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The current prospective risk assessment study evaluated the application of the Chinese translation of the Historical‐Clinical‐Risk Management‐20 Version 3 (HCR‐20V3) in a sample of 152 offenders with mental disorders and civil psychiatric patients. The ratings of the presence and relevance of risk factors were compared, as well as summary risk ratings (SRRs), both across offenders and civil psychiatric patients, and across male and female sub‐samples. Interrater reliability was consistently "excellent" for the presence and relevance of risk factors and for SRRs. Concurrent validity analyses indicated that HCR‐20V3 was strongly correlated with Violence Risk Scale (from r = 0.53 to 0.71). The results of predictive validity analyses provided strong support for the bivariate associations between the main indices of HCR‐20V3 and violence within 6 weeks, 7–24 weeks, and 6 months; SRRs added incrementally to both relevance and presence ratings across three follow‐up lengths. [ABSTRACT FROM AUTHOR]

The article explores the Ohio House Bill 136 which involves the prohibition of execution of criminal offenders that have been deemed mentally ill at the time of their offense. It discussed the amendment of the Ohio criminal code concerning death penalty, the preponderance of evidence which suggests that the offender has been diagnosed by mental conditions such as schizophrenia, bipolar disorder, or schizoaffective disorder, and the criminal punishments prohibited by the Eighth Amendment.

Background: In the UK, little is known about the experience of ex‐prisoners with intellectual disabilities. Method: A qualitative study was therefore conducted to investigate what life is like for ten men with intellectual disabilities who left prison at least 9 months previously. Semi‐structured interviews were employed to explore the men's views of post‐prison life, including opportunities/challenges and support received from services. Results: Through interpretative phenomenological analysis, four over‐arching themes were constructed: the nature of support and services, the difficulty of staying out of trouble, the importance of family and the need to act the "tough guy". The participants reported being extremely under‐supported. They were often hostile about staff who they felt were too focused on their previous crime. Conclusions: In general, men were very under‐supported and the upheavals of post‐prison lives appeared to be "normalized" by them. Better understanding of their lives within their social context would benefit their community re‐entry. [ABSTRACT FROM AUTHOR]

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]

Background: Personality disorder is highly prevalent in offender populations and is associated with poor health, criminal justice, and social outcomes. Research has been conducted into factors that influence offending and health, but, in order to improve (re)habilitation, service providers must also be able to identify the variables associated with social outcomes and the mechanisms by which they operate.Aim: To establish what is known about what influences social outcomes among offenders with personality disorder.Method: A systematic review was completed using Cochrane methods, expanded to include nonrandomised trials. Anticipated high heterogeneity informed a narrative synthesis.Results: Three studies met inclusion criteria. Two were qualitative studies including only 13 cases between them. All studies were low quality.Conclusions: There is insufficient evidence to determine what influences good social outcomes among offenders with personality disorder. Research is required to identify associated variables, to inform the development of effective interventions. [ABSTRACT FROM AUTHOR]

Background: Interactions between individuals experiencing mental health (MH) problems and the police are complex, and effectiveness of innovative support and diversion models in England and Wales not yet fully evaluated.Aims/hypotheses: Our aims were to examine police interactions with suspects and to measure the immediate effectiveness of police/NHS MH interventions, including liaison and diversion and embedded staff in police contact and control rooms. We hypothesised that those with an MH flag would have significantly greater benefit from such interventions than those without in terms of how far they are taken down the criminal justice pathway and how long they spend in police custody.Methods: We examined police interactions with suspects with and without flagged MH problems in relation to key outcome measures over a 15-month period, overall or when flagged by nurses alone. 'MH flagging' is defined as the presence of a marker on police systems, including both historical and current information, that alerts control room staff and response officers that the call may involve an individual/s with MH problems. Serial cross-sectional analysis of material from a database of individual cases integrating information from three police sources (N = 13,472) was used to test for associations between 'mental health flagging' and outcomes.Results: Individuals with an MH flag have almost identical police dispatch response profiles to those without; they were arrested for and charged with similar offences. Those with an MH flag were significantly more likely to be charged with a criminal offence, less likely to receive a caution and spent longer periods in police custody than people under similar accusations but no MH flag.Conclusions: MH flagging appeared to disadvantage the people flagged, despite the presence of theoretically appropriate interventions. Further research is needed to understand this. It may be that indicating this form of vulnerability if the person is not judged to qualify for a MH service is discriminatory and may even account for excessive rates of mental disorder among prisoners. [ABSTRACT FROM AUTHOR]

