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The psychological constructs of teachers have become the focus of a growing line of research in numerous studies in both mainstream and second language teacher education over the recent decades. Many studies have addressed the relationship between teacher commitment and other variables; however, its interaction with teacher burnout and school climate has not received much attention in EFL contexts. The present study investigated the mediating role of teacher burnout and school climate in predicting teacher commitment among Iranian high school EFL teachers. In doing so, 417 teachers completed three measuring instruments: English Language Teacher Commitment Questionnaire, Revised School Level Environment Questionnaire, and Maslach Burnout Inventory. The results of hierarchical regression analysis demonstrated that teacher burnout and school climate could predict teachers' commitment to their profession. Although both variables had a unique effect on teacher commitment, school climate was a stronger predictor of teacher commitment. The results can offer implications for EFL teachers, school principals, educators, and teacher education programs. [ABSTRACT FROM AUTHOR]

Perception is riddled with cases of reliable misperception. These are cases in which a perceptual state is tokened inaccurately any time it is tokened under normal conditions. On the face of it, this fact causes trouble for theories that provide an analysis of perceptual content in non‐semantic, non‐intentional, and non‐phenomenal terms, such as those found in Millikan (1984), Fodor (1990), Neander (2017), and Schellenberg (2018). I show how such theories can be extended so that they cover such cases without giving up their core commitments. [ABSTRACT FROM AUTHOR]

Using a feminist institutional approach, we examine the dominant institutional views and frameworks explaining company positions regarding the implementation of gender policies. A multiple case study was performed on four Spanish companies involved in sectors related to the circular bioeconomy. The analysis relied on secondary sources and semi-structured interviews with women in positions of responsibility in these companies. The results provide evidence on the gender issues encountered and their limitations in terms of organizational change, as well as the dominant institutional frameworks of the companies. The findings suggest that the main drivers for change are intense state regulation, company commitment to formalizing measures and the presence of critical actors. [ABSTRACT FROM AUTHOR]

The concept of commitment is widely used, has been little analyzed formally. It contains an implicit explanation of a mechanism that produces an ongoing form of human behavior. Commitments arise when a person links others' interests with a constant line of activity when making a side or additional bet. Side bets are often the result of the person's participation in social organizations. To fully understand commitments, an analysis of the value system within which these side bets are made is needed. [ABSTRACT FROM AUTHOR]

The article presents the vicissitudes of Professor Anna Przecławska’s life, showing how they influenced her scientific and didactic work, social commitment and attitude towards other people. Thus, reference was made to the period of happy childhood interrupted by the outbreak of World War II, scouting and underground activities, including service as a nurse in the Warsaw Uprising. These events meant that throughout her life she undertook tasks that went far beyond the requirements of everyday life. They also directed her research on topics related to the role of reading in the lives of young people, the world of young people’s values and transformations of culture in the context of upbringing problems. A. Przecławska also emphasized the need to reinterpret the concept of the educational environment in social pedagogy and the importance of serving people, which she considered a constant principle in pedagogy and in her life, changing the world in accordance with the competences she possessed. [ABSTRACT FROM AUTHOR]

Verbal and physical violence in psychiatric hospitals can have harmful consequences for staff members, such as physical injury, traumatisation, and sick leave, and they often accompany involuntary admission. Harm to others may co-occur with self-harm, i.e., dual harm. However, little is known about the association between dual-harm and violent behaviour towards staff members and its clinical outcomes, such as seclusion and rapid tranquilisation after involuntary admission to a psychiatric inpatient unit. A convenience sample of patients admitted involuntarily (N = 384; mean age = 48.03, SD = 19.92) between January 2016 and December 2019 in Western Brabant, the Netherlands, was used to design a retrospective file audit. Distinct harm groups, marked by the presence/absence of self- and/or other-harm, were investigated using multivariate linear regression modelling on the seriousness of violent acts and the total length of admission. Logistic regression analyses were used to study the association between harm groups and the administration of rapid tranquilisation, seclusion, and extended involuntary admissions. Several harm groups were identified, including self-harm only, other-harm only, and dual-harm groups. Psychiatric patients admitted to the hospital because of (the risk of) violence towards others had a higher risk of violent incidents during admission and some restrictive measures. In a subgroup of patients with psychotic disorders, patients with dual harm committed the most serious violent incidents compared to those in the other harm groups. Distinct harm groups were identified in a sample of involuntarily admitted patients. In a general adult psychiatric setting, patients at risk for violent behaviour, especially dual-harm patients, should be identified and monitored as part of the risk assessment. Future research is needed to explore more clinical correlates in the proposed distinction between harmful groups and to assess long-term prognosis. • The dual-harm patients in this sample did not have higher rates of personality or psychotic disorders. • Other-harm-only patients were the most likely to receive rapid tranquilization in the ward. • In patients with psychotic disorders, screening for dual-harmful behaviours upon admission is advisable. • Future research is needed to explore additional clinical correlates in the proposed distinction between the harmful groups. [ABSTRACT FROM AUTHOR]

