Today, we held an internet conference regarding forensic mental health, entitled "Forensic mental health WEB conference 2013".
We have performed this kind of events annually since 2008. Several institutions which engage in forensic psychiatry participated in the conference. The conference is a closed session. Thus, the participants can open detailed discussion with their clinical experiences and statistic data.
Today, we offered some agenda, for example Clozapine use in special hospitals.
Clozapine is one of the medicine which is effective for improvement of the symptoms of schizophrenia. It is now the only solution for treatment-resistant schizophrenia. Its clinical use procedure is strictly regulated since it sometimes causes lethal adverse effect.
Forensic patients are hardly accepted at usual institutions due to their history of the crimes. It sometimes occurs in Japan that a mental clinic refuse to treat an offender with mental disorders. In fact, dealing with troublesome patients with safe needs rich human resource and infrastructure.
In addition, the hospitals can offer Clozapine therapy to patients is limited. The regulation requires some conditions such as a close connection with specialized physicians to provide Clozapine therapy. Only a few hospitals satisfy this regulation in a prefecture.
Therefore, forensic patients taking Clozapine are more difficult to accept in a mental hospital.
Clozapine is a powerful drug. Some patients are much improved with Clozapine. Forensic patients really need Clozapine for their clinical improvement. However, if we give Clozapine to a patient, it will make difficult to find an outpatient clinic in his hometown after discharge. It is quite ironic.
We discussed this problem for one hour. Both the development of a collaborative relationship between the hospitals and the improvement of the skill among psychiatric medication are indispensable. There is no magical solution. Nevertheless we are willing to struggle for a better future.