Background: Interventions for offenders with mental illness have tended to be confined to treatment of illness, with the expectation that symptom reduction will be accompanied by reduced criminal recidivism, but recent evidence suggests that other treatment targets may be more effective against recidivism.Aim: The aim of this study was to examine the effect of a cognitive skills programme (Reasoning and Rehabilitation 2: Short Version for Adults [R&R2]) among offenders with mental illness. Our first hypothesis was that participation in this programme would result in significantly greater improvement in antisocial attitudes than among similar prisoners who did not participate; both groups received "treatment as usual" (TAU). Our second hypothesis was that those receiving R&R2 would show less post-treatment violent or general recidivism than those receiving TAU alone.Method: Incarcerated offenders with serious mental illness (N = 101) were randomly assigned to R&R2 or TAU alone. Criminal attitudes and mental state were examined before and after treatment. Violent and non-violent recidivism was measured, on average, 18 months after release.Results: In both intervention and TAU alone trial arms, there were significant pre- to post-treatment changes in criminal attitudes and symptoms or signs of mental disorder. There was no difference between groups in these respects. These pre/post changes were not associated with reductions in recidivism over time, whether or not controlling for baseline risk.Conclusions: Although there was no demonstrable advantage of R&R2 over TAU alone, non-significant trends towards lower violent recidivism in the R&R2 group and general recidivism in the TAU group suggest that it may be worth repeating the trial in a larger sample with more differentiated control groups. [ABSTRACT FROM AUTHOR]

Youth with disabilities are dramatically overrepresented in the juvenile justice system. These individuals have poorer outcomes compared with their nondisabled peers regarding school graduation, employment, and recidivism. This discussion article explores issues related to transition and outlines research-based practices aimed at increasing postrelease community engagement and decreasing the likelihood of rearrest. Three phases of transition are identified as well as key components, practices, and personnel that can guide transition from initial intake through reentry. [ABSTRACT FROM AUTHOR]

Accessible Summary: Domestic violence abuse is when people hurt family members or partners with their words or actions, take their money or try to control them. It is against the law to do this. We wanted to know more about how many people with intellectual disabilities are being violent in their relationships. Forensic Community Learning Disabilities Team (CLDT) noticed more people were being referred to the team because they had been violent in their relationships. The Forensic CLDT looked at their referrals to see how many people were violent in their relationships. They also looked at referrals for their local Community Learning Disabilities Teams to see how many people were violent in their relationships. The research showed that more people who were referred to the Forensic CLDT needed help for violence in their relationships in 2015. The CLDTs also had referrals for people who were violent in their relationships. It is important to understand more about people with intellectual disabilities who are abusive in their relationships so we can help them. Abstract: Background: Domestic violence abuse (DVA) has been identified by the UK Government as a priority to address. Whilst there is a growing body of research into perpetrators of DVA from the mainstream population, there is scant research into perpetrators of DVA who have an intellectual disability. This lack of an evidence base suggests there may be a group of individuals for whom there is no suitable treatment approach. A Forensic Community Learning Disabilities Team (FCLDT) completed a multiservice evaluation of their service and sector CLDTs to obtain a measure of local unmet need. Materials and methods: A retrospective review was completed for referrals to the FCLDT and four of their sector CLDTs for 2014 and 2015. A record sheet was designed for the process of data collection and the analysis of referrals. Results: In regard to the FCLDT, 14% of the total referrals made to the FCLDT in 2014 referenced DVA perpetration and the figure rose to 26% in 2015. For CLDTs, 1.9% of the total referrals made to the CLDT in 2014 and 3.18% in 2015 referenced DVA perpetration. Conclusions: A significant proportion of referrals to the Forensic CLDT relate to the perpetration of domestic violence abuse. A proportion of Sector CLDT referrals made reference to behaviours that, according to the Home Office definition, would be classified as domestic violence abuse, but was infrequently referred to as such. The paper considers these findings in the light of the Home Office definition and its application to people with intellectual disabilities. [ABSTRACT FROM AUTHOR]

