A prospective study of pathways to hospital readmission in Canadian forensic psychiatric patients

Individuals admitted to secure care often experience lengthy hospitalizations and are likely to be admitted on more than one occasion. In the context of growing demand and costs associated with secure care, the current study investigates the frequency and reasons for readmission among 87 forensic patients recently discharged into the community. We identify risk factors that are associated with the likelihood of readmission and describe areas of overlap and discordance with the existing literature in civil and forensic samples. Using a prospective design that included patient follow-up interviews and records review, we found that 28% of patients were readmitted on one or more occasions over a 12-month period. Psychiatric decompensation, substance use, and treatment non-adherence were the central reasons prompting readmission. Patients with one or more readmissions were found to have spent significantly more time in the forensic mental health system as compared to patients not readmitted. They were more likely to have a substance use disorder and were estimated to be at higher risk for violence. Results replicate the finding of low rates of serious violence and reoffending among discharged forensic patients, and substantiate the centrality of substance use as a growing and clinically important treatment issue.     

Social capital in Scottish and Danish neighbourhoods: paradoxes of a police–community nexus at the front line

Community-oriented social capital strategies and punitive-oriented policing approaches conflict. Establishing local networking initiatives with community-oriented policing at the centre lends itself to an assets-based policing approach, based on honouring, mobilizing and extending the assets of community members. Scholars argue about the need for comparative research on convergences and divergencies across subcultures on the streets and communities. Based on qualitative data gathered from working class communities in Scotland and Denmark in 2014, the article draws inspiration from community-generated theory of social capital to explore the micro-sociology of experiences and understandings about community–police integration policy initiatives. We use this perspective to argue that the building of positive inter-generational and police–community relationships is the result of social exchanges and officers’ use of what we call ‘constructive investment strategies’. Ironically, our insights from Scotland to Denmark also suggest what appear as positive achievements of community policing may instead intensify residents’ negative perceptions of police officers and organizations. In this way, the article illuminates the tangled and conflicted nature of these embedded symbolic interactions, social capital formations and the latter’s form as a potential positional and ‘tribal’ commodity.     

MEDIATING WITH HIGH-CONFLICT COUPLES

Models of mediation based on negotiation assume that participants can think and act rationally, whereas in reality, when individuals are overwhelmed by anger and pain, their capacity for reason and logic diminishes. Family mediators need to appreciate the intensity of the irrational feelings and reactions they see in mediation and to consider their personal impact. Mediators can help to contain family crises by adapting the family crises by adapting the model and methods in this article to fit different levels and patterns of conflict. An understanding of systems theory is particularly helpful in considering the functions of conflict and varying needs to maintain conflict. This article suggests that mediators can use different kinds of nonverbal and verbal communication and surprise those who expect mediators to give them a stock response.     

A new barrier to participation: Heterogeneous application of voter identification policies

In democratic societies there is a tension between maximizing ballot access and minimizing voter fraud. Since the 2000 presidential election, this tension has been central to discussions about election reform at the national, state, and local level. We examine this tension by focusing on the implementation of voter identification laws in one state that has experienced significant issues in recent elections, and that is currently implementing election reform: New Mexico. We hypothesize that Hispanic voters are more likely to show some form of identification than other types of voters. Using a voter data set from New Mexico's First Congressional District in the 2006 election, we find that Hispanic, male and Election Day voters are more likely to show some form of identification than non-Hispanic, female and early voters. In addition, using an overlapping study of Bernalillo County 2006 poll workers, which almost entirely overlaps with the First Congressional District, we find no evidence that differences in poll worker partisanship or ethnicity produce differences in voter identification procedures. Our findings suggest that broad voter identification laws, which may be applied unequally, may be perceived as discriminatory.