Abstract
BackgroundSome suspected criminal offenders in South Africa are required to undergo forensic psychiatry assessments before or during the trial, which can be delayed as a result of the shortage of psychiatrists and inpatient forensic psychiatry beds. In KwaZulu-Natal (KZN) province, only one hospital (Fort Napier Hospital [FNH]) is designated for the 30-day inpatient forensic psychiatry assessments and there is a long waiting list for suspected criminal offenders awaiting assessment. There is a need to find ways of alleviating the backlog in the waiting list, with the use of outpatient forensic assessments being a possible adjunctive method.AimTo determine the demographic, clinical and forensic profile of suspected criminal offenders referred for outpatient preliminary assessment to Ngwelezana Hospital, and identify the profile of those who most likely require referral to FNH for a 30-day inpatient assessment.SettingThe study was conducted at Ngwelezana Tertiary Hospital, in KZN, South Africa.MethodsWe conducted a retrospective chart review of 207 suspected criminal offenders referred for outpatient forensic assessment from January 2009 to June 2015.ResultsThe majority of the participants were males (94.2%), with a diagnosis of substance use disorder (28.2%), intellectual disability (23.4%) or psychotic disorders (21.8%). Forty three per cent were charged with sexual crimes and 10.7% with murder. Fifty seven per cent were recommended for referral to FNH for a 30-day inpatient forensic assessment, whilst 43% were not recommended for referral. Those recommended for inpatient assessment were significantly more likely to have a lower level of education (p = 0.02), to be on a disability grant (p < 0.01), and to have been diagnosed with intellectual disability (p < 0.01), than those not recommended for referral.ConclusionIdentifying the characteristics of suspected criminal offenders who are most likely to be recommended for referral to FNH will potentially reduce the number of unnecessary referrals.
Highlights
Some suspected criminal offenders in South Africa are required to undergo forensic psychiatry assessments before or during the trial, which can be delayed as a result of the shortage of psychiatrists and inpatient forensic psychiatry beds
Some criminal cases in South Africa require a forensic psychiatric assessment if, during any stage of the court proceedings, there is evidence to suggest that the suspected criminal offender is incapable of understanding criminal proceedings in order to make a proper defence.[1]
Suspected adult criminal offenders are referred for psychiatric assessment in accordance with the Criminal Procedure Act (CPA) 51 of 1977, sections 77, 78, and 79,2 whilst children are referred in accordance with the Child Justice Act (CJA) 75 of 2008 Chapter 2(ss 7–11).[3]
Summary
Some suspected criminal offenders in South Africa are required to undergo forensic psychiatry assessments before or during the trial, which can be delayed as a result of the shortage of psychiatrists and inpatient forensic psychiatry beds. In KwaZulu-Natal (KZN) province, only one hospital (Fort Napier Hospital [FNH]) is designated for the 30-day inpatient forensic psychiatry assessments and there is a long waiting list for suspected criminal offenders awaiting assessment. Some criminal cases in South Africa require a forensic psychiatric assessment if, during any stage of the court proceedings, there is evidence to suggest that the suspected criminal offender is incapable of understanding criminal proceedings (by reason of mental illness or intellectual disability) in order to make a proper defence.[1]. In the case of children, the CJA refers to proof of criminal capacity.[3] The process of a 30-day inpatient assessment involves a multidisciplinary team that is involved in conducting the assessment of the referred suspected criminal offender. With no profiling of those who are more likely to require such assessments being available, to reduce the number of suspected criminal offenders being referred for a 30-day inpatient assessment, the problem of long waiting lists is likely to continue
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