This study has examined the predictive validity of the Historical Clinical Future [ Historisch Klinisch Toekomst] Revised risk assessment scheme in a cohort of 347 forensic psychiatric patients, which were discharged between 2004 and 2008 from any of 12 highly secure forensic centers in the Netherlands. Predictive validity was measured 2 and 5 years after release. Official reconviction data obtained from the Dutch Ministry of Security and Justice were used as outcome measures. Violent reoffending within 2 and 5 years after discharge was assessed. With regard to violent reoffending, results indicated that the predictive validity of the Historical domain was modest for 2 (area under the curve [AUC] = .75) and 5 (AUC = .74) years. The predictive validity of the Clinical domain was marginal for 2 (admission: AUC = .62; discharge: AUC = .63) and 5 (admission: AUC = .69; discharge: AUC = .62) years after release. The predictive validity of the Future domain was modest (AUC = .71) for 2 years and low for 5 (AUC = .58) years. The total score of the instrument was modest for 2 years (AUC = .78) and marginal for 5 (AUC = .68) years. Finally, the Final Risk Judgment was modest for 2 years (AUC = .78) and marginal for 5 (AUC = .63) years time at risk. It is concluded that this risk assessment instrument appears to be a satisfactory instrument for risk assessment. [ABSTRACT FROM AUTHOR]

In an A-B-A-B-A single-case research study of 3 incarcerated offenders with mental illness, repeated exposure to the pilot Adult Recidivism Reduction Alternatives (ARRAY) group counseling intervention was an effective or very effective treatment for anxiety, depression, and associated somatic symptoms. [ABSTRACT FROM AUTHOR]

Theoretical suppositions suggest a potential vulnerability in some individuals with autism spectrum conditions (ASCs) to displaying offending behaviours. Additionally, it is recognised that the features of ASCs may result in possible barriers to treatment. A systematic review was undertaken to identify empirical evidence examining the effectiveness of treatment programmes for offenders with ASCs and to explore the potential impact of ASC symptoms on treatment outcomes. The studies identified consisted of a small number of case series and a collection of case reports with little or no direct comparisons to offenders without ASCs. A synthesis of the findings highlighted variability in treatment approach and impact. Effectiveness was primarily defined by reduction in further offending behaviours and was found to be variable across the data. The potential relationship between the symptoms of ASCs and treatment outcome was explored with all case reports identifying the need for adaptations to treatment programmes, necessitated by the symptoms of ASCs. This systematic review joins an existing body of literature emphasising need for more controlled research into the effectiveness of offending behaviour treatment programmes for individuals with ASCs, and for further investigation into the impact of the clinical features of ASCs on treatment outcomes. [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 current study aimed to investigate the specific pathways in the offence process for mentally disordered firesetters. In a previous study, an offence chain model was constructed (i.e., the Firesetting Offence Chain for Mentally Disordered Offenders, FOC-MD) using offence descriptions obtained from 23 mentally disordered firesetters, detailing the sequence of contextual, behavioural, affective, and cognitive factors that precipitate an incidence of firesetting for this population. The current study examines the prevalence of the specific pathways to firesetting for the original 23 mentally disordered firesetters and a further sample of 13 mentally disordered firesetters. Three distinct pathways to firesetting are identified within the FOC-MD: fire interest-childhood mental health, no fire interest-adult mental health, fire interest-adult mental health. In this article, we describe these three pathways in detail using illustrative case studies. The practice implications of these identified pathways are also discussed. [ABSTRACT FROM AUTHOR]

