title: The national trajectory project of individuals found not criminally responsible on account of mental disorder. Part 5: how essential are gender-specific forensic psychiatric services?
abstract: OBJECTIVE
  To state the sociodemographic characteristics, mental health histories, index offence characteristics, and criminal histories of male and female forensic psychiatric patients. Clinicians and researchers advocate that mental health and criminal justice organizations implement gender-specific services; however, few studies have sampled forensic patients to evaluate the extent to which men's and women's treatment and management needs are different.
  
  
  METHODS
  Data were collected from Review Board files from May 2000 to April 2005 in the 3 largest Canadian provinces. Using official criminal records, participants were followed for 3 to 8 years, until December 2008. The final sample comprised 1800 individuals: 15.6% were women and 84.4% were men.
  
  
  RESULTS
  There were few demographic differences, but women had higher psychosocial functioning than men. Both men and women had extensive mental health histories; women were more likely diagnosed with mood disorders and PDs and men were more likely diagnosed with schizophrenia spectrum disorders and SUDs. The nature of the index offence did not differ by gender, except women were more likely to have perpetrated murders and attempted murders. For offences against a person, women were more likely to offend against offspring and partners and less likely to offend against strangers, compared with men. Women had significantly less extensive criminal histories than men.
  
  
  CONCLUSIONS
  Not criminally responsible on account of mental disorder-accused women have a distinct psychosocial, clinical, and criminological profile from their male counterparts, which may suggest gender-specific assessment, risk management, and treatment in forensic services could benefit patients. The findings are also consistent with traditional models (Risk-Need-Responsivity) and ultimately demonstrate the importance of individual assessment and client-centred services.
authors.affiliation: Associate Professor, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia; Senior Research Fellow, Forensic Psychiatric Services Commission, BC Mental Health & Substance Use Services, Coquitlam, British Columbia.
authors.forename: Tonia L
authors.initials: TL
authors.lastname: Nicholls
authors.affiliation: Associate Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Associate Director, Policy and Knowledge Exchange, Douglas Mental Health University Institute Research Centre, Montreal, Quebec.
authors.forename: Anne G
authors.initials: AG
authors.lastname: Crocker
authors.affiliation: Director of Forensic Rehabilitation Research, Royal Ottawa Health Care Group, Brockville, Ontario.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Seto
authors.affiliation: Post-doctoral Research Fellow, University of British Columbia and British Columbia Forensic Psychiatric Services Commission, BC Mental Health & Substance Use Services, Coquitlam, British Columbia.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Wilson
authors.affiliation: Post-doctoral Fellow, Department of Sociology, Yale University, New Haven, Connecticut.
authors.forename: Yanick
authors.initials: Y
authors.lastname: Charette
authors.affiliation: Professor, Department of Psychology, Université du Québec à Trois-Rivières, Trois-Rivières, Quebec; Director, Philippe-Pinel Institute Research Centre, Montreal, Quebec.
authors.forename: Gilles
authors.initials: G
authors.lastname: Côté
mesh_terms: D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D057237:Criminals / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D005260:Female; D005555:Forensic Psychiatry / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D028642:Persons with Psychiatric Disorders / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D008875:Middle Aged; D009864:Ontario / Q000453:epidemiology; D011792:Quebec / Q000453:epidemiology; D012737:Sex Factors