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Several states have recently adopted legislation in support of pre-arrest diversion programs that give police the authority to refer adults with behavioral health needs to treatment providers instead of placing them under arrest and booking them into local jails. The Adult Civil Citation program has been operating since 2013 to divert adults accused for the first time of a misdemeanor offense to a community behavioral health provider with the primary goal of addressing underlying needs that are likely to be associated with future criminal justice contact. The current study analyzed data from a sample of 1,071 adults who participated in the program to assess the impact of behavioral health indicators on time-to-rearrest. Adults who presented greater behavioral health needs were more likely to come into subsequent contact with police, but these indications did not influence the amount of time that lapsed between program participation and rearrest events. [ABSTRACT FROM AUTHOR]

Problem-solving courts (PSCs) developed as a means of mandating treatment and judicial supervision of certain types of court participants. PSCs have rapidly expanded in number and type over several decades. Mental health courts (MHCs) are a type of PSC that arose in response to the growing number of persons with mental illness within the criminal justice system. Their primary role is to divert individuals with mental illness from incarceration into psychiatric treatment and to reduce recidivism while improving psychosocial functioning of participants. Although different in history, philosophy, and program structure, forensic assertive community treatment (FACT) programs serve a similar goal of reducing recidivism and improving functioning in persons with mental illness who are involved with the criminal justice system. FACTs may be used as a standalone diversion option or be linked with a MHC as a form of intensive treatment and monitoring. Suggestions for future research and evaluation of these programs are offered. [ABSTRACT FROM AUTHOR]

The most effective point of intervention to prevent unnecessary arrest/incarceration of persons with serious mental illnesses is the initial encounter with police. We piloted a new police-mental health linkage system. When officers run an enrolled participant's name/identifiers, they receive an electronic message that the person has mental health considerations and that they should call for information. The linkage specialist receives the call and assists telephonically. In this qualitative study to examine acceptability of the linkage system, we conducted nine focus groups with diverse stakeholders (e.g., enrolled patients, officers). Focus groups revealed that patients enrolled with the hope that the linkage system would prevent negative interactions with police and minimize risk of arrest. Officers reported preferring not to arrest mental health patients and were genuinely invested in helping them, and felt that the linkage system might be an additional tool during encounters. Findings revealed acceptability of the intervention, and further research is warranted. [ABSTRACT FROM AUTHOR]

Officers' volunteering for Crisis Intervention Team (CIT) training-rather than being assigned-is assumed to be an important, beneficial self-selection bias. This bias remains poorly characterized, though CIT officers are more likely to be female and to have had exposure to the mental health field. We determined whether or not self-selection is beneficial with regard to knowledge, attitudes, and skills, as well as level of force used (i.e., no or low force versus any form of physical force) and disposition of subjects, in actual encounters. We compared CIT-trained officers who had volunteered with those who had been assigned using data from two prior, linked studies that compared CIT-trained and non-CIT officers on knowledge, attitudes, and skills (251 CIT-trained officers; 68% had volunteered), as well as behaviors (517 actual encounters provided by 91 CIT-trained officers; 70% had volunteered). Of 28 scores on knowledge, attitudes, and skills compared, six were statistically significantly different (p < .01) and another eight were marginally significant (.01 < p < .05). Furthermore, although CIT officers who had volunteered were more likely to report use of some form of physical force as we had defined it (which included the use of handcuffs), when they did so they were more likely to refer to treatment services and less likely to make an arrest. These effects were apparent even when taking into account effects of gender, having had exposure to the mental health field, empathy, and other covariates. In conclusion, we found evidence for benefits of self-selection/volunteering that should be further characterized, as it appears to be associated with better outcomes with regard to key attitudes, skills, and behaviors. [ABSTRACT FROM AUTHOR]