This study examined the impact of statutory revisions in 2016 which aimed to enhance procedural justice within the process of civil commitment for persons diagnosed with mental illnesses (PDMI) in South Korea. These changes included requiring that PDMI pose a threat of danger to self or others and the need for treatment simultaneously as criteria for petitioning civil commitment. Additionally, the revision established a public entity to oversee the legitimacy of petitions to involuntarily commit PDMI to inpatient treatment. Despite these statutory changes, families providing care for PDMI still appear to depend on civil commitment as a way to seek respite from care burden, not necessarily to respond to psychiatric emergencies involving dangerousness. This practice seems to be aided by processes within the public entity providing oversight. Due to such barriers we hypothesized that, even after the statutory revision in 2016, PDMI who had been civilly committed following petitions from families will not exhibit elevated dangerousness compared to PDMI who had never been hospitalized during the same period. Trained interviewers recruited 331 participants self-identified as PDMI from psychiatric rehabilitation agencies in the community and aided them in completing a survey including measures of self-reported hospitalization history, suicidality, and aggression toward others. Participants were classified into four groups: Family-petition committed (FPC) group (n = 30, 9.1%), voluntarily hospitalized (VH) group (n = 34, 10.3%), public-petition committed (PPC) group (n = 31, 9.4%), and never hospitalized (NH) group (n = 236, 71.3%). We conducted logistic regression analyses to compare self-reported dangerousness between groups with the NH group as the reference group. In the past 12 months, 43.5% of PDMI participants had self-reported behaviors that may have met the dangerousness criteria for civil commitment. Controlling for confounding factors, the PPC group was 2.96 times and 3.02 times as likely to report suicidal ideation and physical aggression, respectively, compared to the NH group. However, as hypothesized, the FPC group did not differ from the NH group on any indicator of self-reported dangerousness. The findings were based on cross-sectional correlational data and should not be viewed as conclusive evidence that the 2016 statutory revision is ineffective in preventing family-petitioned civil commitment in cases where dangerousness is not apparent. Nevertheless, these findings encourage further empirical studies that illuminate the etiology of procedural justice in civil commitments petitioned by family members and that assess factors and contexts that promote the consideration of least coercive treatments, rather than resorting to involuntary hospitalization when psychiatric emergencies arise. • Persons with Mental Illnesses (PDMI) in South Korea were studied as to impacts of statutory revisions in 2016 that required dangerousness as criteria for petitioning civil commitment. • PDMI with family-petitioned civil commitment history, weren't expected to display increased danger post-2016 statutory revision. • Among 331 surveyed PDMI, those petitioned by family for civil commitment didn't show elevated dangerousness. • The findings encourage further empirical studies to illuminate the etiology of procedural (in)justice in civil commitments petitioned. [ABSTRACT FROM AUTHOR]

18 U.S.C. § 922(g)(4) imposes a lifetime ban on those who have been involuntarily committed to a mental institution from purchasing, or possessing a firearm, regardless of an extended passage of time, or a finding that the individual is unlikely to pose a danger to themselves or the public. Three circuits have created a split concerning the constitutionality of this statute. The Third Circuit held in Beers v. Attorney General United States that those involuntarily committed were outside of the scope of the Second Amendment; therefore, the § 922(g)(4)'s categorical ban is constitutional. Next, the Ninth Circuit in Mai v. United States assumed, without deciding, that these same individuals are inside of the scope of the Second Amendment but held § 922(g)(4) constitutional under intermediate scrutiny as applied to those whose commitments were long ago. Finally, the Sixth Circuit held in Tyler v. Hillsdale City Sheriff's Department, that individuals such as Tyler, who had been involuntarily committed into a mental institution, were within the Second Amendment's scope. The Sixth Circuit held § 922(g)(4) unconstitutional under intermediate scrutiny. [ABSTRACT FROM AUTHOR]

From the end of the Civil War to the onset of the Great War, the United States experienced an unprecedented increase in commitment rates for mental asylums. Historians and sociologists often explain this increase by noting that public sentiment called for widespread involuntary institutionalization to avoid the supposed threat of insanity to social well-being. However, that explanation neglects expanding rent seeking within psychiatry and the broader medical field over the same period. In this paper, we argue that stronger political influence from mental healthcare providers contributed significantly to the rise in institutionalization. We test our claim empirically with reference to the catalog of medical regulations from 1870 to 1910, as well as primary sources documenting rates of insanity at the state level. Our findings provide an alternative explanation for the historical rise in US institutionalizations. [ABSTRACT FROM AUTHOR]