Background: Previous research suggests that female violent offenders at risk of a prison sentence are more likely than their male counterparts to be assessed as having mental health problems of a nature or degree that would lead to a court requirement for hospital treatment.Aims/hypotheses: To test the hypothesis that there is bias towards hospital disposal of female compared with male violent offenders with mental disorder.Methods: In Sweden, the National Board of Forensic Medicine oversees all assessments of mental disorder for the criminal courts. Twenty-six Board appointed forensic psychiatrists, psychologists and social workers each independently assessed six case vignettes for fit with criteria for 'severe mental disorder', a prerequisite for hospital disposal from court. Each gender neutral vignette described a person who had been convicted of serious assault and had a major mental disorder. A gender was then assigned to each offender randomly within a block design, thus varying between sets. Participants were blind to the main aim of the study and the gender variation.Results: There was no significant association between gender of the person assessed and judgement that s/he had a 'severe mental disorder'. An offender depicted as having mental retardation was more likely to be assessed as at high risk of criminal recidivism if portrayed as female, regardless of the sex, place of work or level of experience of the assessor.Conclusion: We found no evidence of gender bias in determining appropriateness of a hospital disposal of an offender with mental disorder. The difference in assessment of recidivism according to sex of the patient was only in relation to mental retardation; further research would be needed to able to interpret this. As researchers in other countries have reported gender bias in disposals from court, our findings may provide support for a centralised forensic psychiatric assessment board and formal, on-going training. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Clinical trials and meta-analyses provide some evidence for effectiveness of forgiveness therapy delivered individually or in groups. To date, however, forgiveness therapy has not been evaluated with mentally disordered offenders. Given the high prevalence of experienced and perpetrated trauma among such people, this population may particularly benefit from such an intervention.Aim: The aim of this study is to test the feasibility and impact of a 'learn to forgive' group programme among mentally disordered offenders on a specialist secure hospital setting.Methods: We conducted a non-randomised trial with 36 offenders with mental disorders and 29 comparison patients. The intervention group engaged in a six-week manual-based 'learn to forgive' treatment programme, while the comparison group watched a 90-minute video on forgiveness. Both groups completed measures of anger, depression, stress, forgiveness and satisfaction with life at baseline and then 6 and 18 weeks later. A repeated measures mixed-effects model was used to investigate the association between affective outcomes and type of intervention received, after adjusting for baseline characteristics.Results: The group completion rate was over 90%. The treatment and comparison groups were similar on baseline demographic and criminological measures, but the treatment group had higher baseline anger and depression scores. While both groups showed improved capacity to forgive and reduced negative affect over time, those in the 'learn to forgive' programme showed significantly more improvement in forgiveness and on anger measures.Conclusions and Implications For Practice: Forgiveness training can be delivered effectively to offenders with mental disorders in clinical settings. Its range of benefits, including reduction I in anger as well as improved capacity to forgive, suggest that it may have longer term implications for personal safety and reintegration into mainstream societal settings. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate criminal outcomes of mentally disordered offenders in compulsory forensic psychiatric care during the year 2010 versus 2018. More specifically, we sought to identify the occurrence of new criminal sentences during ongoing treatment and possible factors associated with recidivistic criminality. Another aim was to map previous criminality, types of index crime, and whether there were any changes within this decade. Crime-, clinical, and treatment-related variables were collected from the Swedish National Forensic Psychiatric Register for all unique inpatients registered from January 1–December 31 in 2010 (N = 717) and 2018 (N = 757). The mean, frequency, percentage, and standard deviation were calculated per variable and stratified by study year and gender. Between-group comparisons were made using t -tests and Chi-square tests. Binary logistic regression was performed to determine whether variables expected to be associated with recidivism showed any relation to criminal recidivism for each study cohort. Most patients were male and approximately one-quarter and one-half of the men, respectively, had a previous sentence for non-violent and violent crimes. The 2018 cohort showed significantly lower rates of sentences to forensic psychiatry with special court supervision although the numbers were low in both cohorts and for both men and women. Previous violent conviction was associated with criminal recidivism during treatment in 2010, while this was joined by index crime under the influence of alcohol/illicit drugs for the 2018 cohort. Overall, these results showed more similarities between the 2010 and 2018 cohorts then dissimilarities, while on the other hand some quite substantial differences were described between males versus females. The results of this study indicate that it may be possible to tailor forensic psychiatric treatment to gender as a proxy for other variables related to increased criminal recidivism in offenders sentenced to forensic psychiatric care. • Criminal data from mentally disordered offenders were similar in 2010 and 2018 • A tendency to decreased criminal recidivism in 2018 versus 2010 was observed • Sex-specific differences in criminality support sex-specific considerations in care [ABSTRACT FROM AUTHOR]

