Evaluation of Excellence in Italy's Residence for Execution of Security Measure (ITAL-EE-REMS)

University of Bari

Status: Completed

Conditions: Personality Disorders and Disturbances in Behavior; Mental Disorder; Personality Disorders, Antisocial; Schizophrenia and Related Disorders; Intellectual Disability, Mild to Moderate; Recovery

Treatments: Other: Treatment as usual (TAU)

Study type: Observational

Funder types: Other

Identifiers

NCT06018298

ITAL-EE-REMS

Details and patient eligibility

About

The model of care for forensic psychiatry in Italy was changed by law (Law 81/2014) so that the six legacy secure forensic hospitals (Judicial Psychiatric Hospitals, OPG) were closed and new secure community residences for the execution of security measures (REMS) were opened in each of the 20 regions of Italy. This transition was in place by 2015. This observational study evaluates the health gains for patients both previously in OPGs and those admitted first to REMS. Health gains assessed include recovery measured by symptoms, function, need for therapeutic security and recovery of legal autonomy.

Full description

All those detained in REMS in the twelve month period 2019 to 2020 form the reference population. Samples are assessed for symptom severity (BPRS), global function (GAF), cognitive function (MMSE), risk and protective factors for violence (HCR-20, SAPROF), personality factors (PCL-R), measures of need for therapeutic security (DUNDRUM-1), treatment response relevant to violence and mental illness (DUNDRUM-3) and forensic recovery (DUNDRUM-4).

Outcome measures include violent and challenging behaviour (MOAS), length of stay, conditional (legal) discharge.

Enrollment: 245 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• admitted to REMS
• voluntarily consents to participate

Exclusion criteria

• MMSE less than 19

Trial design

245 participants in 2 patient groups

Therapeutic security

Description:

assessment of residents in REMS for need for therapeutic security, treatment response relevant to forensic need and forensic recovery.

Treatment:

Other: Treatment as usual (TAU)

Risk Measures of Need (RISKMON)

Description:

assessed symptom severity, risk and protective factors for violence, global function, personality factors.

Treatment:

Other: Treatment as usual (TAU)