Inspired by Of Hospitality, which consists of two texts on facing pages by Anne Dufourmantelle and Jacques Derrida, the authors hone in on an aporia in Dufourmantelle and Derrida's meditation on hospitality. Why are some forms of asylum considered and others only to be passed over? One author uses Derrida to critique the madness of Ontario and British Columbia's mental health acts, in which rights are stripped from the Mad through a system of carceral psychiatry and a logic that is haunted by its own madness. In a parallel text, the second author focuses on two aspects of Derrida's topology of hospitality, addressing the acts of letting madness into a dwelling and letting madness into the mind. The writing of this collaborative work took place through hospitality: the authors invited each other into their homes, and altered the texts of the host, rendering thresholds porous and troubling the ways in which madness is circumscribed and contained. [ABSTRACT FROM AUTHOR]

I once wrote a statement to make clear that I didn't consent to involuntary injections. Against the institutional power that included the threat of increased force--at each encounter with the psychiatric nurse, security staff on the ready, week after week--I read aloud this statement asserting that my submission should in no way be understood as consent. At its end I explained that one day I would write and publish an essay titled "I Call This Institutionalized Rape." This is that essay. [ABSTRACT FROM AUTHOR]

The Queensland Mental Health Review Tribunal makes difficult decisions regarding involuntary treatment of people with mental illness, applying strict legislative criteria against a backdrop of fundamental human rights considerations. This article reports on focus group research with lawyers and advocates for people with mental illness who appear before the Queensland Mental Health Review Tribunal. Participants expressed concerns regarding the manner in which decisions are made. For example, participants said that their clients' views on the side effects of treatment do not receive adequate consideration when involuntary treatment is authorised. We review these concerns in the light of applicable legal obligations, including those arising from human rights law. We conclude that if these concerns are accurate, some adjustments to the Queensland Mental Health Review Tribunal's decision-making processes are required. [ABSTRACT FROM AUTHOR]

This paper investigates the certification of insanity through a standardized template called Form K which was used in Ontario between 1873 and 1883. My main thesis is that the introduction of the Form K had profound and long-lasting effects on the determination of insanity. In particular, it created a unique case in the history of certification, it grounded civil confinement on a strategy of consensus, and it informed mental health documentation for more than a century. As the result of a transnational mediation from Victorian England, the Form K prescribed an examination setting which involved a high number of participants, including three physicians and several witnesses. By comparing this case with other jurisdictions of the time, this paper shows how Ontario became a distinctive case worldwide. In order to get a closer look at this medico-legal procedure, I consider the archival records of the Toronto asylum and conclude that the certification of insanity relied on a strategy of consensus. While the Form K proved quite successful in preventing legal actions, it produced financial, logistic, and bureaucratic issues. The Form K was thus discontinued after a decade, yet its structure influenced Ontario's mental health documentation throughout the twentieth century. This paper shows the relevance of the certification of insanity for transnational history and for understanding contemporary issues of involuntary confinement and stigma in mental health. [ABSTRACT FROM AUTHOR]

This article analyses the use of coercive measures in two national institutions for high-security psychiatry in Norway – Kriminalasylet (Criminal Asylum) and Reitgjerdet – during the period 1895–1978. Historical study of coercion in psychiatry is a fruitful approach to new insight into the moral and ethical considerations within the institutions. We approach the topic through a qualitative study of patient case files and ward reports from the institutions' archives, as well as a comprehensive quantification of the coercive measures used. The data show shifting considerations of humane treatment and changes in the respect for human dignity in the institutions' practices. They also show that technological developments, such as the introduction of new psychopharmaceuticals, did not necessarily lead to higher standards of treatment. [ABSTRACT FROM AUTHOR]

The article considers the antebellum history of the Franco-American Girard family, especially merchant husband Stephen and his wife Mary of Philadelphia, Pennsylvania by focusing on family correspondence about the onset of Mary's madness. Topics include Stephen's brother Jean who lived in the French colony of Saint-Domingue, issues of gender, capitalism, and cultural economy in the Atlantic world. Mary was diagnosed as being mad in the 1785 after eight years of marriage and by 1790, Stephen had Mary committed to Pennsylvania Hospital, where she remained until her death in 1815.

Involuntary admission is widely used in psychiatry, usually requiring that the patient present an imminent danger to himself or others. Previous studies have established several predictors for involuntary admission, but they have been almost exclusively conducted in Western European or North American countries. By contrast, data on this topic from Eastern European countries is virtually absent. Historically, involuntary admission has been often used as a tool for political repression in Romania before the fall of the communist regime. While there have been significant changes in the legal framework in the last 30 years, there is still no real-world data to build upon. We analyzed a sample of 177 patients admitted to the "Alexandru Obregia" psychiatric hospital in Bucharest between November 2022 and January 2023, of which 49.7% (88) were involuntary hospitalizations. We collected socio-demographic and clinical data by both by direct interview, and by consulting patient records, attending physicians and relatives. Socio-demographic factors predictive for involuntary admission were unemployment, lower income, and urban living. Of the clinical variables analyzed, diagnosis of psychosis or mania on admission carried increased risk of involuntary hospitalization, as did nonadherence to treatment, higher disease severity and aggression. Hospital presentation by police or ambulance carried significant additional risk compared to self-referral. Certain categories of patients are considerably more likely to be involuntarily hospitalized and there appears to be considerable interrelatedness between the identified risk factors. [ABSTRACT FROM AUTHOR]

