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Training for Person Centered Medicine in a Forensic Hospital

Esta Susic, Ema Nicea Gruber, Blazenka Guberina Korotaj


The education and training needed for health professionals performing person centered medicine in a prison hospital is presented. The health professionals involved work in the department for forensic psychiatry of a prison hospital and conduct mandatory psychiatric treatment during a person’s prison sentence using a bio-psycho-social model of treatment and rehabilitation. Such health professionals work with mentally ill people having partially diminished capacity who perpetrated criminal activities and were sentenced according to the Croatian Criminal Code or Criminal Procedures Act and the Law for the Protection of Persons with Mental Illness. Required professional skills include capabilities to provide person-centered psychiatric treatment aimed at reducing psychopathology, articulating theoretical concepts, therapeutic procedures, health professionals' roles and self-understanding, interpersonal issues, relations between patient/prisoner and health professional, ethical dilemmas, and challenges establishing partnerships. Since each patient is also a person serving a prison sentence, the health professional must also know the legislative framework, work as a civil servant, pass the State service examination and be part of a team with different types of other professionals, particularly social workers, occupational therapists, prison officers, court officers, and state officers. For health professionals to practice person centered medicine in a prison setting is a quite demanding and stressful challenge. It may be the hardest way to practice, but it is the right way to do it.


Person centered medicine, education and training, safety measures, mandatory psychiatric treatment, capacity to rehabilitate, correctional facility, prison hospital

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. Groene O. Patient centredness and quality improvement efforts in hospitals: rationale, measurement, implementation. Int J Qual Health Care. 2011, 23(5):531-7.

. Mezzich JE, Kirisci L, Salloum IM: Technical Report from the INPCM-WHO Project on Developing Measures to Assess Progress towards People-centred Care. International College of Person Centred Medicine, New York, 2011.

. Mezzich JE Refining the conceptualization of Person-centred Medicine. 1st International Congress of Person Centered Medicine, Zagreb, 2013.

. Tomasevski K. Prison health: international standards and national practices in Europe. Helsinki, Helsinki Institute for Crime Prevention and Control, 1992.

. Recommendation of the Committee of Ministers to Member States on European Prison Rules. Strasbourg, Council of Europe, Committee of Ministers, 2006. Retrieved May, 2013 from

. Babić V, Josipović M, Tomašević G. Hrvatski zatvorski sustav i zaštita ljudskih prava zatvorenika. Hrvatski Ljetopis Za Kazneno Pravo I Praksu 2006; 13: 685-743.

. Møller L, Stöver H, Jürgens R, Gatherer A and Nikogosian H. Health in prisons. A WHO guide to the essentials in prison health. Geneva: World Health Organization 2007.

. Zakon o izvršenju kazne zatvora (ZIKZ) 48/11 (Croatian Prison Sentence Law)

. Izvještaj o radu kaznionica, zatvora i odgojnih zavoda za 2012. godinu, Uprava za zatvorski sustav, 2013. Ministarstvo Pravosuđa

. WHO: Good governance for prison health in the 21th century. A policy brief on the organization of prison health. Retrieved September, 2013 from

. Sudipto R, Novak T, Mikšaj Todorović Lj. Job Burnout among Prison Staff in the United States and Croatia: A Preliminary Comparative Study. International Journal of Criminal Justice Sciences 2010; 5: 189-202.

. Hoff P. Historical perspectives on person-centred medicine and psychiatry Int J Integr Care. 2010, 10(Suppl): e016

. Jakovljević M. Integrating the brave new psychiatry of the person, for the person, by the person and with the person: the postmodern turn. Psychiatr Danub. 2008 Mar;20(1):2-5.

. Appleyard J, Ghebrehiwet T, Mezzich JE. Development and implications of the Zagreb Declaration on Person-centered Health Professional Education. International Journal of Person Centered Medicine 4: 8-13, 2014.

. E. Sušić : Strategija organizacije zdravstvene zaštite zatvorenika. Hrvatski Ljetopis Za Kazneno Pravo I Praksu 2009; 16, 1.99-115.

. Blaauw E et al. Identifying suicide risk in penal institutions in the Netherlands. British Journal of Forensic Practice, 2001; 3(4):22–28

. WHO Regional Office for Europe, WHO consensus statement on prison health services, 1999.

