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Forensic Psychiatry and Psychology in Europe Forensic Psychiatry and Psychology in Europe A Cross-Border Study Guide Kris Goethals Editor 123 Forensic Psychiatry and Psychology in Europe Kris Goethals Editor Forensic Psychiatry and Psychology in Europe A Cross-Border Study Guide Editor Kris Goethals Antwerp University Hospital, University Forensic Centre (UFC) & University of Antwerp, Faculty of Medicine and Health Sciences Collaborative Antwerp Psychiatric Research Institute (CAPRI) Edegem/Wilrijk Belgium ISBN 978-3-319-74662-3 ISBN 978-3-319-74664-7 (eBook) https://doi.org/10.1007/978-3-319-74664-7 Library of Congress Control Number: 2018943755 © Springer International Publishing AG, part of Springer Nature 2018 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by the registered company Springer International Publishing AG part of Springer Nature The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland Why I See the Necessity for Such a Study Guide It is a pleasure for me to see the publication of the new book Forensic Psychiatry and Psychology in Europe: A Cross-Border Study Guide, which has been edited by Prof. Kris Goethals from the University of Antwerp. In this book, the editor brings together authors from different countries and also from different disciplines that discuss important issues affecting the sphere of forensic psychiatry regarding their importance for the field and their consecutive relevance for the education and train- ing of forensic psychiatrists. As the field of forensic psychiatry is characterized by a blend of different professions that are involved in and cooperate during the legal procedures, the treatment, and the rehabilitation of the patients, it is important that young psychiatrists and psychologists in training are aware of the importance of this interprofessional interactions and their presence in different countries. Furthermore, it is dependent on the legislative and judiciary culture of a country in which way it deals with psychiatrically ill offenders. The interaction of different agencies involved in the process of dealing with psychiatrically ill offenders (multiagency working) differs considerably between the European countries. To describe these different cultures and their manifestations in the systems of forensic psychiatry in different European countries provides an important basement for the discussion of advantages and disadvantages of different approaches. The concept of the book subdivides the contributions into five main categories or areas that are legal frameworks, forensic services, mandatory skills, education, and diverse issues. The legal frameworks relevant to forensic psychiatry are discussed with respect to the importance that the knowledge of different legal aspects has in the training of forensic psychiatrists and psychologists in order to be able to exert their profession in the field of forensic psychiatry. Here, the international aspect gains an ever increasing importance as, specifically in Europe, legal institutions tend to converge. Judgements from local courts in exempli gratia the countries of the European Union (EU) are subject to evaluation by the European superior courts (European Court of Human Rights). Furthermore, placement/hospitalization and treatment in psychiat- ric hospitals and prisons are subject to review by the Committee for the Prevention of Torture (CPT), which is an institution of the Council of Europe that is dedicated to the surveillance of the regulations that have been fixed in the European Convention for the Prevention of Torture. Furthermore, the study guide outlines the provision of forensic services in different countries. From the differences and commonalities of v vi Why I See the Necessity for Such a Study Guide these implementations and their differential effects on criminological outcomes interesting conclusions can be drawn that are very illustrative for trainees in forensic psychiatry. Also important is the reflection of skills that are crucial for the work as forensic psychiatrists. Here, not only language skills are necessary but also a deep understanding of transcultural problems in psychiatry as well as in transcultural dif- ferences in moral norms. These latter transcultural aspects gain an increasing impor- tance not only due to the challenge of the European societies by migration from poorer countries but also because of the increasing professional migration of physi- cians that also affects forensic psychiatrists. Aside from such specific questions, it has also to be discussed what professional requirements are present in different countries for professionals working in forensic psychiatry. Training in a medical specialty such as forensic psychiatry on the one hand relies on theoretical knowledge, which can be obtained from the study of literature and books such as this study guide. On the other hand medical training also requires real-life interaction and discussion of the contents that have been theoretically stud- ied. Naturally, the discussion of these aspects of different systems of forensic psy- chiatry in different countries cannot succeed sufficiently when discussants from only one country are present. Rather, such a discussion requires the participation of discussants from these different cultural backgrounds and forensic psychiatric sys- tems. In order to provide a training opportunity for young psychiatrists from differ- ent European countries, the Ghent group has established an international European summer school for forensic psychiatry. This summer school brings together senior experts and junior professionals as well as trainees in forensic psychiatry from a range of European countries. Therefore it is a perfect real-life counterpart of the present study guide in order to further explore and differentiate the concepts of forensic psychiatry and the approaches taken in different European countries. This study guide is a very important contribution to the education of young psy- chiatrists interested in forensic psychiatry. It provides a collection of important insights and descriptions of how forensic psychiatry is carried out in several differ- ent European societies. Moreover, it compares different aspects and allows for a consideration and evaluation of the effects of the different approaches. This may in the future contribute to a possible European convergence of systems while fostering beneficial elements and attenuating more problematic elements. Kolja Schiltz Recommendations to the Practice of Teaching, Training, and Research in Italy The reform in Italy of treatment for mentally ill offenders led to the closure of Forensic Hospitals, mainly hospital prisons, at the end of 2016: new facilities, resi- dences for security measures (REMS), run totally by Mental Health Services, have since been built. Furthermore, community services are currently taking charge of the less dangerous patients not guilty by reason of insanity. Psychiatrists, psychologists, nurses, and rehabilitation workers need to increase their knowledge of juridical and forensic issues and should receive better training due to the fact that therapeutic plans for forensic patients are currently very com- mon in the network of Community Mental Health Services. At the same time, health workers in prison have the responsibility of identifying detainees suffering from mental illness as quickly as possible and must not only take care of them but also involve the community services in their future treatment. This complex change in Italy will transform the organization of the mental health network without changing the “non-institutional” principle that led to the closure of the psychiatric hospitals in 1978 (Law 180/78). The personnel working in mental health, and in the juridical system, including forensic psychiatrists and psychologists, judges, and any other parties who are involved in the pathways of treatment and security needs, will be trained therefore to have an active participation in the reform. An initial training of health workers is currently underway, but it must be rein- forced and become permanent. The main items to stress with the aim of improving or introducing skills regarding treatment and assessment are, in my opinion: knowledge of the legal framework knowledge of the mental health network of facilities a common language between
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