In England and Wales, mental health in-reach teams manage high levels of mental disorder in prisons, but problems with reception screening and referral triage have been identified. As one potential solution, we examined the effect of an open referral pathway upon one in-reach team by evaluating its referrals and caseload across two time periods (in 2008 and 2011). There was a doubling of team referrals (from 101 to 203) with significantly improved identification of people with no mental health history. There was further evidence for a lowering of thresholds for referral and assessment, an approach that can be seen as helpful within a system that is known to under-identify mental health problems. Despite limitations, this evaluation offers some evidence for the effectiveness of open referral systems. It also raises questions about the potential effects of liaison and diversion services that are presently being piloted for national introduction. [ABSTRACT FROM PUBLISHER]

The main purpose of this study was to examine the association between socio-demographic variables and mental health problems on 357 offenders out of which 306 (86%) males and 51 (14%) females found in Oromiya Regional state, Horro-Guduru Wallaga Correctional Center, western Ethiopia with an age range of 19-65 with a mean age of 33.01+11.15 SD. General Health Questionnaire-28 (GHQ-28) was used to examine offenders'mental health status. Results were analyzed using descriptive statistics via mean and standard deviations, and inferential via t- test and one-way ANOVA. 84% of inmates were affected by mental health problems, mostly belonging to the age group of 31-45 years. Male offenders were more affected (89%) than females (80%). Education and term of the sentence were found to have significant effects on mental health problems. [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 aim of this article is to describe the social, relational and mental health characteristics of a sample of offenders serving prison or community sentences in the south-west England. About 100 adult male offenders were screened for anxiety and depressive disorders, post-traumatic stress disorder (PTSD), drug and alcohol dependence, and likely personality disorder using validated instruments. Fifty-eight per cent of the sample reported at least one common mental health problem, of these only 26% reported receiving treatment. Participants exposed to traumatic events and/or participants with past mental health problems were more likely to score positive for current common mental health problems. Our study identified factors that may increase the risk of a first episode or recurrent anxiety and/or depression for offenders. Health and criminal justice services should create partnerships and develop interventions that address the risk factors which lead and/or contribute to offenders' mental health difficulties. [ABSTRACT FROM PUBLISHER]

This review explored outcomes of individual and group-based offence-focussed psychological treatments in studies published between 1 January 1990 and 31 August 2014. Very few high-quality studies using individual treatments (n= 13) were identified. There were even fewer comparisons of individual versus group-based treatment (n= 2); several studies incorporating both individual and group-based treatment components for high-risk high-need clients were also identified. Extant findings suggest comparable outcomes for group-based and individual treatment. In concluding, we adopt a pragmatic perspective and propose a model for conceptualising the role of individual treatment in offender rehabilitation and its relationship to group-based offence-focussed treatments. Group-based treatments are promoted due to their larger evidence base. Individual interventions may prepare clients for group treatment, and/orpromotetreatment gains when stable internal factors impair responsivity. Individual treatments may also helppreventhigh-risk clients from engaging in problem behaviours that may result in their removal from the programme. On occasions, individual treatments may be necessary to provide another treatment pathway when group treatments are not possible. Identifying and attending to responsivity factors through both individual and group-based treatments increases the likelihood that rehabilitation efforts are sensitive to each participant's needs. [ABSTRACT FROM PUBLISHER]

