Longer treatment times than expected in forensic psychology

Facts: Forensic psychiatric care

The court can order forensic psychiatric treatment if the person suspected of a crime suffers from a serious mental disorder. The term “serious mental disorder” is not a diagnosis but a legal term. Examples of a serious mental disorder can be delusions, thought disorders and hallucinations.

In some cases, forensic psychiatric care can be combined with a special discharge examination. It is relevant when there is a risk that the defendant will relapse into crimes of a serious nature. Special discharge review means that the administrative court makes decisions about care, instead of a chief medical officer.

The current study has been published in the scientific journal Frontiers in Psychiatry.

The study is the first in a larger project, where in the future the researchers also want to compare the length of time in forensic psychiatry with prison sentences for similar crimes and how the groups differ in terms of recidivism.

Sources: Sweden’s courts, RMV

In previous studies, the average length of care for people in forensic psychiatric care has been estimated at five years and nine months.

But according to a new study from RMV, the average time is significantly longer than that: seven years and six months.

The difference is explained by the fact that previous calculations were only based on discharged patients, which has led to the fact that patients with very long periods of care who are still in care are not counted.

— It is as if you were to calculate the average survival time for a certain form of cancer, and only take into account those who have already died of cancer, says Thomas Masterman, senior physician in forensic psychiatry at RMV and associate professor at Karolinska Institutet, who led the study.

Thomas Masterman, senior physician in forensic psychiatry at the Swedish Medical Research Agency and docent and adjunct lecturer at the Karolinska Institutet, leads the research group that conducted the study.

The new study also took into account patients who are still enrolled.

— We have calculated the median for everyone instead of the average length of care only for those who have been discharged, says Thomas Masterman and adds:

— It is a fairer way of calculating an average.

The researchers have looked at the length of care for people who were sentenced to forensic psychiatric care between the years 2009 and 2019, a total of 2,064 patients.

However, points out Thomas Masterman, it can be difficult to stare blindly at an average. Especially when it comes to forensic psychiatric care, where the length of care varies from person to person.

— The discharges are not grouped around the average as they might be for prison terms, he says.

“There are few facts”

Nevertheless, he thinks the study is important, not least in relation to the social debate about forensic psychiatric care.

— There are perceptions that the care is far too short, or perceptions that the care is far too long. But there are very few facts that people can refer to, so this is important, says Thomas Masterman.

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