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The knowledge–practice gap remains a challenge in many fields. Health research has shown that professional networks influence various aspects of patient care, including diffusion of innovative practices. In the current study, we examined the potential utility of professional networks to spread the use of violence-risk-assessment tools in forensic psychiatric settings. A total of 6,664 reports, written by 708 clinicians, were used to examine the effect of clinicians’ use of risk-assessment tools on subsequent reports by other clinicians with whom they share patients. Results show that professional networks serve as an important channel for the spread of assessment practices. Simulation of a continuing education program showed that targeting more influential clinicians in the network could be 3 times more efficient at disseminating best practices than randomly training clinicians. Decision-makers may consider using professional networks to identify and train influential clinicians to maximize diffusion of the use of risk-assessment instruments.

In the Canadian forensic mental health system, a person found Not Criminally Responsible on account of Mental Disorder (NCRMD) and given a conditional discharge returns to the community while remaining under the jurisdiction of a provincial/territorial Review Board. However, the individual can be re-hospitalized while on conditional discharge, for reasons such as substance use, violation of conditions, or violence. We investigated whether being re-hospitalized has an impact on the factors associated with the subsequent Review Board disposition. Persons found NCRMD from the three largest Canadian provinces who were conditionally discharged at least once during the observation period were included in the sample (N = 1,367). These individuals were involved in 2,920 disposition hearings; nearly one-third of patients (30%) were re-hospitalized after having been conditionally discharged by the Review Board. The factors examined included the scales of the Historical Clinical Risk Management-20 and salient behavior that occurred since the previous hearing, such as substance use or violence. The greater presence of clinical items resulted in a greater likelihood of a hospital detention decision at the next hearing. The effect was larger for the re-hospitalized group than for the group who successfully remained in the community since the last hearing. The results suggest that dynamic factors, specifically indicators of mental health, are heavily weighted by the Review Boards, consistent with the literature on imminent risk and in line with the NCRMD legislation.

Objective : To examine the psychosocio-criminological characteristics of not criminally responsible on account of mental disorder (NCRMD)–accused people and compare them across the 3 most populous provinces. In Canada, the number of people found NCRMD has risen during the past 20 years. The Criminal Code is federally legislated but provincially administered, and mental health services are provincially governed. Our study offers a rare opportunity to observe the characteristics and trajectories of NCRMD–accused people. Method : The National Trajectory Project examined 1800 men and women found NCRMD in British Columbia (n = 222), Quebec (n = 1094), and Ontario (n = 484) between May 2000 to April 2005, followed until December 2008. Results : The most common primary diagnosis was a psychotic spectrum disorder. One-third of NCRMD–accused people had a severe mental illness and a concomitant substance use disorder, with British Columbia having the highest rate of dually diagnosed NCRMD–accused people. Most accused people (72.4%) had at least 1 prior psychiatric hospitalization. Two-thirds of index NCRMD offences were against the person, with a wide range of severity. Family members, followed by professionals, such as police and mental health care workers, were the most frequent victims. Quebec had the highest proportion of people with a mood disorder and the lowest median offence severity. There were both interprovincial differences and similarities in the characteristics of NCRMD-accused people. Conclusions : Contrary to public perception, severe violent offenses such as murder, attempted murder or sexual offences represent a small proportion of all NCRMD verdict offences. The results reveal a heterogeneous population regarding mental health and criminological characteristics in need of hierarchically organized forensic mental health services and levels of security. NCRMD—accused people were well known to civil psychiatric services prior to being found NCRMD. Risk assessm, Objectif : Examiner les caractéristiques psychologiques, sociales et criminologiques des accusés déclarés non criminellement responsables pour cause de troubles mentaux (NCRTM) et les comparer dans les 3 provinces les plus peuplées. Au Canada, le nombre de personnes déclarées NCRTM a augmenté ces 20 dernières années. Le Code criminel relève de la compétence du gouvernement fédéral mais son application relève des provinces, et les services de santé mentale sont régis par les provinces. Cette étude offre l'occasion unique d'observer les caractéristiques et la trajectoire des accusés NCRTM. Méthode : Le Projet national des trajectoires a permis d'examiner 1800 hommes et femmes déclarés NCRTM en Colombie-Britannique (n = 222), au Québec (n = 1094) et en Ontario (n = 484) de mai 2000 à avril 2005, et de les suivre jusqu'en décembre 2008. Résultats : Le diagnostic principal le plus courant était un trouble du spectre de la psychose. Un tiers des accusés NCRTM souffraient d'une maladie mentale grave et d'un trouble concomitant lié à l'utilisation de substances, la Colombie-Britannique ayant le taux le plus élevé d'accusés NCRTM ayant ces troubles concommitants. La plupart des accusés (72,4%) avaient déjà été hospitalisés au moins une fois dans un établissement psychiatrique. Les deux tiers des infractions répertoriées des accusés NCRTM étaient des infractions contre la personne, de niveaux de gravité variables. Les membres de la famille, puis des intervenants comme les agents de police et les travailleurs de la santé mentale, étaient les victimes les plus fréquentes. C'est au Québec que la proportion de personnes souffrant d'un trouble de l'humeur était la plus élevée et que la gravité médiane des infractions était la plus basse. Les caractéristiques des accusés NCRTM entre les provinces présentent à la fois des différences et des similarités. Conclusions : Contrairement à la perception publique, les infractions graves avec violence comme le meurtre, les tentatives de meur

Objective : To state the sociodemographic characteristics, mental health histories, index offence characteristics, and criminal histories of male and female forensic psychiatric patients. Clinicians and researchers advocate that mental health and criminal justice organizations implement gender-specific services; however, few studies have sampled forensic patients to evaluate the extent to which men's and women's treatment and management needs are different. Method : Data were collected from Review Board files from May 2000 to April 2005 in the 3 largest Canadian provinces. Using official criminal records, participants were followed for 3 to 8 years, until December 2008. The final sample comprised 1800 individuals: 15.6% were women and 84.4% were men. Results : There were few demographic differences, but women had higher psychosocial functioning than men. Both men and women had extensive mental health histories; women were more likely diagnosed with mood disorders and PDs and men were more likely diagnosed with schizophrenia spectrum disorders and SUDs. The nature of the index offence did not differ by gender, except women were more likely to have perpetrated murders and attempted murders. For offences against a person, women were more likely to offend against offspring and partners and less likely to offend against strangers, compared with men. Women had significantly less extensive criminal histories than men. Conclusions : Not criminally responsible on account of mental disorder-accused women have a distinct psychosocial, clinical, and criminological profile from their male counterparts, which may suggest gender-specific assessment, risk management, and treatment in forensic services could benefit patients. The findings are also consistent with traditional models (Risk-Need-Responsivity) and ultimately demonstrate the importance of individual assessment and client-centred services., Objectif : Établir les caractéristiques sociodémographiques, les antécédents de santé mentale, les caractéristiques de l'infraction répertoriée, et les antécédents criminels des patients masculins et féminins de psychiatrie légale. Cliniciens et chercheurs revendiquent que les organisations de santé mentale et de justice pénale offrent des services sexospécifiques; toutefois, peu d'études ont évalué à quel point les besoins de traitement et de prise en charge des hommes et des femmes sont différents dans des échantillons de patients médicolégaux. Méthode : Les données ont été recueillies dans les dossiers de la CE, de mai 2000 à avril 2005, dans les 3 provinces les plus populeuses. Au moyen des casiers judiciaires officiels, les participants ont été suivis de 3 à 8 ans, jusqu'en décembre 2008. L'échantillon final comptait 1800 personnes dont 15,6% étaient des femmes et 84,4%, des hommes. Résultats : Il y avait peu de différences démograhiques, mais les femmes avaient un fonctionnement psychosocial plus élevé que celui des hommes. Les hommes comme les femmes avaient de longs antécédents de santé mentale, les femmes étant plus susceptibles de recevoir un diagnostic de trouble de l'humeur ou de la personnalité et les hommes, un diagnostic du spectre de la schizophrénie ou d'un trouble lié aux substances. La nature de l'infraction répertoriée ne différait pas selon le sexe, sauf que les femmes étaient plus susceptibles d'avoir commis un meurtre ou une tentative de meurtre. Pour les infractions contre la personne, les femmes étaient plus susceptibles de s'en prendre à leurs enfants et leurs partenaires et moins à des étrangers, comparées aux hommes. Elles avaient des antécédents criminels significativement moins lourds que les hommes. Conclusions : Les femmes NCRTM ont un profil psychosocial, clinique et criminologique distinct de celui des hommes, suggérant ainsi qu'une évaluation, une gestion de risque et un traitement sexospécifiques dans les services psycho-légaux po

