A comparison between former forensic and non-forensic patientsliving in psychiatric residential facilities: Anationalsurvey in Italy

Abstract

Discharge from a psychiatric forensic institution is a critical moment for patients with severe mental disorders; often it leads to relocation to a non-forensic residential facility (RF) where treatment and support needs can be met. The present study used data from the Italian PROGRES project (aimed at studying the country's residential mental health care system) to investigate the characteristics of a large sample of patients formerly admitted to forensic mental hospitals (FMH) living in a psychiatric RF, and to compare them with RF patients never admitted to FMH. Structured interviews were conducted with the managers and staff of a representative sample of Italian RFs (n = 265); residents were also evaluated using standardized rating instruments. Among 2,962 surveyed residents, a total of 193 patients (6.5%) had previously been admitted to a FMH. The majority had a diagnosis of schizophrenia or a related disorder (n = 149, 78.0% of FMH patient vs. 1830, 66.8% of non-FMH patients). Overall, the symptom profile did not differentiate former forensic patients from residents who had never been admitted to an FMH. The rate of violent behaviour reported during stay in current residence was low and limited to a very small group of former FMH patients. The present study's main conclusion is that patients discharged from FMHs and selected as suitable for relocation to ordinary RFs are able to remain in this type of accommodation without posing a significant danger in terms of violent behaviour or threats.

Keywords:

• residential facility
• process of care
• long-term patients
• severe mental illness
• violence
• supportive housing
• community mental health
• forensic
• offenders

Acknowledgements

The PROGRES group included the following people. National coordinators: Dr. G. de Girolamo, Dr. A. Picardi, and Dr. P. Morosini (National Mental Health Project, National Institute of Health, Rome); biostatistician: Professor R. Micciolo (University of Trento); regional coordinators: Dr. P. Argentino, Professor G. Borsetti, Professor M. Casacchia, Dr. P. Ciliberti, Ms. G. Civenti, Dr. A. Colotto, Dr. G. Dell'Acqua, Dr. W. Di Munzio, Dr. G. Fagnano, Dr. A. Fioritti, Dr. N. Longhin, Dr. M. Miceli, Dr. M. Nicotera, Ms. M. Pisetta, Ms. R. Putzolu, Dr. E. Rossi, Dr. M.E. Rotunno, Dr. D. Semisa, Dr. R. Tomasi, Dr. P. Tulli, and Dr. E. Zanalda; researchers: Dr. C. Barbini, Dr. F. Basile, Dr. G. Bazzacco, Ms. R. Bracco, Dr. A. Calvarese, Dr. G. Canuso, Dr. E. Caroppo, Dr. L. Caserta, Dr. M. Cellini, Dr. M. Colangione, Dr. S. Damiani, Dr. T. De Donatis, Dr. F. Di Donato, Dr. V. Di Michele, Dr. R. Esposito, Dr. M. Facchini, Dr. S. Ferraro, Dr. P. Fracchiolla, Dr. P. Gabriele, Dr. A. Galli, Dr. D. Gallicchio, Dr. G. Giardina, Dr. A. Greco, Dr. F. Grilletti, Dr. S. Guzzo, Dr. A.M. Lerario, Dr. M.R. Marinelli, Dr. C. Marino, Dr. E. Monzani, Dr. K. Pesaresi, Dr. F. Picco, Dr. L. Pinciaroli, Dr. G. Pitzalis, Dr. C.A. Rossetti, Dr. P. Rubatta, Dr. G. Santone, Dr. F. Scorpiniti, Dr. V. Scrofani, Ms. M. Stefani, Dr. A. Svettini, Dr. L. Tarantino, and Dr. A. Zaffarano.