Involuntary admissions (IA) to psychiatric hospitals are controversial because they interfere with people's autonomy. In some situations, however, they appear to be unavoidable. Interestingly, not all patients perceive the same degree of coercion during IA. The aim of this study was to assess whether the level of knowledge about one's own IA is associated with perceived coercion. This multicenter observational study was conducted on n = 224 involuntarily admitted patients. Interviews were conducted at five study centers from April 2021 to November 2021. The Macarthur Admission Experience Survey was administered to assess perceived coercion. Knowledge of involuntary admission, perceptions of information received, and attitudes towards legal aspects of involuntary admission were also assessed. We found that higher levels of knowledge about IA were negatively associated with perceived coercion at admission. Perceived coercion did not differ between study sites. Only half of the patients felt well informed about their IA, and about a quarter found the information they received difficult to understand. Legislation in Switzerland requires that patients with IA be informed about the procedure. Strategies to improve patients' understanding of the information given to them about IA might be helpful to reduce perceived coercion, which is known to be associated with negative attitudes towards psychiatry, a disturbed therapeutic relationship, avoidance of psychiatry, and the risk of further coercion. • Involuntary admission for psychiatric treatment is a matter of controversy. • Around half of patients do not feel well informed about their involuntary admission. • Feeling coerced and knowing less about ones' involuntary admission are associated. [ABSTRACT FROM AUTHOR]

Most states empower doctors to detain psychiatric patients if they pose a danger to themselves or others due to a mental illness; however, they do not cover patients whose mental status is dangerously altered due to a non-psychiatric illness, for example, an electrolyte imbalance. Physicians generally handle these 'medically incapacitated' patients by saying they lack capacity to decide to leave against medical advice. The medical and legal literature does not address the legal basis for a doctor to effectively trap a patient in the hospital. This article analyzes the laws of California to show how and under what circumstances such a detention could be justified; in doing so, it provides guidance for a legally sound policy for holding 'medically incapacitated' patients. [ABSTRACT FROM AUTHOR]

The United Nations human rights system has in recent years been divided on the question as to whether coercive care interventions, including coercive psychiatric care, can ever be justified under UN human rights standards. Some within the UN human rights community hold that coercive care can comply with human rights standards, provided that the coercive intervention is a necessary and proportionate means to achieve certain approved aims, and that appropriate legal safeguards are in place. Others have held that coercive care is never justified. Disagreement over this issue has produced an impasse in the UN human rights system. We survey the impasse with particular attention to the legal arguments that inform the divergent positions. In doing so we introduce a distinction among a variety of different 'abolitionist' positions regarding coercive care, and draw a distinction between 'non-consensual' and 'coercive' treatment. We conclude with three proposals for moving beyond the current impasse. [ABSTRACT FROM AUTHOR]

Background: Involuntary admission (IA) for psychiatric treatment is a massive restriction of human rights. Therefore, its execution is regulated by law. During executing IAs referring physicians find themselves in a dual role: support of patients in the recovery process but also safe-keeper of society. In Zurich, Switzerland the law stipulates that physicians regardless of their medical specialization may admit patients who suffer from a mental disorder, mental disability or severe neglect involuntarily if care cannot be provided otherwise, regardless of their decision-making capacity. The referring physician is obliged to examine the patients, hear their views on the IA, inform them about the following steps and about their right of appeal at the civil court. We aimed to assess whether referring physicians can comply with those legal requirements for an IA. Additionally, we examined whether legal considerations differed according to the physicians` professional backgrounds and attitudes towards coercion in general.Methods: We invited physicians from different in- and outpatient settings who executed IAs to the University Hospital of Psychiatry Zurich to participate in a newly developed online survey. We used correlation analysis, chi-square and t-tests to analyze the responses of 43 psychiatrists with those of 64 other physicians.Results: In about 1/3 of the IAs referring physicians were not able to hear the patients' views on the IA, to inform the patients about the following steps and about their right of appeal. Psychiatrists felt more certain with the legal basis of IA compared to physicians other than psychiatrists. Nevertheless, the latter stated that the assessment of the risk for suicide and danger should not be restricted only to psychiatrists. Both groups differed in their attitudes towards coercion with psychiatrists being more critical.Conclusions: Interventions should be developed to facilitate a compliance with legal requirements during IA. Physicians who execute IAs must have a thorough knowledge of the clinical and legal basis for their actions. We recommend specialized consultation teams for the assessment of PES and regular training including ethical discussions, especially for physicians other than psychiatrists. [ABSTRACT FROM AUTHOR]