The objectives of this study were to describe the disposition and housing trajectories of individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD), and the factors that predict different trajectories. To do so, disposition and housing status were coded for 934 NCRMD patients over a 36-month follow-up period. Sequential data analysis resulted in four distinct trajectories: detention in hospital, conditional discharge in supportive housing, conditional discharge in independent housing, and absolute discharge to unknown housing. The likelihood of a placement in supportive housing compared with detention significantly decreased for individuals with a higher index offense severity. Less restrictive trajectories were significantly predicted by clinical factors. The results revealed little change in the disposition and housing trajectories of NCRMD patients. Furthermore, decisions about disposition and housing placement reflect a knowledge–practice gap between risk factors known to be predictive of community resources use in the forensic population.

Canadian legislation makes Review Boards (RBs) responsible for rendering dispositions for individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD) after considering public safety, the mental condition of the accused, and his/her potential for community reintegration. We reviewed 6,743 RB hearings for 1,794 individuals found NCRMD in the three largest Canadian provinces to investigate whether items from two empirically supported risk assessment measures, the Historical Clinical Risk Management‐20 and the Violence Risk Appraisal Guide, were considered. Less than half the items were included in expert reports or in RBs' reasons for dispositions, and consideration of these items differed according to gender and index offense severity of the accused. These items included evidence‐based risk factors and/or legally specified criteria: mental health, treatment, and criminal history. These results illustrate the gap between research on risk factors and the integration of this evidence into practice. In particular, we recommend the implementation of structured measures to reduce the potential for clinicians to be unduly influenced by gender and offense severity.

In Canada, Review Boards are mandated to evaluate individuals found Not Criminally Responsible on Account of Mental Disorder (NCRMD) on an annual basis and render 1 of 3 dispositions: (a) custody, (b) conditional discharge, or (c) absolute discharge. To promote social reintegration, conditional discharge can be ordered with the condition to live in supportive housing. However, NCRMD accused face great barriers to housing access as a result of the stigma associated with the forensic label. The goal of this study was to evaluate the role of housing in the clinical and criminal trajectories of forensic patients as they reintegrate into the community. Data for this study were extracted from a national study of individuals found NCRMD in Canada (Crocker, Nicholls, Seto, Côté, et al., in press). The present study focuses on a random sample of NCRMD accused in the province of Québec, who were under a conditional discharge disposition during the study period (n = 837). Controlling for sociodemographic, clinical, and criminal variables, survival analysis showed that individuals placed in independent housing following a conditional discharge from the Review Board were 2.5 times more likely to commit a new offense, nearly 3 times more likely to commit an offense against a person, and 1.4 times more likely to be readmitted for psychiatric treatment compared with individuals residing in supportive housing. These results point to the influence housing can have on the trajectories of forensic patients, above and beyond a range of clinical, criminological, and sociodemographic factors.

Objective : To examine the processing and Review Board (RB) disposition outcomes of people found not criminally responsible on account of mental disorder (NCRMD) across the 3 most populous provinces in Canada. Although the Criminal Code is federally legislated, criminal justice is administered by provinces and territories. It follows that a person with mental illness who comes into conflict with the law and subsequently comes under the management of a legally mandated RB may experience different trajectories across jurisdictions. Method : The National Trajectory Project examined 1800 men and women found NCRMD in British Columbia (n = 222), Quebec (n = 1094), and Ontario (n = 484) between May 2000 and April 2005, followed until December 2008. Results : We found significant interprovincial differences in the trajectories of people found NCRMD, including time detained in hospital and time under the supervision of an RB. The odds of being conditionally or absolutely discharged by the RB varied across provinces, even after number of past offences, diagnosis at verdict, and most severe index offence (all covariates decreased likelihood of discharge) were considered. Conclusions : Considerable discrepancies in the application of NCRMD legislation and the processing of NCRMD cases through the forensic system across the provinces suggests that fair and equitable treatment under the law could be enhanced by increased national integration and collaboration., Objectif : Examiner les résultats du processus et des dispositions de la Commission d'examen (CE) pour les personnes déclarées non criminellement responsables pour cause de troubles mentaux (NCRTM) dans les 3 provinces les plus populeuses du Canada. Le Code criminel relève de la compétence du gouvernement fédéral, mais la justice pénale est administrée par les provinces et territoires. Il s'ensuit qu'une personne ayant un trouble mental qui a des démêlés avec la justice et qui est subséquemment placée sous la supervision d'une CE peut connaître différentes trajectoires dans différentes juridictions ou régions ou provinces. Méthode : Le Projet national des trajectoires a permis d'examiner 1800 hommes et femmes déclarés NCRTM en Colombie-Britannique (n = 222), au Québec (n = 1094) et en Ontario (n = 484) de mai 2000 à avril 2005, et de les suivre jusqu'en décembre 2008. Résultats : Nous avons constaté des différences interprovinciales significatives dans les trajectoires des personnes déclarées NCRTM, notamment le temps de détention dans un hôpital et le temps sous la supervision d'une CE. Les probabilités d'une libération conditionnelle ou absolue accordée par la CE variaient entre les provinces, même après examen du nombre d'infractions passées, du diagnostic au verdict, et des infractions répertoriées les plus graves (toutes les covariables réduisaient la probabilité d'une libération). Conclusions : Les écarts considérables dans l'application de la législation NCRTM et dans le traitement des cas NCRTM au sein du système psycho-olégal entre les provinces suggèrent qu'un traitement juste et équitable en vertu de la loi pourrait être amélioré par une plus grande intégration et collaboration nationale.

