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Doody's Review ServiceReviewer: John Claro Onate, BS, MD (Rush University Medical Center)
Description: This book on the theory and practice of the treatment, in the community, of people who suffer from mental illness and who break the law also highlights the conflict between serving the patient and protecting the community.
Purpose: The purpose is to describe the current emphasis on treating people with psychiatric problems and reducing the chance of a violent acts in the community. This is a very relevant subject in psychiatry and law today. The author is successful in describing the current theory, practice, and ethics of outpatient forensic psychiatry in the U.K.
Audience: The book is intended for psychologists, psychiatrists, lawyers, residents, or fellows, but it is written on a level which undergraduate or graduate students can understand. The book is easy to read, although some of the authors write more clearly than others. The author is a professor of forensic psychiatry at the Institute of Psychiatry in London and is well suited to the topic.
Features: The book is divided into three parts. Essays and discussions on society and the mentally ill with a focus on violent crime perpetrated by the mentally ill make up chapter one. The development and understanding of risk assessment and predicting violent outbursts bridge into part two. Part two covers the specifics of treating the mentally ill from a forensic stance, including assessing risk of violence, compliance, psychotherapy, and psychopharmacology. The organization and role of the mental health team and, finally, the involuntary outpatient treatment policies and laws in the United States rounds out part two. Part three covers the integration of general psychiatric and forensic psychiatric practitioners and the demands of divergent forces on the psychiatrist taking care of mentally ill offenders. The most helpful sections are on risk assessment from a clinical, medical-legal, and theory standpoint. The only drawback is the fact that the book is written about British practice and law save for the chapter on involuntary outpatient treatment in the United States.
Assessment: This book is helpful in understanding the complex relationship between the law and psychiatry which is invoked in treating medically ill offenders. It is mostly an overview of policy and practice with a focus on areas of controversy and ambiguity. It attempts and succeeds in showing an organized and evidence-based approach to outpatient forensic psychiatry.