The crisis intervention team (CIT) is a tool that can be used to foster pre-booking diversion of individuals with mental illness from the criminal justice system and into community treatment services. Although CIT is often implemented solely as the training of law enforcement officers, the model stipulates that CIT is a vehicle for collaboration with community stakeholders who share a similar philosophy, as well as expanded mental health services offering a 24 hour-seven days per week drop-off option for law enforcement officers. This case study presents the countywide implementation of CIT and expands previous findings on the prevalence of officer interaction with persons with mental health issues and CIT training outcomes, including changes in officer perception of individuals with mental health issues. Furthermore, analysis of the disposition of calls for officer assistance coded as mental health or suicide found significant increases in officer drop-offs to the mental health crisis center post-CIT training. Interrupted time series analysis determined that this change has been sustained over time, perhaps owing to the unique communication between county law enforcement and mental health staff. Implications for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

In recent decades, there has been sustained focus on police responses to persons experiencing mental health crises. The Crisis Intervention Team (CIT) model has been a seminal effort to improve safety, reduce arrests and enhance the use of emergency psychiatric assessment. With CIT well established, new discussions have emerged around how to further enhance the police-public health interface, including diversion from hospital emergency departments. In this context, this article takes stock of current police practices, utilizing descriptive data on 428 mental health-related calls addressed by Chicago Police over 3 years triangulated with insights from 21 in-depth officer interviews. During these calls, hospital transports were conducted more often than arrests. Moreover, informal interventions - without any legal action or hospitalization - were used most often, speaking to the "gray zone" nature of mental health-related encounters. Taken together, the data reveal the need for non-crisis diversion options that address chronic vulnerabilities. [ABSTRACT FROM AUTHOR]

The high prevalence of substance use, traumatic brain injury, post-traumatic stress disorder, and other mental illness in the veteran population presents unique public health and social justice challenges. Veteran involvement in the justice system has been identified as a national concern. Criminal justice involvement compounds pre-existing socioeconomic stressors and further strains support systems. The point of contact with the criminal justice system, however, presents an opportunity to establish mental health treatment. This is consistent with the concept of the sequential intercept model that seeks to divert offenders with mental illness from the criminal justice system into treatment. In recent years, many jurisdictions have established veterans treatment courts (VTCs), a type of problem-solving court serving this diversion function for military veterans. This article presents an overview of the problem, the ethical basis for their development, a brief history of the courts, and their potential for success. The Harris County Veterans Court is presented as an example. [ABSTRACT FROM AUTHOR]

Given fragmentation between mental health and criminal justice systems, we tested the feasibility of implementing a potential new form of pre-booking jail diversion. Our "linkage system" consists of three steps: (i) individuals with serious mental illnesses and an arrest history give special consent to be enrolled in a statewide database; (ii) if an officer has an encounter with an enrolled patient and runs a routine background check, he or she receives an electronic message to call; and (iii) the "linkage specialist" provides brief telephonic assistance to the officer. Of 206 eligible individuals, 199 (96.6%) opted in, the database received 679 hits, and the linkage specialist received 31 calls (and in at least three cases an arrest was probably averted). The mean number of arrests was 0.59 ± 0.92 in the year before enrollment (38.7% arrested) and 0.48 ± 0.83 during the 12-month intervention (30.7% arrested). Implementation is feasible, and a signal that the system might reduce incarceration was detected, encouraging development of a larger study. [ABSTRACT FROM AUTHOR]

As academic researchers, we are often asked to opine on whether the Crisis Intervention Team model (CIT) is an evidence-based practice (EBP) or evidence-based policing. Our answer is that it depends on how you define evidence-based practice and what outcome you are interested in. In this commentary, we briefly describe the CIT model, examine definitions of evidence-based practice and evidence-based policing, and then summarize the existing research on what is known about the effectiveness of CIT to date. We conclude that CIT can be designated an EBP for officer-level cognitive and attitudinal outcomes, but more research is needed to determine if CIT can be designated an EBP for other outcomes. Using an evidence-based practice process approach, CIT may also be a justified strategy for many communities. Future directions to inform the field are discussed. [ABSTRACT FROM AUTHOR]

