Integration initiatives for forensic services.

Poorly implemented mental health reform policies are often given as reasons for the growth in demands for forensic psychiatric services and the steady increase of mental patients in prison systems. However, in this paper, additional reasons are advanced to explain the growth of forensic psychiatry, such as an expansion in the types of "psychiatric defences" in courts of law; public concerns about violent behaviour attributed to the mentally ill; the community management of paraphilias, especially pedophilia; the development of risk assessment methodologies and the halo of super-specialization. The net result of these developments is that patients who receive a label of "forensic" enter into a mental health ghetto with little connectivity or integration with the general mental health system. The forensic label increases the stigma and decreases opportunities for reintegration and full social recovery. The paper provides guidelines to reverse these trends.