Financing of forensic psychiatry in view of treatment quality and threat to public safety

• Published in: Psychiatria polska Vol. 51; no. 4; pp. 599 - 608
• Main Authors: Heitzman, Janusz, Markiewicz, Inga
• Format: Journal Article
• Language: English; Polish
• Published: Poland 29-08-2017
• Subjects: Commitment of Mentally Ill - legislation & jurisprudence; Community Mental Health Services - legislation & jurisprudence; Health Care Reform - legislation & jurisprudence; Health Services Needs and Demand - legislation & jurisprudence; Hospitals, Psychiatric - legislation & jurisprudence; Humans; Patient Discharge - legislation & jurisprudence; Professional Competence - legislation & jurisprudence; Public Health - legislation & jurisprudence; Safety - legislation & jurisprudence; financing; preventive measures; psychiatric detention
• ISSN: 0033-2674; 2391-5854
• DOI: 10.12740/PP/76000

Stay in a psychiatric hospital of persons who committed the gravest criminal acts while in a state of insanity aims to ensure their effective treatment (therapeutic function), but above all to prevent the repetition of prohibited acts of significant harm to the community (preventive function). Forensic patients are provided with suitable medical, psychiatric, rehabilitation and resocialization care. The court imposes an indefinite detention. In view of the dual purpose of the stay in a psychiatric hospital, both therapeutic and preventive, the treatment costs generated by forensic wards are higher than those of general psychiatric wards. This prompts person from outside psychiatry, who do not understand the nature of preventive measures, to call for continuing reductions in the expenditure on forensic psychiatric care. It is, therefore, worth analyzing the possible meaning and results of the attempts to economizeforensic psychiatry, to find savings and to manipulate financing system under the pretence of economic incentive to improve treatment quality. In this paper, the authors address and discuss the above and other issues.