Objectives: The variable and changing rates of use of involuntary community treatment orders (CTOs) in the treatment of people living with mental illness are not well-documented or well understood. This new study sought to determine contemporary rates of use in Australia, where local jurisdictions were previously shown to have varied and shifting rates of use that were high by world standards.Methods: Australian state and territory mental health review tribunals, health departments, and/or offices of the chief psychiatrist were surveyed for the most recent published annual data on the total number of individual people placed on a CTO and/or the total number of CTOs made.Findings: Contemporary rates of CTO use in Australia range from 40.0 per 100,000 population (in Western Australia) to 112.5 per 100,000 (in South Australia). Since the last national survey, the rates of people subject to CTOs fell into in two jurisdictions (Victoria and Western Australia). However, rates of CTOs made were higher than previous figures in all jurisdictions reporting data. Use of CTOs in Australia varies considerably within and between jurisdictions.Conclusions: Australian jurisdictions continue to use CTOs at high and varying rates, despite unresolved questions about their role and impact. Transparency and accountability around their use would be improved by regular and nationally uniform public reporting of CTO data. Further research into how and why CTOs are used may also provide opportunities to respond to factors driving their use and thereby reduce the use of coercion in mental health care. [ABSTRACT FROM AUTHOR]

Roughly 14% of male inmates and 31 % of female inmates suffer from one or more serious mental illnesses, such as schizophrenia, bipolar disorder, and major depressive disorder. Policymakers and the public widely ascribe the overrepresentation of offenders with serious mental illness in the justice system to the "criminalization" of the symptoms of this afflicted population. The criminalization theory posits that the criminal justice system has served as the primary agent of social control over symptomatic individuals since the closure of state psychiatric hospitals in the 1950s and the tightening of civil commitment laws. The theory identifies untreated mental illness as the origin of individuals' criminal justice involvement and mental health treatment as the clear solution to breaking their cycle of recidivism. This Article evaluates the three main bodies of evidence offered in support of the criminalization theory: individuals' movement from psychiatric hospitals to jails and prisons ("transinstitutionalization"), the heightened policing of individuals with serious mental illness, and the science linking mental illness and crime. This evaluation reveals that the criminalization theory--the understanding that animates most current policies aimed at offenders with serious mental illness--rests largely on intuitive assumptions that are often unverified and sometimes false. A growing body of behavioral sciences literature constructs an alternative account of the relationship between mental illness and crime. Coined the "normalization theory," it relies upon decades of research that demonstrate that clinical factors, such as diagnosis and treatment history, are not predictive of criminal activity. Instead, the same risks and needs that motivate individuals without mental illness also drive those with mental disorders to commit crimes. These "criminogenic risks" include, among others, substance abuse, employment instability, family problems, and poorly structured leisure time. Behavioral science researchers reject the premise that individuals with serious mental illness are overrepresented in the justice system because these individuals' illnesses directly lead to criminal behavior. Instead, they theorize that serious mental illnesses fuel the greater accumulation and concentration of typical criminogenic risk factors. This recognition holds dramatic potential for the redesign of criminal justice programs. Programs that target the criminal behavior of offenders with mental illness should principally focus on addressing criminogenic risk factors that can be mitigated. Officials should also address mental health needs, but only to the extent necessary to facilitate a better criminogenic risk profile and fulfill constitutional obligations. Moreover, correctional experience suggests that institutions should allocate their scarce programmatic resources according to offenders' risk of reoffending and potential to achieve programmatic goals. These insights, which federal agencies are beginning to recognize, hold radical implications for the redesign--and possibly the existence--of jail diversion programs, mental health courts, specialized probation and parole, and reentry programs for offenders with serious mental illness. [ABSTRACT FROM AUTHOR]

Currently in civil immigration detention centers around the United States, the practice of placing detained immigrants who are mentally ill is allowed by U.S. Immigration and Customs Enforcement (ICE). In some detention centers, placement into solitary confinement is now the main form of psychological "treatment" for mental health concerns. Some facilities even place detainees under suicide watch into solitary confinement. In one tragic case, this "treatment" resulted in a detainee's suicide. The practice also creates a general atmosphere of fear and resistance to disclose mental health concerns. Solitary confinement can have negative psychological effects especially for individuals with mental illness. Other international bodies, including the European Court of Human Rights, have acknowledged the harmful effects of solitary confinement. This Comment focuses on decisions by the European Court of Human Rights as to what constitutes torture. This Comment argues that placing detained immigrants who are mentally ill into solitary confinement constitutes torture, however, because the U.S.'s interpretation of torture is much narrower than other international bodies there is still a long journey to achieve the prohibition of this shameful practice in the United States. [ABSTRACT FROM AUTHOR]

