Psychiatric Monitoring of Not Guilty by Reason of Insanity Outpatients

Individuals deemed Not Guilty by Reason of Insanity (NGRI) by the courts, under Article 20 of the Portuguese Criminal Code, have often committed very serious crimes. 

It is unreasonable to consider that these patients were usually kept without adequate supervision after the security measure had been declared extinct. They often decompensated after leaving the institution where they complied with the security measure, and/or relapsed to alcohol and drug abuse. Very often, severe repeated crime erupted again. 

Considering this, there was an urgent need to keep a follow-up assessment of these patients in order to prevent them from relapsing in crime. This work presents the results of a psychiatric follow-up project with NGRI outpatients. The main goals of the project were: ensuring follow-up and appropriate therapeutic responses for these patients, maintaining all individuals in a care network, and preventing them from decompensating. The team consisted of a psychiatrist, a nurse, and a psychologist. Seventy-two patients were monitored during two years. 

Results demonstrated the unequivocal need to follow up decompensated patients after the court order is extinguished. Suggestions are presented for a better framing and psychiatric follow-up of these patients.

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By:   Almeida F1, Moreira D2, Moura H3, Mota V3.

• 1Social and Behavioral Sciences Department, Maia University Institute, Portugal.
• 2Social and Behavioral Sciences Department, Maia University Institute, Portugal; Laboratory of Neuropsychophysiology, Faculty of Psychology and Educational Sciences, University of Porto, Portugal. Electronic address: dianapmoreira@gmail.com.
• 3Magalhães Lemos Hospital, Portugal. 
• J Forensic Leg Med. 2015 Dec 8;38:58-63. doi: 10.1016/j.jflm.2015.11.018

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