. Chaplow DG, Peters JL, Kydd RR. The expert witness in forensic psychiatry. Aust N Z J Psychiatry. 1992; 26(4):624-30.

. Rappeport JR. Differences between forensic and general psychiatry. Am J Psychiatry. 1982 Mar; 139 (3) : 331-4.

. Miller RD. Who's afraid of forensic psychiatry? Bull Am Acad Psychiatry Law. 1990; 18(3):235-47.

. Fazel S, Danesh J. Serious mental disorder among 23000 prisoners: systematic review of 62 surveys. Lancet, 2002; 359,545–550.

. Blaauw E, Kerkhof A, Vermunt R. Psychopathology in police custody.International Journal of Law and Psychiatry, 1998; 21(1):73–87.

. WHO Report on health in prisons. WHO Regional Office for Europe, 1999

. Adams, N. Establishing Common Ground: The Essence of Person-Centred Practice. 1st International Congress of Person Centered Medicine, Zagreb, 2013.

. Office of the United Nations High Commissioner for Human Rights, 1957

. Mason T, Williams R, Vivian-Byrne S. Multi-disciplinary working in a forensic mental health setting: ethical codes of reference. J Psychiatr Ment Health Nurs. 2002 9(5):563-72.

. Burdon, W. M., Roll, J. M., Prendergast, M. L., Rawson, R. (2001): Drug courts and contingency management. Journal of Drug Issues. 31(1). 73-90.

. Hochschild, A. R. [1983): The managed heart: Commercialization of human feeling. University of California Press. Berkeley. CA.

. Pont, J. (2006): Medical ethics in prisons. International Journal of Prisoners Health. 2. 259-267.

. Hiller, M., Knight, K., Broome, K., Simpson, D. (1998): Legal pressure and treatment retention in a national sample of long-term residential programs. Criminal Justice and Behavior. 25. 463–481.

. McLellan, A. T., Lewis, D., O’Brien, C., Kleber, H: Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcome evaluation. Journal of the American Medical Association. 2000; 284. 1689– 1695.

. Kessler, R. C., Chiu, W. T., Demler, O., Walters, E.: Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry. 2005; 62. 617– 627.

. Sudipto, R., Novak, T., Mikšaj Todorović, Lj. : Job Burnout among Prison Staff in the United States and Croatia: A Preliminary Comparative Study. International Journal of Criminal Justice Sciences . 2010; 5 (1). 189-202.

. Babić V., Josipović M., Tomašević G.: Hrvatski zatvorski sustav i zaštita ljudskih prava zatvorenika. Hrvatski Ljetopis Za Kazneno Pravo I Praksu.2006; 13 (2). 685-743.

. Cashmore AW , Indig D, Hampton SE, Hegney DG, Jalaludin BB. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records. BMC Health Serv Res. 2012 ;9,12(1):245-250.

. Mikšaj-Todorović Lj, Novak T. Istraživanje emocionalnog dobrostanja i sagorjevanja na poslu zatvorskog osoblja. Kriminologija i socijalna integracija 2008; 16, 1: 45-61.

. Novak T, Laušič H, Jandrić A. Profesionalni stres i sagorijevanje zatvorskog osoblja - pregled literature. Kriminologija & socijalna integracija 2008; 16, 1: 109-126.

. Goldberg P, David S, Landre MF, Goldberg M, Dassa S, Fuhrer R. Work conditions and mental health among prison staff in France. Scand J Work Environ Health 1996;22(1):45-54.8.

. Dickinson T, Wright KM. Stress and burnout in forensic mental health nursing: a literature review. Br J Nurs. 2008 Jan 24-Feb 13;17(2):82-7.

. Van den Pol-Grevelink A, Jukema JS, Smits CH. Person-centred care and job satisfaction of caregivers in nursing homes: a systematic review of the impact of different forms of person-centred care on various dimensions of job satisfaction. Int J Geriatr Psychiatry. 2012 Mar;27(3):219-29.

. Fish D, Coles C (1998) Developing Professional Judgement in Health Care. Amsterdam: Elsevier.

. Robertson MD, Walter G. Many faces of the dual-role dilemma in psychiatric ethics. Aust N Z J Psychiatry. 2008 Mar;42(3):228-35.,

. Adshead G, Sarkar SP. Justice and welfare: two ethical paradigms in forensic psychiatry. Aust N Z J Psychiatry. 2005 Nov-Dec;39(11-12):1011-7.