Beginning in November 2012, New Haven, Connecticut, served as the pilot site for Project Longevity, a statewide focused deterrence gun violence reduction strategy. The intervention brings law enforcement, social services, and community members together to meet with members of violent street groups at program call-ins. Using autoregressive integrated moving average models and controlling for the possibility of a non-New Haven–specific decline in gun violence, a decrease in group offending patterns, and the limitations of police-defined group member involved (GMI) categorization of shootings and homicides, the results of our analysis show that Longevity is associated with a reduction of almost five GMI incidents per month. These findings bolster research confirming the efficacy of focused deterrence approaches to reducing gun violence.

Considérant que la probabilité d’être puni varie d’un individu à l’autre, la théorie de la dissuasion doit être adaptée pour tenir compte à la fois des expériences délinquantes punies et impunies. L’omission de ce paramètre du modèle de décision peut amener des biais importants et une surestimation de l’échec au sein d’une carrière délinquante. Les études de prédiction de la récidive se basant uniquement sur les données pénales sont vulnérables à ce biais. Dans le cadre de cette étude, les données de délinquance autorévélée d’un échantillon de 199 détenus, mises en parallèle avec des données pénales, ont permis d’estimer la capacité individuelle d’évitement pénal. Lorsqu’on prend en considération cette disposition, les antécédents pénaux deviennent un indicateur des échecs auxquels les délinquants font face durant leur trajectoire délinquante plutôt que de la poursuite même de cette trajectoire, créant l’illusion de l’efficacité de sa prédiction par les antécédents pénaux. L’intensité des coûts pénaux antérieurs ainsi que les opportunités d’emploi conventionnel sont deux facteurs qui réduisent la probabilité de la poursuite de la carrière criminelle. Les bénéfices soutirés des activités criminelles augmentent cette probabilité., Given the fact that the probability of being punished varies between individuals, deterrence theory needs to be adapted to consider both punished and unpunished criminal experiences. Omitting this parameter from the decision model can lead to considerable biases and an overestimation of failure in the course of a criminal career. Studies in the prediction of recidivism that rely only on penal data are prone to this bias. In our study, self-reported offending data from an inmate sample (n = 199), in conjunction with penal data, allowed us to assess individual penal avoidance ability. When taking into consideration penal avoidance, past penal experiences appear to be an indicator of failure faced by offenders during their criminal career rather than its true continuation, creating the illusion of the efficient prediction of recidivism using past penal experiences. The intensity of past penal costs as well as legitimate opportunities are two factors that reduce the probability of the continuation of the criminal career. The benefits of crime increase this probability.

The National Trajectory Project examined longitudinal data from a large sample of people found not criminally responsible on account of mental disorder (NCRMD) to assess the presence of provincial differences in the application of the law, to examine the characteristics of people with serious mental illness who come into conflict with the law and receive this verdict, and to investigate the trajectories of NCRMD–accused people as they traverse the mental health and criminal justice systems. Our paper describes the rationale for the National Trajectory Project and the methods used to collect data in Quebec, Ontario, and British Columbia, the 3 most populous provinces in Canada and the 3 provinces with the most people found NCRMD., Les membres du Projet national des trajectoires ont examiné les données longitudinales d’un vaste échantillon de personnes déclarées non criminellement responsables pour cause de troubles mentaux (NCRTM) afin d’évaluer la présence de différences provinciales en matière d’application de la loi, d’étudier les caractéristiques de personnes ayant une maladie mentale grave qui, ayant des démêlés avec la justice, sont déclarées non criminellement responsables, et d’examiner les trajectoires des accusés NCRTM à travers les systèmes de santé mentale et de justice pénale. Le présent document décrit la raison d’être du Projet national des trajectoires et les méthodes utilisées pour recueillir des données au Québec, en Ontario et en ColombieBritannique, les 3 provinces les plus populeuses du Canada et celles où se trouve la majorité des personnes déclarées NCRTM.

Chaque numéro publié d’une revue scientifique vient clore plusieurs rondes de tractations qui débutent au sein du comité de rédaction, se déplacent ensuite autour de ceux qui ont accepté de participer au numéro et se ramifient et se prolongent durant les évaluations et les révisions des manuscrits qui seront finalement publiés. Les directeurs successifs sont contraints de balancer la part relative des articles de réflexion et des articles d’investigation, la proportion relative des enquêtes empiriques qui procèdent par vérification d’hypothèses et celle des investigations ouvertes et exploratoires. En se basant sur l’ensemble des articles publiés dans la revue Criminologie de 1968 à 2016 (n = 658), cette étude s’intéresse à l’effet des différentes stratégies éditoriales mises en place sur la part relative qui sera accordée à la recherche empirique quantitative dans le discours criminologique. Les analyses montrent que les directeurs, par l’intermédiaire des comités de rédaction, peuvent agir sur l’offre par des innovations éditoriales (introduction de numéros thématiques, publication semestrielle, ouverture aux publications hors thèmes, diversification de la provenance des auteurs), mais aussi contrôler cette offre par une hausse des standards (uniformité de la taille des articles, complexité des analyses) et par une sollicitation active d’articles innovateurs. Ces innovations éditoriales ont diversifié le discours scientifique de la revue et ont assuré, au final, la survie de la revue durant un demi-siècle., Each issue of a scientific journal is the result of many rounds of negotiation, beginning with the editorial board, moving to those who have agreed to help with the issue, and ending with the process of review and revision of those manuscripts that will finally be published. Journal editors must maintain a balance between theoretical and experimental articles and between those that deal with empirical research that tests a particular hypothesis and those that are exploratory and open-ended. Based on the articles published in Criminologie from 1968 to 2016 (n = 658), this study analyses the effect of editorial strategies on the relative share of empirical quantitative research. Analyses show that editors, through the editorial board, can influence the supply of such articles through editorial innovations (such as thematic issues, biannual publication, open topic issues, encouraging diversity in authors’ locations) but can also affect submissions through an increase in standards (uniform length, complex analysis) and by soliciting innovative articles. These editorial innovations have led to a journal that is scientifically diverse and have ensured the journal’s survival for half a century., Cada número publicado en una revista científica viene a clausurar varias rondas de negociaciones, que comienzan en el seno del comité de redacción, se desplazan luego alrededor de quienes aceptaron participar en el número, y se ramifican y se prolongan durante las evaluaciones y las revisiones de los manuscritos que serán finalmente publicados. Los sucesivos directores deben balancear la parte relativa a los artículos de reflexión y a los artículos de investigación con la proporción relativa a las investigaciones empíricas que proceden por verificación de hipótesis y aquella a las investigaciones abiertas y exploratorias. Basándose en el conjunto de los artículos publicados en la revista Criminologie de 1968 a 2016 (n = 658), este estudio se interesa por el efecto de las diferentes estrategias editoriales adoptadas sobre la parte relativa que será acordada a la investigación empírica cuantitativa en el discurso criminológico. Los análisis muestran que los directores, por intermedio de los comités de redacción, pueden incidir sobre la oferta de innovaciones editoriales (introducción de números temáticos, publicación semestral, apertura hacia las publicaciones de tema libre, diversificación del origen de los autores), pero también controlar esta oferta por medio de un alza de los estándares (uniformidad del tamaño de los artículos, complejidad de los análisis) y por una solicitud activa de artículos innovadores. Estas innovaciones editoriales permitieron diversificar el discurso científico de la revista y, al final, aseguraron la supervivencia de la revista durante medio siglo.

