Providing mental health services to adult offenders in Victoria, Australia: overcoming barriers.
OBJECTIVE
To illustrate the development of the interface between general and forensic mental health services in Victoria, Australia.


METHODS
Developing effective cooperation between the general and forensic mental health services requires overcoming a number of barriers. The attitude of general services that antisocial behaviour was none of their business was tackled through ongoing workshops and education days over several years. The resistance to providing care to those disabled by severe personality disorders or substance abuse was reduced by presenting and promoting models of care developed in forensic community and inpatient services which prioritised these areas. The reluctance of general services to accept offenders was reduced by involving general services in court liaison clinics and in prisoner release plans. Cooperation was enhanced by the provision of risk assessments, the sharing of responsibility for troublesome patients, and a problem behaviours clinic to support general services in coping with stalkers, sex offenders and threateners.


CONCLUSIONS
Active engagement with general services was promoted at the level of providing education, specialised assessments and a referral source for difficult patients. This generated a positive interface between forensic and general mental health services, which improved the quality of care delivered to mentally abnormal offenders.
Mullen
P
P
Department of Psychological Medicine, Monash University and Victorian Institute of Forensic Mental Health, Victoria, Australia. paul.mullen@forensicare.vic.gov.au
Ogloff
J
J
D000328:Adult; D000987:Antisocial Personality Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D001291:Attitude of Health Personnel; D003134:Commitment of Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence*; D003156:Community Mental Health Services / Q000331:legislation & jurisprudence*; D015897:Comorbidity; D003299:Cooperative Behavior; D003415:Crime / Q000331:legislation & jurisprudence / Q000517:prevention & control; D003430:Cross-Sectional Studies; D003617:Dangerous Behavior; D004493:Education; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D006801:Humans; D033183:Interdisciplinary Communication; D010348:Patient Care Team / Q000331:legislation & jurisprudence; D010351:Patient Discharge / Q000331:legislation & jurisprudence; D011329:Prisoners / Q000523:psychology* / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D012017:Referral and Consultation / Q000331:legislation & jurisprudence; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation; D014739:Victoria