Seattle University Collaborative Projects - International Academy of ...

Aggressive behavior is a major concern in both mental health and criminal justice settings.Although pharmacotherapy is often used in the treatment of the violent individual, no medicationis presently approved by the US Food and Drug Administration specifically for such use. Theresearch literature has implicated several neurobiologic deficits associated with impulsive(reactive) aggression, including reduced central serotonergic functioning, executive dysfunction,and prefrontal deficits. It has been suggested that the neurobiologic deficits specific to impulsiveaggressive behavior may serve as indicators of an ineffective behavioral control system. Areview of the literature finds that several pharmacological agents are effective in reducing thefrequency and intensity of impulsive aggressive outbursts both when used as the primary agentof treatment and as an adjunct to ongoing pharmacotherapy. This presentation will discussempirical evidence for treatment efficacy in impulsive aggression for a broad range ofpharmacological agents.Bringing the Forensic Psychiatrist into the Prisons or the Mentally DisorderedOffenders into Security HospitalsMarc Graf, University of Basel (marc.graf@upkbs.ch)For reasons well known and researched in detail, prevalence rates for mental disorders are muchhigher in prison populations all over the world than in general, not only for prison inmates butalso for prisoners on remand, asylum seekers on warrant for deportation and others. In addition,the proportion of imprisoned people is rising in most countries with an increase in preventativedetention to ensure public safety, leading to longer prison stays, and excessive aging of thispopulation. Therefore forensic psychiatry not only has to deal with the typically young criminalpopulation, vulnerable to becoming mentally ill for social reasons and in a period of life whereincidence of schizophrenia, suicide, drug abuse and most personality disorders are highest, butalso with an increasingly older population with high incidence of affective disorders anddementia. While treatment standards for these mental disorders are largely published andaccepted, and scientific evidence about the screening for mental disorders in prisoners isgrowing, it remains unclear where to treat them: In the prison, in special medical wards in theprisons or in security hospitals. This discussion presents an algorithm based on considerationsabout public safety, criminal proceedings, criminal theory, medical safety and needs, humanrights, ethics and availability of services at the interface between prisons and mental hospitals.Correctional Health Care for WomenMorag MacDonald, Birmingham City University (morag. macdonald@bcu.ac.uk)This intervention will examine the specific experiences of women in prison, focusing onprevious (and continuing) physical and mental abuse, the consequent health care requirements ofwomen prisoners, the policy response and the availability of suitable health care in prisons across94