OBJECTIVE: To examine criminal recidivism rates of a large sample of people found not criminally responsible on account of mental disorder (NCRMD) in Canada's 3 most populous provinces, British Columbia, Ontario, and Quebec. Public concern about the dangerousness of people found NCRMD has been fed by media attention on high-profile cases. However, little research is available on the rate of reoffending among people found NCRMD across Canadian provinces. METHOD: Using data from the National Trajectory Project, this study examined 1800 men and women in British Columbia (n = 222), Ontario (n = 484), and Quebec (n = 1094) who were found NCRMD between May 2000 and April 2005 and followed until December 2008. RESULTS: Recidivism was relatively low after 3 years (17%). There were interprovincial differences after controlling for number of prior criminal offences, diagnosis, seriousness of the index offence, and supervision by the review boards. British Columbia (10%) and Ontario (9%) were similar, whereas Quebec had almost twice the recidivism (22%). People who had committed severe violent index offences were less likely to reoffend than those who had committed less severe offences. People from the sample were less likely to reoffend when under the purview of review boards, across all 3 provinces. CONCLUSION: The results of this study, along with other research on processing differences, suggest systemic differences in the trajectories and outcomes of persons found NCRMD need to be better understood to guide national policies and practices

Objective Few studies have addressed use of resources in police interventions involving individuals with mental illness. The time police officers spend on interventions is a straightforward measure with significant administrative weight, given that it addresses human resource allocation. This study compared the characteristics of police interventions involving individuals with mental illness and a control sample of individuals without mental illness. Methods A total of 6,128 police interventions in Montreal, Québec, were analyzed by using a retrospective analysis of police intervention logs from three days in 2006. Interventions involving citizens with (N=272) and without (N=5,856) mental illness were compared by reason for the intervention, the use of arrest, and the use of police resources. Results Police interventions involving individuals with mental illness were less likely than those involving individuals without mental illness to be related to more severe offenses. However, interventions for minor offenses were more likely to lead to arrest when they involved citizens with mental illness. Interventions for reasons of equal severity were twice as likely to lead to arrest if the citizen involved had a mental illness. After controlling for the use of arrest and the severity of the situation, the analysis showed that police interventions involving individuals with mental illness used 87% more resources than interventions involving individuals without mental illness. Conclusions Future studies using administrative police data sets could investigate the use of resources and division of costs involved in new programs or partnerships to better address the interface of criminal justice and mental health care.

With the increased need to assess and manage risk in inpatient settings, the Short-Term Assessment of Risk and Treatability (START) was implemented on a civil psychiatric unit. The goal of the present study was to examine the tool's predictive validity when completed by clinical teams as part of routine practice. Data were collected for 34 patients hospitalized for a minimum of 30 days prior to and after a START evaluation. Several challenging behaviors, such as aggression towards others, self-harm, and substance abuse were assessed using the START Outcomes Scale (Nicholls et al., 2007 Nicholls, T. L., Gagnon, N., Crocker, A. G., Brink, J. H., Desmarais, S. L. and Webster, C. D. 2007. START Outcome Scale SOS, Vancouver, , Canada: BC Mental Health & Addiction Services. [Google Scholar] ). Results from multilevel logistic regression and Receiver Operating Characteristics analyses lend partial support for the predictive validity of the START. A limited set of START items combined was significantly better at predicting the challenging behaviors than the original total Strength and Vulnerability scales. Results are discussed in terms of the clinical use of risk assessment.

The majority of individuals found not criminally responsible on account of mental disorder (NCRMD) in Canada spend some time in hospital before they are conditionally or absolutely (no conditions) discharged to the community by a legally mandated review board. By law, the decision to conditionally discharge an individual found NCRMD should be guided by the need to protect the public, the mental condition of the accused, and the other needs of the accused, especially regarding his/her community reintegration. At the time of this study, Canadian legislation and case law required that the review board disposition should be the "least onerous and least restrictive" possible for the accused. This means that, if there is no evidence that the person poses a significant risk to public safety, he/she must be released. However, the Canadian Criminal Code does not specify the criteria that must be considered when making this risk assessment. This leads to two questions. (1) What predicts review board dispositions? (2) To what extent do disposition determinations reflect evidence-based practices? The present study examined dynamic and static predictors of detention in custody, conditional discharge (CD), and absolute discharge (AD) dispositions among persons found NCRMD across the three largest provinces in Canada. The National Trajectory Project (NTP) examined men and women found NCRMD in British Columbia (BC), Québec (QC), and Ontario (ON) between May 2000 and April 2005, followed until December 2008. For the purposes of this study, individuals who had at least one hearing with a review board were extracted from the NTP dataset (N = 1794: QC = 1089, ON = 483, BC = 222). Over the course of the study, 6743 review board hearings were examined (QC = 3505, ON = 2185, BC = 1053). Despite advances in the risk assessment field, presentation of a comprehensive structured risk assessment to the review board was not the norm. Yet our findings suggest that review boards were taking into

Objective: The number of police interventions with people presenting a mental health problem has been increasing during the past 30 years, and police services are becoming increasingly aware of the human resources and skills these interventions require. Our study addresses the characteristics explaining police time used and outcomes of interventions as police officers interact with people with mental illness. Method: Using a police service administrative database from a large Canadian city, and an identification algorithm method, police interventions with people with mental illness were identified on 3 randomly selected days in 1 year. A content analysis of intervention logs was carried out to identify characteristics of those interventions: the call initiator, the location, and the final outcome of the intervention. Results: Interventions with people with mental illness represent a small proportion (3%; n = 272) of all police interventions (n = 8485). General linear models show that the type of outcome is the most important factor in estimating the time required by police interventions. Arrests and hospitalizations are the least time-efficient outcomes, consuming 2.0 and 3.2 times, respectively, more time than informal dispositions. A multiple correspondence analysis shows that police interventions can be depicted in 2 dimensions, representing their main roles concerning people with mental illness, namely, to ensure the public safety and to protect the most vulnerable citizens. The more these services are required, the more police time will be required. Conclusion: Education and partnerships between police services and mental health services are essential to a proper management of outcomes., Objectif: Le nombre d'interventions policières auprès de personnes présentant un problème de santé mentale s'est accru au cours des 30 dernières années, et les services de police sont de plus en plus conscients des ressources humaines et des compétences que nécessitent ces interventions. Notre étude aborde les caractéristiques expliquant le temps de la police utilisé et les résultats des interventions quand les policiers interagissent avec des personnes souffrant de maladie mentale. Méthode: À l'aide de la base de données administrative d'un service de police d'une grande ville canadienne, et d'une méthode d'algorithme d'identification, les interventions policières auprès de personnes souffrant de maladie mentale ont été identifiées sur 3 jours choisis au hasard dans 1 année. Une analyse du contenu des rapports des interventions a été menée pour identifier les caractéristiques de ces interventions: le lancement de l'appel, l'endroit, et l'issue finale de l'intervention. Résultats: Les interventions auprès de personnes souffrant de maladie mentale représentent une proportion modeste (3 %; n = 272) de toutes les interventions policières (n = 8485). Les modèles linéaires généraux indiquent que le type de résultat est le facteur le plus important de l'estimation du temps requis par les interventions policières. Les arrestations et les hospitalisations sont les résultats dont les délais sont les moins efficients, prenant 2,0 et 3,2 fois plus de temps, respectivement, que les règlements à l'amiables. Une analyse des correspondances multiple indique que les interventions policières peuvent être décrites en 2 dimensions, représentant leurs rôles principaux à l'égard des personnes souffrant de maladie mentale, notamment, assurer la sécurité du public et protéger les citoyens les plus vulnérables. Plus ces services sont requis, plus le temps de la police sera requis. Conclusion: L'éducation et les partenariats entre les services de police et les services de santé mentale sont