The issue of violence and threats against public servants has attracted significant public attention in recent years and plays an important role in the ongoing discussion of possible explanations for the recent significant growth in the number of sentences to psychiatric treatment in Denmark. The proportion of sentences given for violence and threats against public servants (Danish Penal Code § 119) has increased dramatically, from 5 % in 1980 to approximately 25 % of the total annual number of new sentences to some kind of psychiatric measure in 2014. Studies show that victims are most frequently social and health care assistants, nurses and physicians. This study is part of a larger mixed method study comprising all patients treated in a specialized forensic outreach team (ForACT) in the Mental Health Services in the Capital Region of Denmark over a period of 71/2 years (2006- 2014) (n=181). The types of assault against public servants examined in this sample are diverse, varying from mockery and verbal threats to physical attacks with severe injuries. Displaying complexity and diversity, the mentally disordered offenders (MDOs) in this study are generally characterised as having significant social problems, severe mental illness, substance use issues, and extensive criminal records. MDOs in the sample who have been convicted under §119 seem to score higher than MDOs never convicted of assaults against public servants on a range of parameters, e.g., criminal onset, type of crime(s) committed, and frequency of psychiatric hospitalisation. [ABSTRACT FROM AUTHOR]

Empirical research has demonstrated a link between legal coercion and treatment engagement following conviction among those with severe personality disorder. Legal coercive pressures were often applied by the Indeterminate Sentence for Public Protection (IPP), until it was replaced by the Extended Determinate Sentence by the Legal Aid, Sentencing and Punishment of Offenders Act 2012. In this paper, it is proposed that use of the new determinate sentence will lessen motivation for treatment engagement. One effect of treatment refusal may be greater reliance by the Secretary of State for Justice on his jurisdiction to transfer prisoners due for release to secure hospital transfers under the Mental Health Act 1983. Not only will this risk posturing undermine the principal aim of the Offender Personality Disorder Implementation Pathway to improve treatment engagement among the target group, it will also have negative implications for medical practitioners working in secure forensic hospitals. To demonstrate what is at stake, the paper briefly recapitulates empirical findings familiar to readers of the journal, before drawing on original unpublished data. [ABSTRACT FROM AUTHOR]

In a sequence of decisions between 1989 and 2014, the United States Supreme Court grappled with intellectual and developmental disabilities in the shadow of the imposition of the death penalty on criminal offenders. InPenry v Lynaugh, 492 US 302 (1989), it jettisoned the notion of ‘mental age’ as a tool for assessing such disabilities. InHall v Florida, 572 US (2014); 134 S Ct 1986 (2014), it abandoned the terminology of mental retardation and identified intellectual disability as existing on a spectrum, not being just an IQ number, to be determined by reference to various forms of evidence, lay and expert. InAtkins v Virginia, 536 US 304 (2002), it pronounced imposition of the death penalty on persons who are ‘mentally retarded’ to be cruel and unusual punishment in breach of the Eighth Amendment to the Constitution. Importantly, too, the Supreme Court jurisprudence has evidenced an increasing sophistication in awareness of the forensic repercussions of ‘intellectual and developmental disorders’ (IDDs). This editorial traces the evolution of United States intellectual disability jurisprudence in respect of imposition of the death penalty, reflects on the ongoing areas of vulnerability for criminal offenders with IDDs and calls for further consideration to be given to the option for offenders with an IDD to be sentenced to reside in a forensic IDD environment as a humane containment and behaviour modification alternative to other forms of disposition. [ABSTRACT FROM PUBLISHER]

A workshop was held to formulate difficulties encountered in multi-agency working. Significant parallels with individual formulations were identified, particularly the importance of developing collaborative relationships. Service-level formulation was agreed to be a useful strategy for overcoming obstacles in multi-agency work. [ABSTRACT FROM AUTHOR]