Diversion programs screen justice-involved individuals for the presence of psychiatric disorders, and after negotiations take place with attorneys and treatment providers, these programs link participants with community-based treatment programs in lieu of incarceration. As the number of diversion programs, including mental health courts, continues to rapidly grow, so does the need for "diversion evaluations". Diversion evaluations are a type of forensic mental health assessment (FMHA) conducted to assist the courts in making decisions regarding diversion eligibility. As a result, they should follow the general principles of FMHA and the American Academy of Psychiatry and Law Practice Guideline for Forensic Assessment. Diversion evaluations also require application of specific areas of knowledge and experience, as court-based diversion is a unique, therapeutically focused context that is purposefully non-adversarial. The diversion evaluator is a role that combines objective decision-making with clinical consultation. The purpose of this article is to apply generally accepted forensic report standards to diversion evaluations, with a particular focus on the unique issues of diversion-specific forensic evaluations. [ABSTRACT FROM AUTHOR]

This study assessed perceptions of voluntary consent among 69 veterans who enrolled in a "jail diversion" program for co-occurring disorders. Perceptions were measured using modified items from the MacArthur Perceived Coercion and Negative Pressure Scales. A majority reported that they "chose to" (88.4%) or "felt free to" (85.5%) enroll. Most reported having "control over" (69.6%) and "more influence than anyone else" regarding (60.9%) their participation. About half reported that enrollment was "their idea" (49.3%). Fewer reported perceptions of negative pressure, including the feeling that someone "talked them into" enrolling (24.6%), "threatened them with the maximum criminal punishment" (13.0%), "offered or promised them something" (5.8%), or "forced" them to enroll (5.8%). Nobody felt "tricked, lied to, or fooled into" participating. Total negative pressure scores were higher in those with combat experience, U = 406.50, p = .016. Although potentially inappropriate pressures were reported, these data suggest that the majority perceived enrollment as voluntary. [ABSTRACT FROM AUTHOR]

A conceptual model for community-based strategic planning to address the criminalization of adults with mental and substance use disorders, the Sequential Intercept Model has provided jurisdictions with a framework that overcomes traditional boundaries between the agencies within the criminal justice and behavioral health systems. This article presents a new paradigm, Intercept 0, for expanding the utility of the Sequential Intercept Model at the front end of the criminal justice system. Intercept 0 encompasses the early intervention points for people with mental and substance use disorders before they are placed under arrest by law enforcement. The addition of Intercept 0 creates a conceptual space that enables stakeholders from the mental health, substance use, and criminal justice systems to consider the full spectrum of real-world interactions experienced by people with mental and substance use disorders with regard to their trajectories, or lack thereof, through the criminal justice system. [ABSTRACT FROM AUTHOR]

This study examined the mental health court (MHC) outcomes of 160 adult offenders with developmental disabilities and co-occurring disorders of mental health or substance abuse who were serviced by the forensic unit of an agency. A descriptive analysis of 120 offenders evaluated by the court clinic identified 23 (19.2%) with developmental disabilities only and three groups with co-occurring disorders including 32 (26.7%) with substance abuse disorders, 45 (37.5%) with mental health disorders, and 20 (16.7%) with mental health and substance abuse disorders. There was no clinical evaluation of the other 40 participants. Crimes varied from burglary to conspiracy using weapons, drug and narcotics trafficking, and theft. For MHC and non-MHC judges, differences in court outcomes were revealed with regard to community control (67% vs. 62%), prison sentences (33% vs. 38%), and recidivism rates. For best practice, additional disability-specific training was recommended for judges and other court professionals. [ABSTRACT FROM AUTHOR]