Occupational prestige is a measure used in sociology of occupations to establish the social status of a job as a hierarchized continuum. The measure can be defined according to income, level of supervision, independence, and competence. Based on interviews with violators committed to imprisonment (n = 133), this study assesses the applicability of the notion of prestige to illicit occupations. Results show that the domains of activities associated with illicit occupations are not consistent regarding prestige, contrary to licit occupations. Some of the characteristics that define the prestige of licit occupations, such as income and competence, contribute to define the prestige of illicit ones as well. The criminal milieu reveals specific characteristics, among which is the difficulty to obtain occupational stability. Studying criminality with the same notions we use for the population at large allows us to compare both environments to understand their components and differences. And understanding social desirability within the criminal milieu would allow for a better understanding of the permutations in an offender’s career, that is, what motivates a delinquent to go back and forth between criminal and conventional occupations. ; Le prestige occupationnel est une mesure utilisée en sociologie des professions pour déterminer le statut social d’un emploi sous la forme d’un continuum hiérarchisé. Cette mesure peut être définie selon : le revenu, le niveau de supervision, l’autonomie et les compétences. En se basant sur des entrevues auprès de délinquants incarcérés (n = 133), cette étude évalue si cette notion de prestige s’applique aux occupations illicites. Les résultats suggèrent que, contrairement aux occupations licites, les domaines d’activité des occupations illicites ne présentent pas d’homogénéité en ce qui concerne le prestige. Certaines caractéristiques définissant le prestige des occupations licites, comme le revenu et la compétence, contribuent aussi à dé

In the Canadian forensic mental health system, a person found Not Criminally Responsible on account of Mental Disorder (NCRMD) and given a conditional discharge returns to the community while remaining under the jurisdiction of a provincial/territorial Review Board. However, the individual can be re-hospitalized while on conditional discharge, for reasons such as substance use, violation of conditions, or violence. We investigated whether being rehospitalized has an impact on the factors associated with the subsequent Review Board disposition. Persons found NCRMD from the three largest Canadian provinces who were conditionally discharged at least once during the observation period were included in the sample (N=1,367). These individuals were involved in 2,920 disposition hearings; nearly one-third of patients (30%) were re-hospitalized after having been conditionally discharged by the Review Board. The factors examined included the scales of the Historical Clinical Risk Management-20 and salient behavior that occurred since the previous hearing, such as substance use or violence. The greater presence of clinical items resulted in a greater likelihood of a hospital detention decision at the next hearing. The effect was larger for the re-hospitalized group than for the group who successfully remained in the community since the last hearing. The results suggest that dynamic factors, specifically indicators of mental health, are heavily weighted by the Review Boards, consistent with the literature on imminent risk and in line with the NCRMD legislation.

The objectives of this study were to describe the disposition and housing trajectories of individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD), and the factors that predict different trajectories. To do so, disposition and housing status were coded for 934 NCRMD patients over a 36-month follow-up period. Sequential data analysis resulted in four distinct trajectories: detention in hospital, conditional discharge in supportive housing, conditional discharge in independent housing, and absolute discharge to unknown housing. The likelihood of a placement in supportive housing compared with detention significantly decreased for individuals with a higher index offense severity. Less restrictive trajectories were significantly predicted by clinical factors. The results revealed little change in the disposition and housing trajectories of NCRMD patients. Furthermore, decisions about disposition and housing placement reflect a knowledge–practice gap between risk factors known to be predictive of community resources use in the forensic population.

Considérant que la probabilité d’être puni varie d’un individu à l’autre, la théorie de la dissuasion doit être adaptée pour tenir compte à la fois des expériences délinquantes punies et impunies. L’omission de ce paramètre du modèle de décision peut amener des biais importants et une surestimation de l’échec au sein d’une carrière délinquante. Les études de prédiction de la récidive se basant uniquement sur les données pénales sont vulnérables à ce biais. Dans le cadre de cette étude, les données de délinquance autorévélée d’un échantillon de 199 détenus, mises en parallèle avec des données pénales, ont permis d’estimer la capacité individuelle d’évitement pénal. Lorsqu’on prend en considération cette disposition, les antécédents pénaux deviennent un indicateur des échecs auxquels les délinquants font face durant leur trajectoire délinquante plutôt que de la poursuite même de cette trajectoire, créant l’illusion de l’efficacité de sa prédiction par les antécédents pénaux. L’intensité des coûts pénaux antérieurs ainsi que les opportunités d’emploi conventionnel sont deux facteurs qui réduisent la probabilité de la poursuite de la carrière criminelle. Les bénéfices soutirés des activités criminelles augmentent cette probabilité., Given the fact that the probability of being punished varies between individuals, deterrence theory needs to be adapted to consider both punished and unpunished criminal experiences. Omitting this parameter from the decision model can lead to considerable biases and an overestimation of failure in the course of a criminal career. Studies in the prediction of recidivism that rely only on penal data are prone to this bias. In our study, self-reported offending data from an inmate sample (n = 199), in conjunction with penal data, allowed us to assess individual penal avoidance ability. When taking into consideration penal avoidance, past penal experiences appear to be an indicator of failure faced by offenders during their criminal career rather than its true continuation, creating the illusion of the efficient prediction of recidivism using past penal experiences. The intensity of past penal costs as well as legitimate opportunities are two factors that reduce the probability of the continuation of the criminal career. The benefits of crime increase this probability.

Beginning in November 2012, New Haven, Connecticut, served as the pilot site for Project Longevity, a statewide focused deterrence gun violence reduction strategy. The intervention brings law enforcement, social services, and community members together to meet with members of violent street groups at program call-ins. Using autoregressive integrated moving average models and controlling for the possibility of a non-New Haven–specific decline in gun violence, a decrease in group offending patterns, and the limitations of police-defined group member involved (GMI) categorization of shootings and homicides, the results of our analysis show that Longevity is associated with a reduction of almost five GMI incidents per month. These findings bolster research confirming the efficacy of focused deterrence approaches to reducing gun violence.

