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In this article I examine the advancement of therapeutic penality in the UK, a penal philosophy that reimagines prison policy, practices and environments utilising psychological knowledge. Adopting a historical approach, I show how modern therapeutic penality is linked to the emergence of personality science in the nineteenth century and the development of the democratic therapeutic community (DTC) model in the twentieth century. I outline how at the turn of the twenty-first century a catalytic event generated a moral panic that led the British government to mobilise psychological knowledge and technologies in an attempt to manage dangerous people with severe personality disorder. Tracing subsequent developments, I argue psychological ways of talking, thinking and acting have obtained unparalleled salience in domains of penality and, in turn, radically transformed the conditions of imprisonment., (© 2017 Foundation for the Sociology of Health & Illness.)

Significant barriers remain regarding the implementation of family-centred approaches in the domain of forensic psychiatry despite their effectiveness at increasing adherence to treatment, improving attendance to medical appointments, decreasing readmission rates and reducing episodes of relapse. We attribute these barriers to a fundamental gap in our understanding of the family function and its role within the forensic psychiatric system. Despite requesting to be included and considered as partners, some families feel excluded and sidelined, which causes distress, incomprehension and disengagement. We approached this tension at the discursive level through a critical ethnography of the Review Board and the work of Foucault on psychiatric power, which provided us with a unique opportunity to understand how the role of families are constructed and sustained in the Canadian forensic psychiatric system. To do so, we mobilized data stemming from ethnographic observations and documentary artifacts entitled 'reasons for disposition'. Data analysis allowed us to identify two discursive constructions of familial functions: (1) families as repositories of information and (2) families as supervisory agents. These results have implications for health care professionals and administrators in forensic psychiatry who are increasingly adhering to family-centred care models without questioning what such care or what such family engagement entails. [ABSTRACT FROM AUTHOR]

Nurses working in correctional and forensic mental health settings face unique challenges in the provision of care to patients within custodial settings. The subjectivities of both patients and nurses are subject to the power relations, discourses and abjection encountered within these practice milieus. Using a poststructuralist approach using the work of Foucault, Kristeva, and Deleuze and Guattari, this paper explores how both patient and nurse subjectivities are produced within the carceral logic of this apparatus of capture. Recognizing that subjectivities are fluid and dynamic, and capable of change, Deleuze and Guattari's concept of deterritorialization will illustrate opportunities for resistance, where nurses can begin to practice outside the dominant carceral logic (and restrictions) of the system. [ABSTRACT FROM AUTHOR]

The present study takes a diachronic corpus-assisted discourse studies approach (Partington et al. 2013) to examine the representation of mentally-ill elderly patients in medical research articles, in the fields of psychology and psychiatry, published between 1950 and 2019. Despite evidence of the expanding scope of mental health research in more recent years, nihilistic views about mental health assessment and intervention underpin the discourse around mentally-ill older adults across the time span under consideration. In the literature, ageing is variously constructed as a process leading to deprivation, resignation and physical decay, increasing the chances of the onset of mental illnesses. The perpetuation of these discourses, which confirm and propagate discriminatory agebias positioning on the part of medical researchers, specialists and the health community at large, may constitute a significant obstacle to an improvement in the quality of mental and physical health care provided for the older population, both currently, and without substantial intervention, for the foreseeable future. Overall, it is hoped that this article has not only made a valuable contribution to the understanding of ageing from a historical discourse analysis perspective, but may be of interest to mental health scholars and professionals alike inspiring them to question their knowledge and practices about and for older patients. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine how gendered discursive norms and notions of masculinity are (re)produced in professional conversations about men cared for as patients in forensic psychiatric care, with a particular focus on the centrality of language and gender. Background: During verbal handovers and ward rounds, care staff converse to share information about patients and make decisions about their mental status. Spoken language is thus a pivotal tool in verbal handovers and ward rounds, one able to reproduce discourses and gender norms. Design: Qualitative. Data collected from audio recordings of verbal handovers and ward rounds in a forensic psychiatric clinic were subjected to discourse analysis. The COREQ checklist was used. Results: While discussing patients, staff subordinated them by reproducing a discourse typical of heteronormative, family‐oriented care. The overarching discourse, which we labelled subordinated masculinities, was supported by three other discourses: being unable to take responsibility, being drug‐addicted and performing masculinity. Such discourse was identified as a disciplining practice that subordinate's patients as a means to maintain order, rules and gender norms. Conclusion: The study reveals a caring practice that position male patients as children or disabled individuals and, in that way, as subordinated other men within a context were staff reproduces a heteronormative family structured care. The process also reveals a practice were downplaying aggressive and deviant behaviour could disempower and reduce patients´ responsibility for personal actions and their possibilities to participate in their care. That finding especially seems to contradict previous findings that patients want to be able to act responsibly and, to that end, want care staff to help them. Relevance to clinical practice: Nurses need to deepen their understanding of how language (re)produces discursive norms of gender and masculinity in forensic care and that process's consequences for such care. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to evaluate the use of a phototherapeutic technique called "Talking Pictures" within the forensic setting. This approach involves the use of a set of photographs to facilitate clients' disclosure, self-growth and promote the development of positive self-narratives. The use of art therapies and the construction of adaptive identity narratives have been proven to support desistance and increase resocialization in the prison population.Design/methodology/approach: A 42-year-old Italian male offender was met for six therapy sessions and invited to talk about his past, present and future through the use of photographs. Session transcripts were analysed using the software for linguistic analysis T-LAB.Findings: Results show a progression in the language used during the sessions: in the beginning the client uses a denotative language with many concrete nouns and no emotional words, in subsequent sessions his speech begins to assume more symbolic connotations and emotional words are used to describe past traumas as well as to find new meanings to present events. Moreover, the fixity of the client's self-image is contrasted with the emergence of new sides to his personality encompassing agency and self-worth.Research Limitations/implications: The study is based on a single case, therefore results cannot be generalised to the prison population; moreover, the absence of any follow-up and standardized measurements of the client's progression should be addressed by future research by both involving larger samples and including follow-up and quantitative measures of the study results.Practical Implications: The paper provides details on an innovative technique that might be used to explore the offenders' goods and values and to develop truly redemptive rehabilitation programmes.Originality/value: This paper adds to the scant literature on phototherapy in prisons and connects it with a reflection on desistance indicating that phototherapeutic interventions might be used to promote positive self-narratives, thus increasing desistance. [ABSTRACT FROM AUTHOR]