This article begins with the history of the rise and fall of the state hospitals and subsequent criminalization of persons with serious mental illness (SMI). Currently, there is a belief among many that incarceration has not been as successful as hoped in reducing crime and drug use, both for those with and those without SMI. Moreover, overcrowding in correctional facilities has become a serious problem necessitating a solution. Consequently, persons with SMI in the criminal justice system are now being released in large numbers to the community and hopefully treated by public sector mental health. The issues to consider when releasing incarcerated persons with SMI into the community are as follows: diversion and mental health courts; the expectation that the mental health system will assume responsibility; providing asylum and sanctuary; the capabilities, limitations, and realistic treatment goals of community outpatient psychiatric treatment for offenders with SMI; the need for structure; the use of involuntary commitments, including assisted outpatient treatment, conservatorship and guardianship; liaison between treatment and criminal justice personnel; appropriately structured, monitored, and supportive housing; management of violence; and 24-hour structured in-patient care. Copyright © 2017 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The article highlights laws concerning criminal prosecution of individuals with mental illness, cognitive deficiencies, and/or developmental disabilities that impact the individual's capacity and criminal responsibility. It addresses needed reforms in the New York criminal justice system for individuals with disabilities and advocates for an increase in the use of alternative sanctions as well as the expansion of mental health courts and other diversion models.

The article discusses the court case Atkins v. Virginia wherein the U.S. Supreme Court held that execution of intellectually disabled people is cruel and unusual punishment in violation of the Eighth Amendment. Topics discussed include creation of a legal framework by Texas Court of Criminal Appeals (CCA) to govern claims related to execution of disabled; creation of new categories of assessment Briseno factors by CCA; and CCA recognizing Brienso factors as unconstitutional.

This study examined demographic characteristics of 315 adult offenders with developmental disabilities receiving forensic services in one northeast Ohio urban setting. Data were entered in an SPSS database, and frequency and cross-tabulation tests were performed to determine the most prominent characteristics of the participants. The sample included 295 (93.65%) male offenders and was composed of African Americans (198; 62.86%); whites (77; 24.44%); Hispanics/non-Hispanic Latinos (6; 1.9%); and others (34; 10.8%). The majority of initial charges included drug possession, felonious and aggravated assault, and receiving stolen property. Disposition charges ranged from drug trafficking offenses to burglary. Recidivism varied depending on length of time post-disposition: six, twelve, or eighteen months. A profile was developed to improve the development of service delivery models aimed at enhancing success. Social advocacy and collaborative approaches within the criminal justice system are necessary for successful services tailored to meet these adult offenders' needs. [ABSTRACT FROM AUTHOR]

Although some authors have suggested that there are higher rates of people with Autism Spectrum Disorder (ASD) in forensic and offending groups, systematic studies have not supported the hypothesis. The present study reviewed 477 referrals made to forensic intellectual disability (ID) services in one calendar year. It was found that 10% of referrals had ASD, a figure similar to the general population of people with ID. Those with ASD had similar patterns of offending to those without but they showed a lower prevalence of contact sexual offences and fewer had been previously charged. We concluded that there is no persuasive evidence that ASD is a risk factor for offending or for any particular type of offending. [ABSTRACT FROM AUTHOR]

Purpose. To compare characteristics of sex offenders with an intellectual disability (ID) referred to community-based and different levels of secure services. To identify those characteristics, which predict referrals to community-based or secure services. Methods. A total of 131 cases of sex offenders with ID referred to an ID service in a number of health board regions in the UK in 2002 (and 2003 for high secure referrals) were reviewed. Data were collected on demographic information, ethnicity, level of learning disability, possible medical diagnoses, psychiatric diagnoses, abuse experienced in childhood, living circumstances, employment or occupation, referring agent, legal status on day of referral, index behaviour, age at time of index behaviour, charges, legal status on day of index behaviour, previous problematic behaviour, and previous offending. Data were entered into a binomial logistic regression model in an attempt to predict the referrals to community-based services. Results. Numerous characteristics were found to be associated with the different levels of service security, but only two predictor variables retained a strong association with community or secure referrals in the model. The likelihood of the offender being referred to a community-based service increased if they were based in the community at the time of the index behaviour and decreased as the diversity of problematic behaviour exhibited by the offenders increased. Conclusions. Given the relatively high proportion of referrals to community-based services and the fact that many of these referrals had a complicated offence history, it is important that community-based services are properly equipped and resourced to deal with such referrals. In particular, the case is made that services for sexual offenders with ID at all levels of security should at least have available interventions directed at aggression. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the use of simulation in educating police about mental illness in Canada. It looks at the support shown by interactions police to the comprehensive police education as well as offers statistics related to mental illness and the prevalence of police interactions with people with mental health challenges. The extent of the simulations' ability to be used as a tool to educate police officers on mental illness is discussed.