OBJECTIVE: To examine criminal recidivism rates of a large sample of people found not criminally responsible on account of mental disorder (NCRMD) in Canada's 3 most populous provinces, British Columbia, Ontario, and Quebec. Public concern about the dangerousness of people found NCRMD has been fed by media attention on high-profile cases. However, little research is available on the rate of reoffending among people found NCRMD across Canadian provinces. METHOD: Using data from the National Trajectory Project, this study examined 1800 men and women in British Columbia (n = 222), Ontario (n = 484), and Quebec (n = 1094) who were found NCRMD between May 2000 and April 2005 and followed until December 2008. RESULTS: Recidivism was relatively low after 3 years (17%). There were interprovincial differences after controlling for number of prior criminal offences, diagnosis, seriousness of the index offence, and supervision by the review boards. British Columbia (10%) and Ontario (9%) were similar, whereas Quebec had almost twice the recidivism (22%). People who had committed severe violent index offences were less likely to reoffend than those who had committed less severe offences. People from the sample were less likely to reoffend when under the purview of review boards, across all 3 provinces. CONCLUSION: The results of this study, along with other research on processing differences, suggest systemic differences in the trajectories and outcomes of persons found NCRMD need to be better understood to guide national policies and practices

The National Trajectory Project examined longitudinal data from a large sample of people found not criminally responsible on account of mental disorder (NCRMD) to assess the presence of provincial differences in the application of the law, to examine the characteristics of people with serious mental illness who come into conflict with the law and receive this verdict, and to investigate the trajectories of NCRMD–accused people as they traverse the mental health and criminal justice systems. Our paper describes the rationale for the National Trajectory Project and the methods used to collect data in Quebec, Ontario, and British Columbia, the 3 most populous provinces in Canada and the 3 provinces with the most people found NCRMD., Les membres du Projet national des trajectoires ont examiné les données longitudinales d’un vaste échantillon de personnes déclarées non criminellement responsables pour cause de troubles mentaux (NCRTM) afin d’évaluer la présence de différences provinciales en matière d’application de la loi, d’étudier les caractéristiques de personnes ayant une maladie mentale grave qui, ayant des démêlés avec la justice, sont déclarées non criminellement responsables, et d’examiner les trajectoires des accusés NCRTM à travers les systèmes de santé mentale et de justice pénale. Le présent document décrit la raison d’être du Projet national des trajectoires et les méthodes utilisées pour recueillir des données au Québec, en Ontario et en ColombieBritannique, les 3 provinces les plus populeuses du Canada et celles où se trouve la majorité des personnes déclarées NCRTM.

Objective : To examine the psychosocio-criminological characteristics of not criminally responsible on account of mental disorder (NCRMD)–accused people and compare them across the 3 most populous provinces. In Canada, the number of people found NCRMD has risen during the past 20 years. The Criminal Code is federally legislated but provincially administered, and mental health services are provincially governed. Our study offers a rare opportunity to observe the characteristics and trajectories of NCRMD–accused people. Method : The National Trajectory Project examined 1800 men and women found NCRMD in British Columbia (n = 222), Quebec (n = 1094), and Ontario (n = 484) between May 2000 to April 2005, followed until December 2008. Results : The most common primary diagnosis was a psychotic spectrum disorder. One-third of NCRMD–accused people had a severe mental illness and a concomitant substance use disorder, with British Columbia having the highest rate of dually diagnosed NCRMD–accused people. Most accused people (72.4%) had at least 1 prior psychiatric hospitalization. Two-thirds of index NCRMD offences were against the person, with a wide range of severity. Family members, followed by professionals, such as police and mental health care workers, were the most frequent victims. Quebec had the highest proportion of people with a mood disorder and the lowest median offence severity. There were both interprovincial differences and similarities in the characteristics of NCRMD-accused people. Conclusions : Contrary to public perception, severe violent offenses such as murder, attempted murder or sexual offences represent a small proportion of all NCRMD verdict offences. The results reveal a heterogeneous population regarding mental health and criminological characteristics in need of hierarchically organized forensic mental health services and levels of security. NCRMD—accused people were well known to civil psychiatric services prior to being found NCRMD. Risk assessm, Objectif : Examiner les caractéristiques psychologiques, sociales et criminologiques des accusés déclarés non criminellement responsables pour cause de troubles mentaux (NCRTM) et les comparer dans les 3 provinces les plus peuplées. Au Canada, le nombre de personnes déclarées NCRTM a augmenté ces 20 dernières années. Le Code criminel relève de la compétence du gouvernement fédéral mais son application relève des provinces, et les services de santé mentale sont régis par les provinces. Cette étude offre l'occasion unique d'observer les caractéristiques et la trajectoire des accusés NCRTM. Méthode : Le Projet national des trajectoires a permis d'examiner 1800 hommes et femmes déclarés NCRTM en Colombie-Britannique (n = 222), au Québec (n = 1094) et en Ontario (n = 484) de mai 2000 à avril 2005, et de les suivre jusqu'en décembre 2008. Résultats : Le diagnostic principal le plus courant était un trouble du spectre de la psychose. Un tiers des accusés NCRTM souffraient d'une maladie mentale grave et d'un trouble concomitant lié à l'utilisation de substances, la Colombie-Britannique ayant le taux le plus élevé d'accusés NCRTM ayant ces troubles concommitants. La plupart des accusés (72,4%) avaient déjà été hospitalisés au moins une fois dans un établissement psychiatrique. Les deux tiers des infractions répertoriées des accusés NCRTM étaient des infractions contre la personne, de niveaux de gravité variables. Les membres de la famille, puis des intervenants comme les agents de police et les travailleurs de la santé mentale, étaient les victimes les plus fréquentes. C'est au Québec que la proportion de personnes souffrant d'un trouble de l'humeur était la plus élevée et que la gravité médiane des infractions était la plus basse. Les caractéristiques des accusés NCRTM entre les provinces présentent à la fois des différences et des similarités. Conclusions : Contrairement à la perception publique, les infractions graves avec violence comme le meurtre, les tentatives de meur

Objective : To state the sociodemographic characteristics, mental health histories, index offence characteristics, and criminal histories of male and female forensic psychiatric patients. Clinicians and researchers advocate that mental health and criminal justice organizations implement gender-specific services; however, few studies have sampled forensic patients to evaluate the extent to which men's and women's treatment and management needs are different. Method : Data were collected from Review Board files from May 2000 to April 2005 in the 3 largest Canadian provinces. Using official criminal records, participants were followed for 3 to 8 years, until December 2008. The final sample comprised 1800 individuals: 15.6% were women and 84.4% were men. Results : There were few demographic differences, but women had higher psychosocial functioning than men. Both men and women had extensive mental health histories; women were more likely diagnosed with mood disorders and PDs and men were more likely diagnosed with schizophrenia spectrum disorders and SUDs. The nature of the index offence did not differ by gender, except women were more likely to have perpetrated murders and attempted murders. For offences against a person, women were more likely to offend against offspring and partners and less likely to offend against strangers, compared with men. Women had significantly less extensive criminal histories than men. Conclusions : Not criminally responsible on account of mental disorder-accused women have a distinct psychosocial, clinical, and criminological profile from their male counterparts, which may suggest gender-specific assessment, risk management, and treatment in forensic services could benefit patients. The findings are also consistent with traditional models (Risk-Need-Responsivity) and ultimately demonstrate the importance of individual assessment and client-centred services., Objectif : Établir les caractéristiques sociodémographiques, les antécédents de santé mentale, les caractéristiques de l'infraction répertoriée, et les antécédents criminels des patients masculins et féminins de psychiatrie légale. Cliniciens et chercheurs revendiquent que les organisations de santé mentale et de justice pénale offrent des services sexospécifiques; toutefois, peu d'études ont évalué à quel point les besoins de traitement et de prise en charge des hommes et des femmes sont différents dans des échantillons de patients médicolégaux. Méthode : Les données ont été recueillies dans les dossiers de la CE, de mai 2000 à avril 2005, dans les 3 provinces les plus populeuses. Au moyen des casiers judiciaires officiels, les participants ont été suivis de 3 à 8 ans, jusqu'en décembre 2008. L'échantillon final comptait 1800 personnes dont 15,6% étaient des femmes et 84,4%, des hommes. Résultats : Il y avait peu de différences démograhiques, mais les femmes avaient un fonctionnement psychosocial plus élevé que celui des hommes. Les hommes comme les femmes avaient de longs antécédents de santé mentale, les femmes étant plus susceptibles de recevoir un diagnostic de trouble de l'humeur ou de la personnalité et les hommes, un diagnostic du spectre de la schizophrénie ou d'un trouble lié aux substances. La nature de l'infraction répertoriée ne différait pas selon le sexe, sauf que les femmes étaient plus susceptibles d'avoir commis un meurtre ou une tentative de meurtre. Pour les infractions contre la personne, les femmes étaient plus susceptibles de s'en prendre à leurs enfants et leurs partenaires et moins à des étrangers, comparées aux hommes. Elles avaient des antécédents criminels significativement moins lourds que les hommes. Conclusions : Les femmes NCRTM ont un profil psychosocial, clinique et criminologique distinct de celui des hommes, suggérant ainsi qu'une évaluation, une gestion de risque et un traitement sexospécifiques dans les services psycho-légaux po