The authors examine the frequency of civil commitment petitions and rates of congruence within those initial requests. Using data provided by the Idaho Department of Health and Welfare Division of Behavioral Health, the authors analyzed 32,749 petitions for civil commitment, between 2010 and 2016, as submitted by police officers, inpatient physicians, hospital administrators, and others. Results demonstrate a persistent decrease in the level of congruence with police officers displaying the lowest level of concurrence. Factors contributing to these lower rates are discussed with emphasis given to future research and broader policy consideration and discussion. [ABSTRACT FROM AUTHOR]

Women are one of the fastest growing sectors of the prison population, and have different pathways into prison and differing needs during the reentry process when compared to men (Cloyes et al. J Forensic Nurs; 6:3-14, 2010b; Herrschaft et al. J Offender Rehabil; 48:463-482, 2009). Women report higher levels of mental health problems overall, and report more severe symptomatology (Cloyes et al. J Forensic Nurs; 6:3-14, 2010a; Hyde 2012; Lynch et al. 2014). The current study focuses on the role of severe mental disorders for women released from prison. Data collected from the North Carolina Division of Adult Correction and Juvenile Justice were used to analyze the specific role of severe mental disorders in women’s recidivism at eight years post-release (n = 2311). Approximately 20% of women in this sample met the criteria for diagnosis with a severe mental disorder (SMD). Logistic regression analysis indicated that there was an association between SMDs and recidivism for this sample only (p = .11). Cox regression analyses indicated that women diagnosed with SMDs were 16% more likely to have recidivated at eight years post-release compared with women who were not diagnosed with an SMD (p < .05). Implications for the recognition, role, and treatment of SMDs during reentry are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this article is to discuss the current state of involuntary mental health treatment in the United States. Specifically, an exploration of the risk factors for commitment and potential physical and psychological consequences for involuntary treatment is presented. In addition, recommendations for protecting patient rights are discussed with the end goal being the greatest well-being for patients. [ABSTRACT FROM AUTHOR]

The article reports on the case of Palakovic v. Wetzel regarding the solitary confinement of a mentally ill person. It discusses the repeated confinement of the patient for behavior caused by his mental illness, his lack of care and eventual suicide, and the finding of the 3rd Circuit Court that his confinement constituted cruel and unusual punishment.

The article explores the U.S. involuntary civil commitment process for confining a mentally ill who is dangerous in a psychiatric hospital. It identifies the factors that constitute dangerous behavior under various approaches and the risk factors used to assess dangerous behavior. The use of psychotropic medicine to treat mental illness is discussed, as well as recommendations for clarifying and improving the process.

Involuntary psychiatric admission is an established practice for patients who are acutely or severely mentally ill but the factors contributing to involuntary (as opposed to voluntary) admission are not fully clear. Nor is it clear why rates of involuntary admission often vary between hospitals within the same jurisdiction. We studied all admissions, voluntary and involuntary, in three inpatient psychiatry units in Dublin, Ireland, which cover a population of 552,019 people, over a one-year period (1 July 2014 until 30 June 2015, inclusive), as part of the Dublin Involuntary Admission Study (DIAS). During the study period, there was a total of 1136 admissions to these three units, of which 17% were involuntary for all or part of their admission. The overall admission rate (205.8 admissions per 100,000 population per year) was lower than the national rate (387.9) but this varied substantially across the three units studied. On multi-variable analysis, involuntary admission status was associated with male gender, being unmarried, and a diagnosis of schizophrenia, and was not significantly associated with age, occupation or which inpatient unit the person was admitted to. We conclude that variations in involuntary admission rates between different psychiatry admission units in Dublin are significantly explained by patient-level variables (such as gender, marital status and diagnosis) rather than centre-level variables, but that much of the variation in admission status between patients remains unexplained. Future, multi-level research could usefully focus on other patient-level factors of possible relevance (e.g. symptom severity), centre-level factors (e.g. local mental health service resourcing) and community-level factors (e.g. socio-economic circumstances in different areas) in order to further elucidate unexplained variance in admission status between patients. [ABSTRACT FROM AUTHOR]

Drawing on ethnographic and activist work in New York, I analyze three contemporary cases of mentally ill people charged violent crimes. State violence against them can be characterized as a differential and differentiated set of racial and gendered practices. The case studies offer something between a parable, a field report, and a cautionary tale of the dystopian tendencies already embedded within the criminal justice system in the United States. Based on these cases, I will argue that despite recent liberal reform, scant evidence suggests any deep shift in the web of agencies that pipe people, especially the mentally ill, into prison and jail, or a shift in the cruel and humiliating practices these agencies embody. For the society to achieve what Du Bois called an abolition democracy, the affective infrastructure and psychic investment in debasing subordinated others would have to be abolished. [ABSTRACT FROM PUBLISHER]

