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COC Report: Car Wash & Polish

Date: 24 October 2007

DR HJH RABAIAH MOHD SALLEH
CONSULTANT FORENSIC PSYCHIATRIST
HOSPITAL BAHAGIA ULU KINTA

INTRODUCTION


Hospital Bahagia Ulu Kinta, the largest of 4 psychiatric institutions in Malaysia came into operation way back in 1911. Then, it had a population of about 5000 inmates, some of whom had been brought in from places as far as Singapore and Sumatra, Indonesia.

Slowly over time, with the advancement of better medicine and good psychiatric care provided, Hospital Bahagia Ulu Kinta (HBUK) was able to bring its total number of inmates to the present average of 1900-2200

Admissions to HBUK are either via civil or medico-legal admissions. The definition of medico-legal or forensic admissions is admissions via referrals through the courts, prisons and other relevant detention centers. Forensic psychiatric patients are those patients who have had some problems with the law. Usually their first contact with HBUK is as a result of running foul of the law and the judicial system. A large majority of the mentally disordered offenders gets referred by the courts for a psychiatric assessment as is provided for under the Malaysian Criminal Procedure Code (CPC). A psychiatric report is issued at the end of their stay, which is then used in courts. Most of them do not come back as forensic admissions anymore. However the law provides for readmissions to the Forensic Wards HBUK under Section 344 of the CPC, a section of the law which provides for detention because the patients (accused in the court of law) were not fit to stand trial and Section 348 of the CPC which provides for detention because the patients were found guilty as charged but acquitted because of insanity at the time of offence.

Thus, most of the patients at the Forensic Wards of HBUK are those detained under the above-mentioned sections of the Malaysian CPC, 142 patients under section 348 CPC and 28 patients under section 344 CPC, out of which 15 are female forensic patients. The majority was diagnosed to be suffering from schizophrenia (90%) while the rest had diagnoses, which included bipolar mood disorder, organic mental disorder, mental sub normality and personality disorder with poor impulse control.

FORENSIC REHABILITATION

Forensic psychiatric patients are difficult to treat. They are involuntarily committed for treatment, and few would seek inpatient treatment of their own violation, despite or perhaps because of gross psychiatric and functional impairment. A psychosocial approach to treatment focuses on the reduction of psychiatric symptoms, primarily through medication and the development of functional skills associated with relapse prevention and adaptation to less restrictive environments. The ultimate goals are recovery, reestablishment of normal roles in the community, development of a personal support network and increased quality of life. With the objective of preparing patients for an independent life in the community, a paradigm shift from totally custodial to active promotion of Psychosocial Rehabilitation with the support of a multidisciplinary team was actively pursued.


Please download the full report below...

  arrowCar Wash & Polish (English - pdf) [1931 Kb]



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