Canadian legislation makes Review Boards (RBs) responsible for rendering dispositions for individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD) after considering public safety, the mental condition of the accused, and his/her potential for community reintegration. We reviewed 6,743 RB hearings for 1,794 individuals found NCRMD in the three largest Canadian provinces to investigate whether items from two empirically supported risk assessment measures, the Historical Clinical Risk Management‐20 and the Violence Risk Appraisal Guide, were considered. Less than half the items were included in expert reports or in RBs' reasons for dispositions, and consideration of these items differed according to gender and index offense severity of the accused. These items included evidence‐based risk factors and/or legally specified criteria: mental health, treatment, and criminal history. These results illustrate the gap between research on risk factors and the integration of this evidence into practice. In particular, we recommend the implementation of structured measures to reduce the potential for clinicians to be unduly influenced by gender and offense severity.

Occupational prestige is a measure used in sociology of occupations to establish the social status of a job as a hierarchized continuum. The measure can be defined according to income, level of supervision, independence, and competence. Based on interviews with violators committed to imprisonment (n = 133), this study assesses the applicability of the notion of prestige to illicit occupations. Results show that the domains of activities associated with illicit occupations are not consistent regarding prestige, contrary to licit occupations. Some of the characteristics that define the prestige of licit occupations, such as income and competence, contribute to define the prestige of illicit ones as well. The criminal milieu reveals specific characteristics, among which is the difficulty to obtain occupational stability. Studying criminality with the same notions we use for the population at large allows us to compare both environments to understand their components and differences. And understanding social desirability within the criminal milieu would allow for a better understanding of the permutations in an offender’s career, that is, what motivates a delinquent to go back and forth between criminal and conventional occupations. ; Le prestige occupationnel est une mesure utilisée en sociologie des professions pour déterminer le statut social d’un emploi sous la forme d’un continuum hiérarchisé. Cette mesure peut être définie selon : le revenu, le niveau de supervision, l’autonomie et les compétences. En se basant sur des entrevues auprès de délinquants incarcérés (n = 133), cette étude évalue si cette notion de prestige s’applique aux occupations illicites. Les résultats suggèrent que, contrairement aux occupations licites, les domaines d’activité des occupations illicites ne présentent pas d’homogénéité en ce qui concerne le prestige. Certaines caractéristiques définissant le prestige des occupations licites, comme le revenu et la compétence, contribuent aussi à dé

In Canada, Review Boards are mandated to evaluate individuals found Not Criminally Responsible on Account of Mental Disorder (NCRMD) on an annual basis and render 1 of 3 dispositions: (a) custody, (b) conditional discharge, or (c) absolute discharge. To promote social reintegration, conditional discharge can be ordered with the condition to live in supportive housing. However, NCRMD accused face great barriers to housing access as a result of the stigma associated with the forensic label. The goal of this study was to evaluate the role of housing in the clinical and criminal trajectories of forensic patients as they reintegrate into the community. Data for this study were extracted from a national study of individuals found NCRMD in Canada (Crocker, Nicholls, Seto, Côté, et al., in press). The present study focuses on a random sample of NCRMD accused in the province of Québec, who were under a conditional discharge disposition during the study period (n = 837). Controlling for sociodemographic, clinical, and criminal variables, survival analysis showed that individuals placed in independent housing following a conditional discharge from the Review Board were 2.5 times more likely to commit a new offense, nearly 3 times more likely to commit an offense against a person, and 1.4 times more likely to be readmitted for psychiatric treatment compared with individuals residing in supportive housing. These results point to the influence housing can have on the trajectories of forensic patients, above and beyond a range of clinical, criminological, and sociodemographic factors.

Objective : To examine the processing and Review Board (RB) disposition outcomes of people found not criminally responsible on account of mental disorder (NCRMD) across the 3 most populous provinces in Canada. Although the Criminal Code is federally legislated, criminal justice is administered by provinces and territories. It follows that a person with mental illness who comes into conflict with the law and subsequently comes under the management of a legally mandated RB may experience different trajectories across jurisdictions. Method : The National Trajectory Project examined 1800 men and women found NCRMD in British Columbia (n = 222), Quebec (n = 1094), and Ontario (n = 484) between May 2000 and April 2005, followed until December 2008. Results : We found significant interprovincial differences in the trajectories of people found NCRMD, including time detained in hospital and time under the supervision of an RB. The odds of being conditionally or absolutely discharged by the RB varied across provinces, even after number of past offences, diagnosis at verdict, and most severe index offence (all covariates decreased likelihood of discharge) were considered. Conclusions : Considerable discrepancies in the application of NCRMD legislation and the processing of NCRMD cases through the forensic system across the provinces suggests that fair and equitable treatment under the law could be enhanced by increased national integration and collaboration., Objectif : Examiner les résultats du processus et des dispositions de la Commission d'examen (CE) pour les personnes déclarées non criminellement responsables pour cause de troubles mentaux (NCRTM) dans les 3 provinces les plus populeuses du Canada. Le Code criminel relève de la compétence du gouvernement fédéral, mais la justice pénale est administrée par les provinces et territoires. Il s'ensuit qu'une personne ayant un trouble mental qui a des démêlés avec la justice et qui est subséquemment placée sous la supervision d'une CE peut connaître différentes trajectoires dans différentes juridictions ou régions ou provinces. Méthode : Le Projet national des trajectoires a permis d'examiner 1800 hommes et femmes déclarés NCRTM en Colombie-Britannique (n = 222), au Québec (n = 1094) et en Ontario (n = 484) de mai 2000 à avril 2005, et de les suivre jusqu'en décembre 2008. Résultats : Nous avons constaté des différences interprovinciales significatives dans les trajectoires des personnes déclarées NCRTM, notamment le temps de détention dans un hôpital et le temps sous la supervision d'une CE. Les probabilités d'une libération conditionnelle ou absolue accordée par la CE variaient entre les provinces, même après examen du nombre d'infractions passées, du diagnostic au verdict, et des infractions répertoriées les plus graves (toutes les covariables réduisaient la probabilité d'une libération). Conclusions : Les écarts considérables dans l'application de la législation NCRTM et dans le traitement des cas NCRTM au sein du système psycho-olégal entre les provinces suggèrent qu'un traitement juste et équitable en vertu de la loi pourrait être amélioré par une plus grande intégration et collaboration nationale.