Objective: To examine whether medical homes have heterogeneous effects in different subpopulations, leveraging the interpretations from a variety of statistical techniques.Data Sources/study Setting: Secondary claims data from the NC Medicaid program for 2004-2007. The sample included all adults with diagnoses of schizophrenia, bipolar disorder, or major depression who were not dually enrolled in Medicare or in a nursing facility.Study Design: We modeled a number of monthly service use, adherence, and expenditure outcomes using fixed effects, generalized estimating equation with and without inverse probability of treatment weights, and instrumental variables analyses.Data Collection: Data were received from the Carolina Cost and Quality Initiative.Principal Findings: The four estimation techniques consistently revealed generally positive associations between medical homes and access to primary care, specialty mental health care, greater medication adherence, slightly lower emergency room use, and greater expenditures. These findings were consistent across all three major severe mental illness diagnostic groups. Some heterogeneity in effects were noted, especially in preventive screening.Conclusions: Expanding access to primary care-based medical homes for people with severe mental illness may not save money for insurance providers, due to greater access for important outpatient services with little cost offset. Health services research examining more of the treatment heterogeneity may contribute to more realistic projections about medical homes outcomes. [ABSTRACT FROM AUTHOR]

Specific laws aimed at the confinement of mentally disabled sexually violent persons have existed for years. Originally, these laws aimed to rehabilitate a person within a mental hospital and help him with his disorders, aiming to help him enter back into society. However, throughout the years, the laws morphed into ways to keep convicted criminals from society after their prison sentence ended for fear of potential future crimes. In Illinois, the courts find a man falls within the sexually violent persons law when he remains too dangerous to be released after his criminal confinement. A person must have a "mental disorder" to fall under this law, and questions remain on how these disorders are established. In Illinois, a psychologist often makes a "mental disorder diagnosis." This Comment argues the state should have the psychologist qualified as an expert using a Frye hearing before the expert can classify the person with a "mental disorder" within the sexually violent persons law. This way, the person is classified using a legal classification, not just the prevailing psychological definition of the day. [ABSTRACT FROM AUTHOR]

Committed: The Battle Over Involuntary Psychiatric Care explores the complex battle over involuntary hospitalization for mental illness. This article aims to explore the flaws of involuntary commitment as the authors presented in their book and seeks to foster a discussion that will improve the lives of the mentally ill. This discussion includes the negative experiences of patients, some of the legal issues surrounding involuntary care, and some issues with the process of commitment that were presented in the book. [ABSTRACT FROM AUTHOR]

While the ethics of involuntary admission for psychiatric inpatient care is widely contested, the practice is legally permissible across most jurisdictions. In many countries, laws governing the use of involuntary admission set out core criteria under which involuntary admission is permitted; these parameters broadly related to either risk of harm to self or others, need for treatment, or both. In South Africa, the use of involuntary admission is governed by the Mental Health Care Act no. 17 of 2002 (MHCA 2002), which sets out clear criteria to direct mental healthcare practitioners' decision-making and delineates a process by which decision-making should occur. However, recent research suggests that, in practice, the process of decision-making differs from the procedure prescribed in the MHCA 2002. To further explore how decision-making for involuntary admission occurs in practice, we interviewed 20 mental healthcare practitioners, all with extensive experience of making involuntary admission decisions, working in district, regional, and tertiary hospitals across five provinces. We also interviewed four mental health advocates to explore patient-centered insights. Our analysis suggests that the final decision to involuntarily admit individuals for a 72-h assessment period under the MHCA 2002 was preceded by a series of 'micro-decisions' made by a range of stakeholders: 1) the family's or police's decision to bring the individual into hospital, 2) a triage nurse's decision to prioritise the individual along a mental healthcare pathway in the emergency centre, and 3) a medical officer's decision to sedate the individual. Practitioners reported that the outcomes of each of these 'micro-decisions' informed aspects of their final decision to admit an individual involuntarily. Our analysis therefore suggests that the final decision to admit involuntarily cannot be understood in isolation because practitioners draw on a range of additional information, gleaned from these prior 'micro-decisions', to inform the final decision to admit. [ABSTRACT FROM AUTHOR]

Background: Norway has extensive and detailed legal requirements and guidelines concerning involvement of next of kin (NOK) during involuntary hospital treatment of seriously mentally ill patients. However, we have little knowledge about what happens in practice. This study explores NOK's views and experiences of involvement during involuntary hospitalisation in Norway. Methods: We performed qualitative interviews-focus groups and individual-with 36 adult NOK to adults and adolescents who had been involuntarily admitted once or several times. The semi-structured interview guide included questions on experiences with and views on involvement during serious mental illness and coercion. Results: Most of the NOK were heavily involved in the patient's life and illness. Their conceptions of involvement during mental illness and coercion, included many important aspects adding to the traditional focus on substitute decision-making. The overall impression was, with a few exceptions, that the NOK had experienced lack of involvement or had negative experiences as NOK in their encounters with the health services. Not being seen and acknowledged as important caregivers and co sufferers were experienced as offensive and could add to their feelings of guilt. Lack of involvement had as a consequence that vital patient information which the NOK possessed was not shared with the patient's therapists. Conclusions: Despite public initiatives to improve the involvement of NOK, the NOK in our study felt neglected, unappreciated and dismissed. The paper discusses possible reasons for the gap between public policies and practice which deserve more attention: 1. A strong and not always correct focus on legal matters. 2. Little emphasis on the role of NOK in professional ethics. 3. The organisation of health services and resource constraints. 4. A conservative culture regarding the role of next of kin in mental health care. Acknowledging these reasons may be helpful to understand deficient involvement of the NOK in voluntary mental health services. [ABSTRACT FROM AUTHOR]