This article aims to develop a Lacanian approach to bioethics. Point of departure is the fact that both psychoanalysis and bioethics are practices of language, combining diagnostics with therapy. Subsequently, I will point out how Lacanian linguistics may help us to elucidate the dynamics of both psychoanalytical and bioethical discourse, using the movie One flew over the Cuckoo's Nest and Sophocles' tragedy Antigone as key examples. Next, I will explain the 'topology' of the bioethical landscape with the help of Lacan's three dimensions: the imaginary, the symbolical and the real. This will culminate in an assessment of the dynamics of bioethical discourse with the help of Lacan's theorem of the four discourses. Bioethics, I will argue, is not a homogeneous discourse. Rather, four modalities of bioethical discourse can be distinguished, all of them displaying specific weaknesses and strengths, opportunities and threats. This will be elucidated with the help of two case studies, namely the debates on human reproductive technologies and on the use of animals as biomedical research models. [ABSTRACT FROM AUTHOR]

Accessible summary Throughout recorded history, the mentally ill have been living at the fringes of society, frequently alienated, treated inhumanely, and made as scapegoats for the prevailing societal ills., Australia has seen the number of public psychiatric hospital beds fall from 30 000 in the early 1960's to 8000 as of 2006. The Australian population has more than doubled since this time, such phenomena is mirrored in the UK and the USA., As of June 2011, there were 28 964 individuals detained in Australian prisons, this represents a figure close to 70% higher than in comparison to the figure reported in 1996. However, Australia's population has only increased by just over 27% in this time period., Authors and researchers are claiming that a debilitated public psychiatric healthcare system has resulted in large 'trans-migrations' of patients from psychiatric hospital beds to prisons and jails, via an intermediary period in their communities., Abstract The World Health Organization declared in 1948 that the enjoyment of the highest individual attainment of health for any person is a fundamental human right. Australia, the UK and the United States all legally ratified this declaration as becoming signatories to their founding treatise with the United Nations. Despite this, there are many conspicuous examples of inequities of public health as found within these nations. One of the more disparate and outrageous examples of inequities in public health has been an insidious trend towards criminalizing mental illness, and the largely unjust treatment of many mentally ill persons. This change has resulted in untold numbers of mentally ill persons being over-represented within the criminal justice system, experiencing higher morbidity, co-morbidity and mortality rates, and having difficulty in surviving in a society frequently dealing with their illness in a persecutory manner. Questions must be raised: that although over the passage of time medical science and technology has changed, but has western societies' attitudes to health equity kept pace? [ABSTRACT FROM AUTHOR]

