Chapter 33: Forensic Nursing in Mental Health

The specialized field of forensic nursing integrates traditional nursing practice with forensic knowledge and the legal system to address the health needs of populations impacted by trauma and violence, a pressing public health concern highlighted by rising crime rates and the goals of Healthy People 2030. Forensic nurses, who may function as generalists or advanced practice nurses, are proficient in the assessment and treatment of both victims and perpetrators, emphasizing meticulous evidence collection, proper documentation, and the application of trauma-informed care, which prioritizes a culture of safety and empowerment for individuals who have experienced acute or long-term trauma. Specialized roles include the Sexual Assault Nurse Examiner (SANE), the Nurse Coroner/Death Investigator, and the forensic psychiatric nurse. Forensic psychiatric nurses are uniquely prepared through combined medical, psychiatric, and legal education to serve as competency evaluators, psychotherapists, hostage negotiators, and expert witnesses. These roles require assessing complex legal issues, such as determining a defendant's capacity for legal sanity (understanding right versus wrong at the time of the crime, often utilizing standards like the McNaughton rules) or their competence to proceed (current mental capacity to assist their attorney in trial). Furthermore, correctional nursing focuses on providing mandated healthcare to incarcerated individuals, a population struggling with significantly elevated rates of serious mental illnesses (such as major depressive disorder and psychoses) and substance use disorders. Correctional nurses facilitate comprehensive treatment plans and discharge planning, seeking to balance the institutional focus on custody with the professional mandate for caring, ultimately aiming to reduce recidivism among offenders.