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There has been growing interest about procedural justice in mental health tribunals. A process considered procedurally just increases adherence to treatment, increases compliance with judicial decisions and allows efficient community reintegration. Yet, little is known about how procedural justice is carried out and the role of professionals in its implementation. Stemming from the results of a critical ethnography of the Ontario Review Board, in this article we examine how procedural justice materializes during Review Board hearings and the role of nurses in this materialization. We do so by leveraging Goffman’s work on total institutions and institutional ceremonies. Our findings suggest that nurses participate in activities that provide a perception of procedural justice, rather than serve their patients’ right to true procedural justice. We conclude by recommending that nurses engage in reflections about the distal effects of their clinical practice to broaden the possibilities for resistance within the forensic psychiatric system.

Mental health nurses report experiencing stigmatization both from within and outside the profession, and associative stigma provides one way to explore that experience. To better understand the current state of the literature on mental health care professionals' experiences of associative stigma, and particularly on nurses' experience of this phenomenon, an integrative review of the literature on the subject was conducted. The results detail factors associated with associative stigma, the effects of associative stigma on nurses and caregivers of persons with mental illnesses, and the quantification of associative stigma. This article concludes by discussing implications for nursing practice, education, and research.

Forensic psychiatric nursing is a specialty at the junction of two well-researched intersecting systems with two mandates: criminal justice and health care. Nurses' involvement at one of the systems' points of juncture, review board (RB) hearings, has largely been left unexplored. At RB hearings, a panel of legal and healthcare professionals determines if persons unfit to stand trial (UST) or not criminally responsible on account of mental disorder (NCR) represent significant threats to the safety of the public and orders conditions aimed at keeping the community safe. The aim of this article is to present the results of a critical ethnography that explored how psychiatric and public safety discourses construct the identity of persons UST or NCR during RB hearings as well as nurses' contribution to such identity construction. The main finding is that the forensic psychiatric structure leverages nursing interventions and documentation as evidence of deviancy, so that persons UST or NCR can be objectified and produced as dangerous. Structures sustaining the forensic psychiatric system inscribe nursing care within a disciplinary scheme, rendering the care-and-custody dichotomy insufficient to explain the complex processes at play in forensic psychiatry. These findings have implications for the practice of nurses working in forensic psychiatric settings and for that of other nurses who practice on the medicolegal borderland.

In the Canadian forensic psychiatric context, the concepts of risk and dangerousness interact, intersect, and morph into the notion of significant threat to the safety of the public. Stemming from the results of a critical ethnography of the Ontario Review Board, this article unpacks the central role of forensic psychiatric nursing, as an example of a 'psych' discipline (e.g., psychiatry and psychology), in a system that is built to produce risky persons and to legitimize their detention and supervision. By using excerpt of interviews conducted with nurses, ethnographic observations of Review Board hearings, and other documentary artifacts, the findings illustrate how rationalizations of risk and dangerousness are contingent on space, time, and observer. Depending on the time of the assessment or on the health-care professional who performs it, different elements including, but not limited to, mental illness, interpersonal relationships, financial instability, and sexual vulnerability, are relied upon in very fluid, interchangeable, and discretionary ways to justify findings of dangerousness. Such a dynamic expands the reach of psychiatry's legitimacy at identifying risky conduct and controlling risky persons to domains very loosely associated with the notion of dangerousness. The work of Foucault and Castel provides the theoretical backdrop on which rests the discussion and the implications for nursing.

Introduction : la portee caritative des soins infirmiers psycholegaux est rarement remise en question.Contexte : ces soins sont balises indirectement par la Commission d’examen (CE), un tribunal parajudiciaire veillant a la securite publique.Objectif : nous proposons une reflexion critique au sujet des effets politiques et sociaux de la CE, des hopitaux de psychiatrie legale et de la pratique des infirmieres qui y travaillent.Methode : notre reflexion est axee sur les concepts de biopouvoir, de ceremonie de degradation, de carriere morale et de (re)construction identitaire.Resultats : les pratiques « therapeutiques » infirmieres s’inserent, d’une part, dans la visee disciplinaire de l’hopital psycholegal, dans la mesure ou elles permettent l’identification et la gestion des personnes dangereuses, et d’autre part, dans la portee biopolitique de la CE puisqu’elles aident cette derniere a maintenir la securite publique.Discussion : le milieu psycholegal s’avere problematique pour les infirmieres puisqu’il les confronte a une double allegeance mettant sous tension leurs responsabilites envers les patients (consentement et confidentialite) et celles qu’elles ont envers l’institution (protection du public).Conclusion : notre cadre d’analyse permet de repenser d’autres processus tenus pour acquis en milieux psychiatriques, mais qui constituent tout autant des rituels de (re)construction identitaire.

Purpose Forensic mental health programs (FMHPs) in Ontario, Canada provide rehabilitation and supervision services. However, models available to guide their delivery are primarily adapted from fields outside of forensic mental health. To partially fill this gap, this paper aims to provide a general review of the process a multi-professional team took to develop the Integrated Forensic Program [IFP]-Ottawa Model of Risk Management & Recovery. Design/methodology/approach Working groups were initiated to identify the needs of patients in their local setting, conduct a literature review on care delivery models in forensic mental health and build a service delivery model specific to forensic mental health. Findings The resulting model places patient engagement at its centre and encompasses eight domains of need that contribute towards the patient’s recovery and the management of the safety risk they pose to the public, namely, the basic needs, diversity and spirituality, social, occupational, psychological, substance use, physical health and mental health domains. Practical implications The IFP-Ottawa Model of Risk Management & Recovery provides a framework to which therapeutic group services for persons in FMHPs can be aligned. Originality/value The leadership teams in FMHPs could use this framework and the method used for its development to ensure group services provided at their FMHPs are evidence-informed and coincide with their patients’ specific needs.

HIV-related criminal laws in some jurisdictions may hamper population health efforts to manage HIV and bring about an AIDS-free generation. HIV care nurses have an instrumental role to play in ensuring equitable care and health for all in a context of HIV. The purpose of our study was to determine HIV care nurses' knowledge of HIV-related criminal laws. Ecosocial theory and content expert opinion guided development of a questionnaire to assess nurses' knowledge of HIV-related criminal laws. A total of 174 HIV care nurses from Canada (n = 23) and the United States (n = 151) completed the questionnaire. Knowledge gaps were observed in several aspects of HIV-related criminal laws that can influence nursing clinical practices. Nurses should increase their knowledge of HIV-related criminal laws to ensure the success of population health initiatives and to reduce stigma and discrimination experienced by people living with HIV.