Factors Associated with Successful 'Insanity ' Defense and Characteristics of Defendants Pleading ‘insanity’ in Ethiopia: Facility-based Retrospective Report Review.
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Date
2022-02
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Addis Ababa University
Abstract
Introduction: Forensic psychiatry operates at the interface of two disparate disciplines: Law and
psychiatry. Forensic psychiatry is a subspecialty of psychiatry in which scientific and clinical
expertise are applied to legal issues legal contexts Amanuel Mental Specialized Hospital is one
of the largest and oldest psychiatric hospital in Ethiopia; it is also the only hospital that gives
inpatient forensic psychiatry service at this time. To our knowledge, the clinical & criminal
justice characteristics of the 'insane' have never been a subject of study in Ethiopia. We are very
hopeful that this study will be beneficial for the improvement of the forensic service training of
mental health professionals and ultimately benefit those affected by the limitations of
information and scarcity of research to pinpoint issues we can work on to better the care
provided to forensic psychiatry patients.
Objective: To describe cases and explain the reason for their acquittal due to being "criminally
irresponsible" in the forensic inpatient service at Amanuel Mental Specialized Hospital in a span
of 6.5 years (between 01/01/2015 and 08/01/ 2021 GC).
Methods: A retrospective facility-based study was conducted in Amanuel mental specialized
hospital for a study period of 6.5 years from January 2015-August 2021. Forensic reports were
used as a source of data, a data extraction sheet was used to collect data, and SPSS version 24
was used to analyze the data. Descriptive statistics are displayed in text, tables, and figures.
Variables that showed association with the outcome variable using binary logistic regression
were subjected to multivariate logistic regression. Statistical significance was declared at p-value
< 0.05.
Result: A total of 205 forensic reports of defendants were identified in the study period. Of this,
15 (7.3 %) cases did not have a conclusive forensic opinion regarding criminal responsibility;
these cases were excluded from the analysis. The mean age of the defendants was 33.13 years
with a standard deviation of 10.6 years. This study also showed that the magnitude of insane
defendants among patients who had forensic mental health assessment at Amanuel mental health
specialized hospital was found to be 39.5 %. The study revealed from the cases who have
neuropsychiatric diagnoses 62.2 % were found to be "criminally irresponsible."
Conclusion & recommendation: The number of insane defendants among patients who had
forensic mental health assessment at Amanuel mental health specialized hospital was relatively
high.
Factors that had an association with insane defendants include psychiatric diagnosis of
schizophrenia spectrum disorder, bipolar І disorder, and disordered psychiatric condition during
the time of assessment. Creating awareness about severe mental illness and early detection and
initiation of treatment may contribute to the prevention of the offenses as a society and improve
the quality of life for the clients.
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Keywords
Forensic psychiatry,Psychiatry,Law