Highlights: [•] Minimal differences of ID mixed sex and non-sex offenders on dynamic client factors. [•] Minimal differences of ID mixed sex and non-sex offenders on environmental factors. [•] There are possible common factors for a more general theory of offending behavior. [Copyright &y& Elsevier]

The article discusses a proposal which prohibit felons from possessing firearms in Vermont. It provides an overview of the federal firearms law and the development and rationale behind the different categories of people prohibited from gun ownership. It examines the different approaches of different state in prohibiting felons from firearm possession. It talks about the legal culture in the state and proposes a statute that restricts gun ownership for felons. It adds that the proposed statute bans most felons and those convicted of domestic crimes, as well as people with a history of mental illness, from owning firearms for a period of time after their conviction or after their illness has subsided.

The article focuses on a study on the decision-making process in identifying mentally ill individuals who are appropriate for jail diversion programs. The study revealed that a greater number of those who are included in the program are composed of women, whites, and older persons. Those who were charged of felony and violence are less likely to be included in the program. It was concluded that there is disproportionate representation among individuals for jail diversion programs. Examination on the process of choosing individuals that must be included in the programs is recommended.

Editorial. Discusses key issues and developments relevant to the treatment of mentally disordered offenders. Concept of evidence-based treatment; Developments in forensic mental health service; Psychoanalytic type approach to emotional disturbance and antisocial behavior in young people.

Forensic nursing is a fast-developing branch of psychiatric nursing and now at an international level covers many aspects of practice. As its field of study develops to incorporate working with vicyims, survivors and offenders, it becomes increasingly important to establish the evidence base for the practice areas. This paper outlines these developing areas and highlights the expansive nature when see from an international perspective. [ABSTRACT FROM AUTHOR]

The article discusses the international norms on the execution of the insane. It is stated that international human rights law is considering the abolition of death penalty especially for certain categories of people such as juveniles, pregnant women, and the insane. However, no treaty provision exists to protect the insane from death penalty. According to the author, the prohibition of death penalty for the insane will have consequences both in international and domestic laws.

Background: Tragic and high profile killings by people with mental illness have been used to suggest that the community care model for mental health services has failed.Aims: To consider whether such homicides have become more frequent as psychiatric services have changed.Method: Data were extracted from Home Office-generated criminal statistics for England and Wales between 1957 and 1995 and subjected to trends analysis.Results: There was little fluctuation in numbers of people with a mental illness committing criminal homicide over the 38 years studied, and a 3% annual decline in their contribution to the official statistics.Conclusions: There are many reasons for improving the resources and quality of care for people with a mental disorder, but there is no evidence that it is anything but stigmatising to claim that their living in the community is a dangerous experiment that should be reversed. There appears to be some case for specially focused improvement of services for people with a personality disorder and/or substance misuse. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the criminal behavior of mentally retarded adults. Results noted that a higher percentage of the severely retarded criminals engaged in crime due to the impulsive reactions to momentary stimuli compared among the general population of the prison. The criminal act of the severely retarded which has been observed based from the generalization implies that the adult of lower intelligence does not have the capacity for adequate foresight.

Discusses findings of a study of retarded persons prior to and after adjudication proceedings. Misconceptions about the retarded individual who comes into conflict with the law; Series of chi-square analyses aimed at determining the extent to which the questionnaire items were associated; Process of arrest and temporary confinement of a retarded person pending legal action.