Your new experience awaits. Try the new design now and help us make it even better

ORIGINAL RESEARCH article

Front. Psychiatry

Sec. Forensic Psychiatry

Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1604957

This article is part of the Research TopicWomen Offenders: The Challenge of Evidence-based Practice in Correctional and Forensic Mental Health ServicesView all 3 articles

Gender Needs in Forensic Care Short Stays, High Needs: Gender Disparities in Czech Forensic Psychiatric Inpatient Care

Provisionally accepted
Marek  PávMarek Páv1,2*Jaroslav  PekaraJaroslav Pekara3*Jáchym  ValešJáchym Valeš4Jiří  ZávoraJiří Závora5Dominik  KorenýDominik Korený2Michaela  Zahrádka-KöhlerováMichaela Zahrádka-Köhlerová2Martin  AndersMartin Anders1Eva  KitzlerovaEva Kitzlerova1
  • 1Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Prague, Czechia
  • 2Psychiatric Hospital Bohnice, Prague, Prague, Czechia
  • 3Medical College, Prague, Czechia
  • 4Faculty of Arts, Charles University, Prague, Prague, Czechia
  • 5Institute of Forensic Sciences, Prague, Czechia

The final, formatted version of the article will be published soon.

Abstract Introduction: Limited research has explored the sociodemographic profiles, institutional behaviours, and treatment needs of women receiving forensic psychiatric care, particularly in Eastern Europe. Existing evidence suggests that women differ from men in several clinically significant ways that impact service delivery, treatment strategies, and overall care. Methods: A cross-sectional design was employed involving 85 women and 753 men across 14 forensic psychiatric facilities in the Czech Republic. Data were collected at two-time points, six months apart, using the Health of the Nation Outcome Scale-Secure (HoNOS-secure) and the Modified Overt Aggression Scale (MOAS). Gender differences in psychiatric diagnoses, length of stay (LoS), aggression, and unmet needs were statistically analysed. Results: The mean age of women was 45.08 years, compared to 41.43 years for men. Women had a significantly shorter average LoS (893.27 days; SD 116–3935) than men (1358.36 days; SD 28– 15311). Women were more often diagnosed with psychotic and substance use disorders, had higher Gender Needs in Forensic Care This is a provisional file, not the final typeset article rates of violent index offences, and were 2.33 times more likely to receive antipsychotic medications. Although women initially demonstrated higher MOAS scores, they showed significant improvement over time. Both genders exhibited reduced security needs at follow-up. Nonetheless, high levels of unmet needs remained, particularly among women. Conclusions: The findings emphasise the importance of gender-responsive approaches in forensic psychiatric care. Establishing specialised forensic units for women is crucial to addressing their distinct clinical and psychosocial needs, enhancing treatment outcomes, and reducing recidivism. This study identifies critical service delivery gaps and reinforces the need to develop targeted interventions tailored to women in forensic settings.

Keywords: Forensic Psychiatry, women needs, HoNOS-Secure, MOAS (Modified Overt AggressionScale), inpatient forensic treatment, female forensic population, Inpatient violence, genderdifferences

Received: 02 Apr 2025; Accepted: 06 Oct 2025.

Copyright: © 2025 Páv, Pekara, Valeš, Závora, Korený, Zahrádka-Köhlerová, Anders and Kitzlerova. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Marek Páv, marek.pav@bohnice.cz
Jaroslav Pekara, pekara@vszdrav.cz

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.