Polypharmacy practice with adults in secure forensic psychiatric care: Clinical characteristics and implications for service delivery
Abstract
Healthcare consumers within the forensic mental health systems receive an array of treatments designed to address serious and persistent mental illness (SPMI) as well as aggressive and illegal behavior. Pharmacological interventions, specifically psychotropic medications, are the most commonly used treatment. Many patients in these systems experience polypharmacy, or the use of multiple medications to treat conditions. Polypharmacy practice varies with the preferences of treating prescribers but also with the clinical presentation and demographic characteristics of the patient. The current study explores the use of psychotropic polypharmacy in a sample of 182 adults residing in inpatient forensic psychiatric settings. Data was extracted from psychological, medical, and criminal history records. The majority of patients were male (80.8%) and either White (55.5%) or Black (40.1%), with an average hospitalization length of 8 years at the time of data collection. Patients had high rates of diagnostic comorbidity (mean # major mental health disorder categories = 3.37; SD = 1.65), histories of prior psychiatric hospitalization (mean # prior hospitalization = 14.78; SD = 12.27), suicide attempts (46%), and institutional aggression (86.8%). Psychotropic polypharmacy was also common, with most of the sample prescribed four or more categories of psychiatric medications simultaneously (75.7%). The most frequently prescribed medications were those to address mood (92.4%), psychotic (89.3%), and anxiety (85.5%) disorder symptoms. We plan to evaluate the role of clinical and non-clinical characteristics, such as gender, age, and psychiatric presentation, via regression analyses to determine which patients are at elevated risk of psychotropic polypharmacy. Polypharmacy practices have many implications for physical well-being and quality of life for forensic patients. Psychiatric stability of patients also has implications for perceived risk and ability to manage risk and psychiatric needs in less restricted settings. We will discuss the implications of our findings for forensic mental health system administrators and treatment providers.
Start Time
15-4-2026 1:30 PM
End Time
15-4-2026 4:30 PM
Room Number
Culp Ballroom 316
Poster Number
25
Presentation Type
Poster
Presentation Subtype
Posters - Competitive
Presentation Category
Social Sciences
Student Type
Graduate and Professional Degree Students, Residents, Fellows
Faculty Mentor
Jill Stinson
Polypharmacy practice with adults in secure forensic psychiatric care: Clinical characteristics and implications for service delivery
Culp Ballroom 316
Healthcare consumers within the forensic mental health systems receive an array of treatments designed to address serious and persistent mental illness (SPMI) as well as aggressive and illegal behavior. Pharmacological interventions, specifically psychotropic medications, are the most commonly used treatment. Many patients in these systems experience polypharmacy, or the use of multiple medications to treat conditions. Polypharmacy practice varies with the preferences of treating prescribers but also with the clinical presentation and demographic characteristics of the patient. The current study explores the use of psychotropic polypharmacy in a sample of 182 adults residing in inpatient forensic psychiatric settings. Data was extracted from psychological, medical, and criminal history records. The majority of patients were male (80.8%) and either White (55.5%) or Black (40.1%), with an average hospitalization length of 8 years at the time of data collection. Patients had high rates of diagnostic comorbidity (mean # major mental health disorder categories = 3.37; SD = 1.65), histories of prior psychiatric hospitalization (mean # prior hospitalization = 14.78; SD = 12.27), suicide attempts (46%), and institutional aggression (86.8%). Psychotropic polypharmacy was also common, with most of the sample prescribed four or more categories of psychiatric medications simultaneously (75.7%). The most frequently prescribed medications were those to address mood (92.4%), psychotic (89.3%), and anxiety (85.5%) disorder symptoms. We plan to evaluate the role of clinical and non-clinical characteristics, such as gender, age, and psychiatric presentation, via regression analyses to determine which patients are at elevated risk of psychotropic polypharmacy. Polypharmacy practices have many implications for physical well-being and quality of life for forensic patients. Psychiatric stability of patients also has implications for perceived risk and ability to manage risk and psychiatric needs in less restricted settings. We will discuss the implications of our findings for forensic mental health system administrators and treatment providers.
