Danish forensic psychiatry
Peter Kramp
Former head
Clinic of Forensic Psychiatry
Copenhagen
PK/CO
Danish forensic psychiatry
Central concepts
The Danish penal code § 16 (1):
“Persons who, at the time of the act, were
irresponsible owing to mental illness or
similar conditions or a pronounced mental
retardation are not punishable.
eDoc 8479
PK/CO
Danish forensic psychiatry
Central concepts
“Mental illness” = psychosis
The current psychiatric definition of psychotic
conditions.
PK/CO
Danish forensic psychiatry
Central concepts
“Mental illness or similar conditions”
Examples:
Hypoglucemia
Epileptic confusion
Severe dissociative disorders
…
…
PK/CO
Danish forensic psychiatry
Central concepts
Irresponsible
(in Danish ”utilregnelig”, in latin ”non compos (mentis))
Other possibilities:
Mentally incompetent
Not attributable to
But - the word is ”without meaning”
The court - never the psychiatrist - decide whether the
defendant is “irresponsible” owing to a psychotic condition/mental retardation.
PK/CO
Danish forensic psychiatry
Central concepts
“Not punishable”
The court decide whether the defendant is
guilty/not guilty independent of the mental
state of the person in question.
Psychotics and mentally retarded are thus
“responsible”.
PK/CO
Danish forensic psychiatry
Central concepts
If “non punishable” the court will pass a
treatment sanction
a: Placement in a psychiatric ward
b: Psychiatric treatment
c: Outpatient psychiatric treatment
Court decision: a  b
Treatment continues until the sanction is lifted
by the court.
Danish forensic psychiatry
The main Problem
The increasing number of forensic patients
Forensic patients in Denmark
Monthly prevalence 1977-2004
Number
1500
1000
500
1975
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
1980
1985
1990
1995
2000
Reported number of offences in 2004 is an estimate
based on the first six months of the year
2005
…
Observed monthly prevalence
Estimated monthly prevalence
1980-2004
ooo Reported annual number of
offences against the penal law
(in 1.000)
Annual growth rate
1980-1999:
6.8%
2000-2001: - 1.50%
2002-2004: 10.96%
Year
Kramp P, Gabrielsen G. Ugeskr Læger, accepteret.
Danish counties 1980-1997
Plot of growth rates of incidences of forensic patients and
growth rates of consumed psychiatric beds; (n=14)
Growth rates of incidences of forensic patients
17.5
15
12.5
10
7.5
5
2.5
0
-2.5
-10
-9
-8
-7
-6
-5
-4
-3
-2
-1
Growth rates of consumed psychiatric beds
0
1
The (positive) growth rates of incidences inversely correlate to the
(negative) growth rates of consumed beds: r = -0.553, p=0.040
Danish forensic psychiatry
The main Problem
Danish Regions – (responsible for the total
health care in the region, including (forensic)
psychiatry:
Forensic psychiatry is a cuckoo in the nest
Danish forensic psychiatry
The main Problem
Another problem
Too long waiting time for reports for the
court – up to six month or even more.
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Danish forensic psychiatry Central concepts