The article focuses on the struggles faced by cofounder Jim O'Connell of the Boston Health Care for the Homeless Program for people with serious mental illness. Topics discussed include involuntary commitment of psychiatric need such as such infringement of civil liberties, insurance limits on patient's hospital stay, and the side effect of the antipsychosis medications which can lead to parkinsonian symptoms and tardive dyskinesia.

Introduction: Law governs the admission and management of involuntary admissions of mentally ill persons who are admitted under the provisions of the mental health act. The court directs the doctor to take charge of such persons. In the further dealings of such person the medical officer of the psychiatric facility comes across legal terms, which require understanding so that patients could be dealt with properly. Various terms such as accused, under police custody, judicial custody, remand prisoner, or under trial prisoner are used to denote their legal status. It is imperative for the medical officer to understand the nuances in the meanings of these terms. There are many times when the relevant section under which the admission is ordered is not found in the reception order. In these cases the terminology by which the patient is mentioned throws a light on the status of the patient. Towards this aim a study was carried out to assess the awareness and understanding of such terms by the faculty and post- graduates of a tertiary care hospital that deals with the admission and care of such patients. Method: They were administered a questionnaire containing these terms and asked to provide the meaning of these terms. Results: The results showed that nearly half the faculty and students were not having clarity in awareness or understanding of the terms. Discussion: Hence these terms and their meanings were gleaned from various judgments. The proper meaning of these terms and their use in judicial process and their importance is discussed. [ABSTRACT FROM AUTHOR]

In this paper, I describe dividing practices in making up a specific medical-legal category-the revolving door patient-to identify, label, and direct the actions of particular people living with mental illness. The revolving door patient was a category that had been spoken of for some time, but became a formal legal subject with the introduction of the Alberta Mental Health Act 2010 and Community Treatment Orders (CTOs). I demonstrate how a rationale of control over unpredictable and dangerous individuals was primary in creating this new category, and that the characterization of the revolving door patient required a disciplinary technology to reduce danger. I argue that the CTO is a medical-legal technology that solves the problem of governing a subject in order to produce a patient that manages mental illness. I conclude by reflecting on how the narrative of the revolving door patient, and of mental illness more broadly, has implications for personal identity and tensions between care and control. [ABSTRACT FROM AUTHOR]

In PS v Ontario, the Ontario Court of Appeal held that section 7 of the Charter requires that persons who are civilly committed for six months or more must have access to meaningful review over the conditions of their detention. In this paper, the authors argue that the decision has broad implications for provincial civil commitment regimes across the country. In particular, the Court's analogy to the Criminal Code Review Board jurisprudence opens the door to a fuller recognition of the profound deprivation of liberty involved in civil commitments. An expanded role for civil review tribunals may be required, including Charter jurisdiction. The decision, and Ontario's legislative response, also leave open the pressing question of the scope of liberty interests guaranteed by section 7 for those who are civilly committed for shorter periods of time. The authors conclude that this decision should trigger a reconsideration of civil commitment review processes across the country for all persons detained in psychiatric facilities. [ABSTRACT FROM AUTHOR]

Objectives: Community treatment orders (CTOs) are a controversial practice as they extend the practice of involuntary treatment into the community. This study aimed to determine whether there was a difference in the rate of CTOs and revocation (readmission) orders following the implementation of a recovery-orientated model across four adult mental health services.Methods: A retrospective cohort study was conducted prior to and after the reconfiguration of services. Population data for those aged 15 to 65 were obtained from a census and rate rates were calculated.Results: Prior to the reconfiguration, there were 893 individuals subject to a CTO and 136 of these individuals had a revocation of their CTO (i.e. were involuntarily readmitted). This represented a rate of 100.8 individuals on CTOs per 100,000 population and a rate of 15.4 revocations per 100,000 population. Following the reconfiguration, the rate of CTOs increased by 10% and there was a trend for the rate of revocation orders to have decreased by 17%.Conclusions: Rates of CTOs and readmissions varied across services and further research is warranted to identify factors associated with these increased rates. Additionally, the very high rate of CTOs in the catchment areas warrants further examination. [ABSTRACT FROM AUTHOR]