KEY POINTS IN THIS CHAPTER
Nurses working with patients with mental disorders and coexisting forensic issues outside of forensic settings must consider the medicolegal aspects of patient care.
Documentation has the added element of potential impact on legal outcomes and the ability of the victim or the perpetrator to receive proper care.
Knowledge of the mental health dynamics of these patients can keep the healthcare staff, patients, and others safe.
Forensic mental health nursing is the intersection of mental health and the legal system. Forensic psychiatric nurses work with offenders who have been deemed mentally disordered and need additional attention separate from the judicial/penitentiary system. Forensic psychiatric nurses work with mentally disordered offenders in secure psychiatric services where they assess the patient (victim or perpetrator) and gather evidence that may influence conviction, sentencing, recidivism, treatment, and prevention (Lyons, 2009). Forensic psychiatric nurses use their training to aid in the rehabilitation of criminal offenders, assess the wellbeing of crime victims, and serve as expert consultants for criminal proceedings. They most commonly work for law enforcement agencies and at facilities such as prisons, mental hospitals, and juvenile detention centers.
Nurses often interface with patients who exhibit mental health issues in many practice settings: hospitals, clinics, physician and nurse practitioner offices, corrections settings, etc. The patient may present as a psychiatric emergency or may present for other healthcare problems, during which time the patient may exhibit long-standing mental disorders. Many of these patients may have forensic issues related to their care. They may have entered the clinical setting with a weapon, been injured during an altercation with law enforcement or directly with a victim, been a victim of a crime, or been involved in one of many other scenarios in which a person with mental disorders requires medical attention while also having legal problems. Frequently, the healthcare team must deal with the personality disorders common in offenders, concerns regarding violence and safety, and those with factitious disorders trying to feign mental illness to avoid jail or legal consequences.
The nurse who understands the impact of mental disorders in patients throughout the healthcare system can make a difference in the way clinicians perceive and treat these patients as well how the patient may progress to a healthy outcome within the system. What is documented in forensic psychiatric cases may be used at a later date and under different circumstances in a court case to either support the patient regarding a legal issue or help to support a victim in a case related to a particular patient. This chapter provides basic information on mental health and psychiatric nursing in patients with concurrent legal issues.
THE ROLE OF THE FORENSIC NURSE
Forensic psychiatric or mental health nurses deal with mental health issues of victims and offenders. The forensic psychiatric ...