Objective: Few studies have addressed use of resources in police interventions involving individuals with mental illness. The time police officers spend on interventions is a straightforward measure with significant administrative weight, given that it addresses human resource allocation. This study compared the characteristics of police interventions involving individuals with mental illness and a control sample of individuals without mental illness. Methods: A total of 6,128 police interventions in Montreal, Québec, were analyzed by using a retrospective analysis of police intervention logs from three days in 2006. Interventions involving citizens with (N=272) and without (N=5,856) mental illness were compared by reason for the intervention, the use of arrest, and the use of police resources. Results: Police interventions involving individuals with mental illness were less likely than those involving individuals without mental illness to be related to more severe offenses. However, interventions for minor offenses were more likely to lead to arrest when they involved citizens with mental illness. Interventions for reasons of equal severity were twice as likely to lead to arrest if the citizen involved had a mental illness. After controlling for the use of arrest and the severity of the situation, the analysis showed that police interventions involving individuals with mental illness used 87% more resources than interventions involving individuals without mental illness. Conclusions: Future studies using administrative police data sets could investigate the use of resources and division of costs involved in new programs or partnerships to better address the interface of criminal justice and mental health care.

The majority of individuals found not criminally responsible on account of mental disorder (NCRMD) in Canada spend some time in hospital before they are conditionally or absolutely (no conditions) discharged to the community by a legally mandated review board. By law, the decision to conditionally discharge an individual found NCRMD should be guided by the need to protect the public, the mental condition of the accused, and the other needs of the accused, especially regarding his/her community reintegration. At the time of this study, Canadian legislation and case law required that the review board disposition should be the "least onerous and least restrictive" possible for the accused. This means that, if there is no evidence that the person poses a significant risk to public safety, he/she must be released. However, the Canadian Criminal Code does not specify the criteria that must be considered when making this risk assessment. This leads to two questions. (1) What predicts review board dispositions? (2) To what extent do disposition determinations reflect evidence-based practices? The present study examined dynamic and static predictors of detention in custody, conditional discharge (CD), and absolute discharge (AD) dispositions among persons found NCRMD across the three largest provinces in Canada. The National Trajectory Project (NTP) examined men and women found NCRMD in British Columbia (BC), Québec (QC), and Ontario (ON) between May 2000 and April 2005, followed until December 2008. For the purposes of this study, individuals who had at least one hearing with a review board were extracted from the NTP dataset (N = 1794: QC = 1089, ON = 483, BC = 222). Over the course of the study, 6743 review board hearings were examined (QC = 3505, ON = 2185, BC = 1053). Despite advances in the risk assessment field, presentation of a comprehensive structured risk assessment to the review board was not the norm. Yet our findings suggest that review boards were taking into

Objective: The number of police interventions with people presenting a mental health problem has been increasing over the past 30 years and police services are becoming more aware of the human resources and skills these interventions require. Our study addresses the characteristics explaining police time used and outcomes of interventions as police officers interact with people with mental illness. Method: Using a police service administrative database from a large Canadian city, and an identification algorithm method, police interventions with people with mental illness were identified on 3 randomly selected days in the year. A content analysis of intervention logs was carried out to identify characteristics of those interventions; the call initiator, the location, and the final outcome of the intervention. Results: Interventions with people with mental illness represent a small proportion (3%; n = 272) of all police interventions (n = 8485). General linear models show that the type of outcome is the most important factor in estimating the time required by police interventions. Arrests and hospitalizations are the least time-efficient outcomes, consuming 2.0 and 3.2 times, respectively, more time than informal dispositions. A multiple correspondence analysis shows that police interventions can be depicted in 2 dimensions, representing their main roles concerning people with mental illness, namely, to ensure the public safety and to protect the most vulnerable citizens. The more these services are required, the more police time will be required. Conclusion: Education and partnerships between police services and mental health services are essential to a proper management of outcomes.

Le traplining est une stratégie de quête alimentaire permettant aux animaux d'exploiter des points de ressources renouvelables dans le temps et distribués de façon inégale dans l'environnement et ce, dans un ordre fixe et répété de façon prévisible. Un exemple bien connu de ressources qui aurait avantage à être exploité par traplining est le nectar présent dans les fleurs. On distingue deux composantes principales au traplining . La première est temporelle du fait que l'animal doit exploiter la fleur du moment que la quantité de nectar générée est suffisante pour au moins combler les pertes énergétiques engendrées par les déplacements, mais sans trop de délais afin de minimiser les pertes occasionnées par les compétiteurs. La deuxième composante est spatiale. L'animal doit exploiter les parcelles de nourriture dans un ordre fixe, répété et prévisible. À ce jour, ce comportement fut généralement décrit de façon plutôt anecdotique en nature ou observé et étudié de façon plus formelle en captivité. De plus, la composante spatiale fut très souvent, sauf pour quelques exceptions, négligée. Cette négligence s'explique d'une part, parce que les nectarivores sont généralement très petits et d'autre part, parce qu'ils se déplacent très rapidement sur de grandes distances, ce qui rend le suivi de leurs déplacements difficiles. Dans cette étude, je développe un indice permettant de quantifier ce comportement au niveau spatial et modélise cet indice en fonction de variables écologiques afin de mieux comprendre les motivations d'un individu à adopter cette stratégie d'exploitation des ressources, et ce, en utilisant comme modèle d'étude le Colibri à gorge rubis Archilochus colubris et une technique innovatrice de suivi des déplacements de ces petits oiseaux. Mes résultats montrent qu'il existe une grande variabilité entre les individus, de même qu'entre les jours pour un individu donné, au niveau de la conformité des patrons de déplacements entre les sources de nectar et les pat

With the increased need to assess and manage risk in inpatient settings, the Short-Term Assessment of Risk and Treatability (START) was implemented on a civil psychiatric unit. The goal of the present study was to examine the tool's predictive validity when completed by clinical teams as part of routine practice. Data were collected for 34 patients hospitalized for a minimum of 30 days prior to and after a START evaluation. Several challenging behaviors, such as aggression towards others, self-harm, and substance abuse were assessed using the START Outcomes Scale (Nicholls et al., 2007 Nicholls, T. L., Gagnon, N., Crocker, A. G., Brink, J. H., Desmarais, S. L. and Webster, C. D. 2007. START Outcome Scale SOS, Vancouver, , Canada: BC Mental Health & Addiction Services. [Google Scholar] ). Results from multilevel logistic regression and Receiver Operating Characteristics analyses lend partial support for the predictive validity of the START. A limited set of START items combined was significantly better at predicting the challenging behaviors than the original total Strength and Vulnerability scales. Results are discussed in terms of the clinical use of risk assessment.