This article presents findings from a discourse analytic study into the constructive nature and textual variations of language in a high-security hospital. It explores how mental health nurses, and men convicted of sexual offences who also have a diagnosis of personality disorder, talked about pornography and sexual crime in the context of forensic provision. Access to sexually-explicit media, in relation to treatment environments for people convicted of sexual offences, has become a cause for professional and political concern in the UK. Data collection and analysis, undertaken concurrently, were informed by a discursive design. Semistructured interviews, as co-constructed accounts with nursing staff and detained patients, were audio-taped and transcribed. Data were coded to identify the discursive repertoires, or collective talk, of respondents. In contrast to empirical inquiry into pornography and sexual violence, methodology shifted attention from measurement to meaning, and situated research in a clinical domain. The findings focus on performative language use, where talk about pornography textured the treatment environment, contributed to an overtly masculine discourse, framed the ward as male space, and promoted gendered inequality. The discussion questions the legitimacy of the therapeutic enterprise. [ABSTRACT FROM AUTHOR]

Patients leaving forensic psychiatric settings on conditional discharge face the challenge of achieving successful community integration, which involves not re-offending, adjusting to the local community and building support networks. Aftercare and monitoring of patients by workers ostensibly assists with integration, but is often dominated by concerns about risks to the public. Risk is seen to emanate from individuals, with steps taken to ensure intensive monitoring and, if necessary, swift return to hospital. This article shows that workers and conditionally discharged patients have distinct views about risk in community living which are driven by contrasting values and priorities; and that some of these differences are associated with the provision of care itself. A discursive analysis of accounts, drawn from 59 interviews with patients and workers, demonstrates that fears about deviant status weigh most heavily for the individual leaving hospital. Aftercare, with its focus on intensive regular visits by nurses, social workers, police and voluntary agencies, works to ‘unmask’ the person to the wider community, setting them apart as needing supervision. Discharged patients express unease that this unmasking undermines their attempts to begin new lives. Their concern suggests that significant iatrogenic risk arises from aftercare. Workers are not indifferent to this issue, but are themselves subject to public safety imperatives which require surveillance and control of individuals deemed risky. Community integration has the potential to be an important mediator in future risk behaviours. However, managing intensive aftercare without allowing for its wider visibility may jeopardise its achievement. [ABSTRACT FROM PUBLISHER]

This article examines how women incarcerated in provincial and federal prisons in Canada experience medicalization as the predominant form of correctional psy intervention. In order to privilege the oft ignored and typically silenced voices of incarcerated women, this article draws on life history interviews with 22 formerly incarcerated women who were living in halfway houses and working to transition from prison to the community. The analysis highlights the (over)use of prescription psychotropic medications as a governance strategy and the impact this practice has on women serving time. Participants had limited access to non-medical interventions in general, and no access to counselling services outside the purview of correctional control. The overlapping of correctional and psy interventions in the prison setting transforms psy treatment not only into a mechanism of social control, but also into a punitive and disciplinary enterprise that delegitimizes the women’s self-identified needs. [ABSTRACT FROM PUBLISHER]

(2011) Journal of Nursing Management 293-301 Drawing on the works of Erving Goffman and Michel Foucault, this article presents part of the results of a qualitative study conducted in a forensic psychiatry setting. For many years, behaviour modification programmes (BMPs) have been subjected to scrutiny and harsh criticism on the part of researchers, clinicians and professional organizations. Nevertheless, BMPs continue to be in vogue in some 'total' institutions, such as psychiatric hospitals and prisons. Discourse analysis of mute evidence available in situ was used to critically look at behaviour modification programmes. Compelling examples of behaviour modification care plans are used to illustrate our critical analysis and to support our claim that BMPs violate both scientific and ethical norms in the name of doing 'what is best' for the patients. We argue that the continued use of BMPs is not only flawed from a scientific perspective, but constitutes an unethical approach to the management of nursing care for mentally ill offenders. Nurse managers need to be aware that BMPs violate ethical standards in nursing. As a consequence, they should overtly question the use of these approaches in psychiatric nursing. [ABSTRACT FROM AUTHOR]

Highlights from the article: B Abstract: b Intense debate regarding whether genetics researchers have a responsibility to offer to return certain clinically relevant findings to individual participants has been going on for more than 15 years. Although an important focus of the discussion regarding return of results (RoR) is the potential benefits for participants, an equally important issue is to identify potential harms, to develop management policies that can help minimize these. To identify which are the potential harms of RoR, it is essential to get the perspective of key stakeholders in the psychiatric genetics research context.