This article describes a prison-based service for men with personality needs. A background to the service is provided alongside staff's reflections on service implementation. First-person resident accounts offer the reader an insight into the perspective of the residents. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this review was to assess the effectiveness of music therapy on improving the mental health of offenders in correctional settings. Methods: Multiple databases and journals were searched to identify randomized controlled trials and quasi-randomized controlled trials of music therapy for offenders in correctional settings. Results: Five studies ( n = 409; predominantly male) were included in random-effects meta-analyses. Music therapy was effective for promoting offenders' self-esteem (Hedges' g = 0.55, p < 0.001) and social functioning ( g = 0.35, p < 0.05). Effects on anxiety and depression depended on the number of sessions. For both outcomes, the studies with 20 or more sessions had larger effects than the study that had fewer than 20 sessions, and this difference was statistically significant (Q = 11.88, df = 1, p < 0.001, anxiety; Q = 9.16, df = 1, p = 0.002, depression). No significant effects were found on behavior management or between different music therapy approaches. Conclusions: Music therapy may be helpful for offenders to improve mental health. Future studies should consider including offenders of both genders, using larger sample sizes, and examining long-term effects. Publication bias may be an issue for this review given the small number of studies and the small sample sizes. [ABSTRACT FROM AUTHOR]

The Good Lives Model (GLM) is a contemporary theory of offender rehabilitation that has the dual foci of promoting offenders’ goals and reducing their risk of reoffending. It has proved popular with practitioners working with offenders in correctional services but its potential as a rehabilitation framework for mentally disordered offenders (MDOs) in forensic mental health services has been largely untapped. The purpose of this article is to explore how the GLM can be theoretically augmented for use with offenders with mental illness and applied to MDOs in a forensic mental health setting. A case study is provided to illustrate how the enriched GLM can promote a cohesive and holistic approach to forensic rehabilitation that integrates risk, psychiatric treatment, and well-being perspectives. The potential benefits of utilizing the GLM as an overarching rehabilitation framework in forensic mental health are discussed and important points of difference from a traditional approach are highlighted. The authors conclude that the GLM represents a paradigm shift for forensic mental health whereby the person, rather than risk reduction and/or the treatment of mental illness, is at centre stage. [ABSTRACT FROM AUTHOR]

Mental health courts are a promising new approach to addressing the overrepresentation of mental health needs among offender populations, yet little is known about how they facilitate change, particularly for youth. The current study reports on a process evaluation of a youth mental health court in Toronto, Canada. Drawing upon observations of the court and interviews with key informants, we developed a program model of the court and explored its implementation within the context of empirical evidence for treating justice-involved youth. Findings revealed that the proposed mechanism of change, which focuses on reducing recidivism through the treatment of mental health needs, should also consider factors directly related to offending behavior. Findings further highlight several strengths of the program, including the program's supportive environment and ability to engage and link youth and families with treatment. Areas for continued growth include the need for comprehensive protections of legal rights. [ABSTRACT FROM AUTHOR]

The involvement of mentally disordered offenders (MDOs) in the criminal justice system (CJS) is currently a major public health concern. This has culminated in several empirical researches over the years, with a particular focus on addressing the problem. The present study examines the criminal and the mental health legislations available to offenders raising fitness to stand trial issues, as well as those pleading insanity at the time of the offense (insanity defense) in Ghana. The legislations are examined within a framework of reducing the overrepresentation of MDOs in the CJS. In doing so, comparisons are made to similar legislations in other commonwealth jurisdictions, when necessary. Regarding fitness to stand trial, it is evident that the Ghanaian legislation does not contain discrete fitness indicators, relative to, for instance, Canada. Yet, it is interesting that the terminologies 'unsound mind' and 'incapable of making a defence' used in the proviso convey similar meaning and requirements to those used in other jurisdictions. The insanity defense standard, on the other hand, is also heavily influenced by the M'Naughton Rules in England. The defense consists of two separate cognitive tests, each of which can result in an acquittal. One of the tests strictly emphasizes knowledge of the nature and consequences of the act while knowledge of the wrongness of the criminal act is implied in the other. However, none of the tests takes into consideration uncontrollable impulse arising from mental disorder. The study proposes some revisions and amendments to the insanity legislation in its current formulation. Recommendations are also offered for critical areas that warrant research attention in relation to MDOs in Ghana, and in Africa as a whole. [ABSTRACT FROM AUTHOR]

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.