A minority of psychiatric patients are unfit for general psychiatric care due to offensive behavior that renders them at risk of coming into contact with the criminal justice system. In the absence of criminal proceedings, these patients find themselves in the “gray zone” between general and forensic psychiatric care. To accommodate these patients, we established a “transforensic” ward. Instead of applying forensic treatment elements reactively (as part of a criminal sentence, after an offense has been committed), we applied it preventively (so as to avert offending behavior and resultant criminal sentences). Psychometric psychopathology and violence risk assessment scores were substantially lower at discharge than at admission (Cohen's ds = −0.3 to −0.6). These results offer ground for cautious optimism about the efficacy of transforensic care in serving as a safety net for psychiatric patients who are found to be unfit for general psychiatric care on account of their aggressive behavior.

中文翻译：

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跨法医精神病学：解决一般和法医精神病学护理之间“灰色地带”的住院患者攻击行为

少数精神病患者不适合接受一般精神病护理，因为他们的冒犯行为使他们面临接触刑事司法系统的风险。在没有刑事诉讼的情况下，这些患者发现自己处于一般和法医精神病护理之间的“灰色地带”。为了容纳这些患者，我们建立了一个“法医”病房。我们不是被动地应用法医处理要素（作为刑事判决的一部分，在犯罪发生后），而是预防性地应用它（以避免犯罪行为和由此产生的刑事判决）。出院时的心理测量精神病理学和暴力风险评估分数显着低于入院时（科恩d s = -0.3 至 -0.6）。这些结果为人们对跨法医护理的有效性持谨慎乐观的态度提供了依据，该护理可以作为因攻击行为而不适合接受一般精神科护理的精神病患者的安全网。