-Harm in Forensic Mental Health Patients with Intellectual Disabilities
Forensic mental health patients with intellectual disabilities (IDs) have a higher risk of self-harming than those without IDs. Female patients and patients with a history of self-harm are at even greater risk. Identifying this elevated risk early can help forensic mental health professionals act sooner and better support patients before they self-harm.
In a recent study published in BMC Psychiatry, Dr. Mark Mohan Kaggwa and colleagues examined the prevalence of self-harm among forensic mental health patients with IDs in Ontario. The researchers reviewed each patient’s demographic, clinical, and forensic history to identify the characteristics most closely associated with self-harm.
Read moreWhy Dual Harm Demands Integrated Care in Forensic Psychiatry
Dual harm refers to when a patient harms themself and acts aggressively toward others or objects. When these behaviours occur together, patients often need closer monitoring and more coordinated care.
A study published in PLoS One by Mark Mohan Kaggwa, Bailea Erb, Sébastien Prat, Arianna Davids, John Bradford, Gary Chaimowitz, and Andrew Olagunju examined which factors were associated with dual harm among forensic patients in Ontario. Their findings highlight the need for integrated, trauma-informed care planning that addresses self-harm and aggression together.
Read moreForensic Psychiatry Patients More Likely to Self-Harm After Harming Healthcare Workers, Support Staff, or Another Patient
Self-harm is a serious concern in forensic psychiatry settings, being more common there than in the general population. Recent research shows that the risk of self-harm depends more on who the patient harmed during their original offence than on the circumstances of the offence itself.
Read moreImproving Rehabilitation Outcomes for Older Adults in Ontario’s Forensic Psychiatry System While Maintaining Public Safety
Historical factors consistently outweighed dynamic and protective factors, but risk assessments for older adults need to be rebalanced.
Read moreHow Virtual Reality Is Changing Medical Training
What if medical trainees could learn complex procedures or practice emergency responses in realistic simulations, without needing to perform them on actual patients or in risky clinical settings? Virtual reality (VR) is reshaping medical education by creating immersive, repeatable experiences that build technical skills, foster collaboration, and strengthen empathy. A recent commentary article by Dr. Mark Mohan Kaggwa, Precious Agboinghale, Diana Marginean, Dr. Gary Andrew Chaimowitz, and Dr. Andrew Toyin Olagunju explores how VR can transform medical training and prepare learners for complex, real-world scenarios.
Read moreReflections at Five Years and Post COVID-19
Almost five years ago, the first issue of the International Journal of Risk and Recovery (IJRR) arrived in an already crowded medical journal market (Chaimowitz, 2018). It strove to both address key forensic psychiatry issues and to make the articles readily accessible for forensic psychiatry clinicians. The journal aimed to focus not only on the myriad of risk issues but also on the rehabilitation of forensic psychiatry patients and especially the application of recovery principles to this patient population (Simpson & Penney, 2011). Finding and maintaining the balance between risk and recovery was key.
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