. Decaire MW, Bédard M, Riendeau J, Forrest R. Incidents in a psychiatric forensic setting: association with patient and staff characteristics. Can J Nurs Res. 2006 Sep;38(3):68-80.

. Meehan T, McIntosh W, Bergen H. Aggressive behaviour in the high-secure forensic setting: the perceptions of patients. J Psychiatr Ment Health Nurs. 2006 Feb;13(1):19-25.

. Meehan T, McIntosh W, Bergen H. Aggressive behaviour in the high-secure forensic setting: the perceptions of patients. J Psychiatr Ment Health Nurs. 2006 Feb;13(1):19-25

. World Medical Association Declaration on Hunger Strikers. Adopted by the 43rd World Medical Assembly Malta, November 1991

. World Medical General Assembly, Pilanesberg, South Africa, October 2006

. Stöver H, Lines R [2005). Silence still = death: 25 years of HIV/AIDS in prisons. In: Matic S, Lazarus JV, Donoghoe MC, eds. HIV/AIDS in Europe: moving from death sentence to chronic disease management. Copenhagen, WHO Regional Office for Europe:67–86 (, accessed 20 December 2006).

. Kirmayer LJ. Rethinking cultural competence. Transcultural Psychiatry. 2012;49(2):149-164.

. Blaauw E, Roesch R, Kerkhof AJFM (2000). Mental health care in European prison systems. International Journal of Law and Psychiatry, 23:649–663.

. Nicholls TL et al. . Jail Screening Assessment Tool (JSAT): guidelines for mental health screening in jails. Burnaby, BC, Mental Health, Law, and Policy Institute, Simon Fraser University, 2005.

. Moerings M . Isolatie: Noodsprong of beleid? Afzondering in de FOBA [Isolation: necessary or policy? Isolation in the FOBA] In: Koenraadt F, ed. Psychiatrisch Juridisch Gezelschap, Behandeling of straf? [Psychiatric judicial company, treatment or punishment?] Arnhem: Gouda Quint 1994; 169–176.

. Gudjonsson Gisli H.; Webster Gemma; Green Timothy The recovery approach to care in psychiatric services: staff attitudes before and after training Psychiatrist, 2010; 34(8): 326-329.

. Melvin, K.B., Gramling, L.K., Gardner, W.M.: A scale to measure attitudes toward prisoners. Criminal Justice and Behavior. 1985; 12. 241-253.

. Glaser D : The effectiveness of a prison and parole system. Indianapolis, Bobbs-Merrill, 1969.

. Kifer, M., Hemmens, C., Stohr, M.K. The goals of corrections: perspectives from the line. Criminal Justice Review. 2003; 28.47-69.

. Jurik, N.C.: Individual and organizational determinants of correctional officer attitudes toward inmates. Criminology. 1985; 23. 523-539.

. Johnson, J., Immerwahr, J.: The revolving door: Exploring public attitudes toward prisoner reentry. U: Prisoner Reentry and Community Policing: Strategies for Enhancing Public Safety., 2004.

. Kjelsberg, E., Skoglund, T.H., Rustad, A.: Attitudes towards prisoners, as reported by prison inmates, prison employees and college students. BMC Public Health, 2007; 7 (71). 147-157.

. Buđanovac, A., Mikšaj-Todorović, Lj.: Stavovi prema osuđenicima i njihovoj rehabilitaciji na slovenskom i hrvatskom uzorku ispitanika. Kriminologija i socijalna integracija. 2002; 10 (2). 153-160.

. Steffensmeier, D.J., Kramer, J.H.: The differential impact of criminal stigmatization on male and female felons. Sex Roles. 1980; 6 (1). 1-8.

. Crandall, C.S.: Ideology and Lay Theories of Stigma: The Justification of Stigmatization. U: Heatherton, T.F., Kleck, R.E., Helb, M.R., Hull, J.G. (ur.), The Social Psychology of Stigma. The Guilford Press. New York. 2000, pp126-152.

. Sušić E., Pleše S.: Aktualni problemi primjene i provođenja sigurnosne mjere obveznog psihijatrijskog liječenja [Current problems related to the application and enforcement of the security measure of compulsory psychiatric treatment), Hrvatski ljetopis za kazneno pravo i praksu, 2006; 13, broj 2.



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