Forensic mental health services provide crucial interventions for society. Such services provide care for people with mental disorders who commit violent and other serious crimes, and they have a key role in the protection of the public. To achieve these goals, these services are necessarily expensive, but they have been criticised for a high-cost, low-volume approach, for lacking consistent standards of care, and for neglecting human rights and other ethical considerations. A key concern is an insufficient evidence base to justify common practices, such as restricting leave from hospital and detaining patients for long periods. There is also insufficient quality evidence for core interventions, including psychological therapies, pharmacotherapy, and seclusion and restraint. The causes for this evidence deficit are complex but include insufficient investment in research infrastructure and fragmentation and isolationism of services, both nationally and internationally. In this Personal View, we highlight some of the major gaps in the forensic mental health evidence base and the challenges in addressing these gaps. We suggest solutions with implications at clinical, societal, and public health policy levels.

中文翻译：

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法医心理健康：设想一个更加实证的未来。


法医心理健康服务为社会提供重要的干预措施。此类服务为犯有暴力和其他严重犯罪的精神障碍患者提供护理，在保护公众方面发挥着关键作用。为了实现这些目标，这些服务必然价格昂贵，但它们因成本高、数量少、缺乏一致的护理标准以及忽视人权和其他道德考虑而受到批评。一个关键问题是证据不足，无法证明常见做法的合理性，例如限制出院和长期拘留患者。核心干预措施的质量证据也不足，包括心理治疗、药物治疗以及隔离和约束。造成这种证据不足的原因很复杂，但包括国内和国际上对研究基础设施的投资不足以及服务的分散和孤立主义。在本个人观点中，我们强调了法医心理健康证据库中的一些主要差距以及解决这些差距的挑战。我们提出对临床、社会和公共卫生政策层面具有影响的解决方案。