Assisted reproduction and mental illness: a human rights perspective from New Zealand

Developments in our ability to artificially assist reproduction have led to new and more social applications for medicine. Parallel to this has been an increasing acceptance and understanding of mental illness. Yet it may be argued that mental illness should preclude an ability to parent by means of state-involved artificial reproductive technologies. Through examination of current New Zealand human rights law, it is argued that such practice would be discriminatory. While there is some room to grant an exception to allow such discrimination, it is doubtful that such a decision would ever be made. Any reasons to justify an exception are unlikely to meet the high threshold demanded by current law.     

Treating offenders with mental illness: a research synthesis

The purpose of this research synthesis was to examine treatment effects across studies of the service providers to offenders with mental illness. Meta-analytic techniques were applied to 26 empirical studies obtained from a review of 12,154 research documents. Outcomes of interest in this review included measures of both psychiatric and criminal functioning. Although meta-analytic results are based on a small sample of available studies, results suggest interventions with offenders with mental illness effectively reduced symptoms of distress, improving offender's ability to cope with their problems, and resulted in improved behavioral markers including institutional adjustment and behavioral functioning. Furthermore, interventions specifically designed to meet the psychiatric and criminal justice needs of offenders with mental illness have shown to produce significant reductions in psychiatric and criminal recidivism. Finally, this review highlighted admission policies and treatment strategies (e.g., use of homework), which produced the most positive benefits. Results of this research synthesis are directly relevant for service providers in both criminal justice and mental health systems (e.g., psychiatric hospitals) as well as community settings by informing treatment strategies for the first time, which are based on empirical evidence. In addition, the implications of these results to policy makers tasked with the responsibility of designating services for this special needs population are highlighted.     

Community reintegration of ex-prisoners: type and degree of change in variables influencing successful reintegration

Community reintegration of ex-prisoners is an important issue in efforts to reduce recidivism. The present study examined the multiple, complex, and dynamic nature of variables influencing successful reintegration by assessing the type and degree of change in reintegration variables over time. Participants were 79 adult prisoners (54 male, 25 female) who completed a prerelease questionnaire 1 month before their release, which focused on prison-related variables, participant background, and anticipated conditions upon release. A postrelease questionnaire was administered to the same participants at 1-4 weeks and 3-4 months postrelease, focusing on the quality of life conditions experienced following release. Results indicate that current health ratings and several indicators of drug use were significantly different over the three measurement phases. Ratings of employment and housing stability, finance, and social support were unchanged over the postrelease period. Theoretical implications of the present investigation for reintegration theory are discussed, together with practical applications.     

The impact of mental health services on arrests of offenders with a serious mental illness

This study examines the impact of mental health services on arrests of offenders with a serious mental Illness (SMI) by assessing changes in associations between receipt of outpatient and emergency room/inpatient services and arrests one, two, and three quarters later. A variety of data sets were used for identifying 3,769 offenders who were in the Pinellas County Florida jail between 7/1/2003 and 6/30/ 2004, and 7,755 offenders who were in the Harris County Texas jail between 10/1/2005 and 9/30/2006. Arrests, out-patient and emergency room/inpatient services were assigned to one of 16 ninety-day periods between 7/1/2002 and 6/10/2006 in Pinellas County and one of 12 such periods between 10/1/2004 and 9/15/2007 in Harris County. Generalized estimating equations were used. Covariates were age, gender, race, diagnosis, and homelessness. The results were also adjusted for exposure to arrests. In Pinellas County, outpatient services significantly reduced the risks of arrests 1 quarter later by 17% (odds ratio [OR] = 0.83, 95% confidence interval [CI]: 0.78-0.87, p < .001), two quarters later by 11% (OR = 0.89, 95% CI: 0.84-0.94, p < .001), and three quarters later by 9% (OR = 0.91, 95% CI: 0.86-0.96, p = .001). In Harris County, these services reduced the risk of arrest 1 quarter later by 5% (OR = 0.95, 95% CI: 0.91-0.99, p = .028), but not two and three quarters later. In Pinellas County, ER/inpatient services increased the risk of arrests by 22% (OR = 1.23, 95% CI: 1.15-1.30, p < .001), 8% (OR = 1.08, 95% CI: 1.02-1.15, p = .010) and 11% (OR = 1.11, 95% CI: 1.02-1.16, p = .001) one, two, and three quarters later. In Harris County, these services increased the risk of arrest only 1 quarter later (OR = 1.16, 95% CI: 1.11-1.22, p < .001). Results suggest that service receipt and its timing may have had some impact on the arrests of adults with a SMI and criminal justice involvement.     

Improving police response to persons with mental illness: a multi-level conceptualization of CIT

The large numbers of people with mental illness in jails and prisons has fueled policy concern in all domains of the justice system. This includes police practice, where initial decisions to involve persons in the justice system or divert them to mental health services are made. One approach to focus police response in these situations is the implementation of Crisis Intervention Teams (CIT). The CIT model is being implemented widely, with over 400 programs currently operating. While the limited evidence on CIT effectiveness is promising, research on CIT is limited in scope and conceptualization-much of it focusing on officer characteristics and training. In this paper we review the literature on CIT and present a conceptual model of police response to persons with mental illness that accounts for officer, organizational, mental health system and community level factors likely to influence implementation and effectiveness of CIT and other approaches. By moving our conceptualizations and research in this area to new levels of specificity, we may contribute more to effectiveness research on these interventions.     

No human cloning: a social ethics perspective

This Essay addresses the negative impact of human cloning on the family, and argues further that market incentives to develop and implement cloning techniques exploit and exacerbate socioeconomic inequities. It suggests that cloning should be prohibited internationally and examines possible routes to that aim. To begin with, it offers some reflections on the nature of moral argument, and on the role of religion in public debate.     

Bullying and social and emotional loneliness in a sample of adult male prisoners

The present study explored social and emotional loneliness, and victimisation among a sample of adult male prisoners. 241 prisoners took part, completing a behavioural measure of behaviours indicative of bullying (DIPC-R: Direct and Indirect Prisoner behaviour Checklist, Ireland, J.L. 2003. The Direct and Indirect Prisoner behaviour Checklist -- Revised. Psychology Department, University of Central Lancashire). and a measure of social and emotional loneliness (SELSA: Social and Emotional Loneliness Scale for Adults, DiTommaso, E. & Spinner, B. (1993). The development and initial validation of the social and emotional loneliness scale for adults (SELSA). Personality and Individual Differences, 14, 127-134.). Differences between the groups involved in bullying (i.e. pure bullies, pure victims, bully/victims and those not involved) were noted, with victim groups (pure victims and bully/victims) presenting with higher levels of social loneliness than those not-involved. Emotional loneliness was not a distinguishing characteristic for membership to the pure victim or bully/victim group, and instead was found to be associated with the type and amount of victimisation reported: victims who reported multiple types of victimisation presented with higher levels of emotional (family) loneliness than victims reporting just one type of victimisation. Increased victimisation was also associated with increased levels of social and emotional loneliness, most notably with regards to indirect victimisation. The results are discussed with reference to the environment in which the victimisation is taking place, and we outline a potential application of life events and added stress models in understanding social maladjustment (loneliness) among prisoners.     

在押犯人精神障碍的特征及其预防

本文回顾了近年来一些国外学者对此问题的探索，总结在押犯人中各种精神障碍的流行病学研究及特征，结合我国实际情况，建立专门的精神障碍治疗机构和对其进行医疗服务。     

在押犯人精神障碍的特征及其预防

本文回顾了近年来一些国外学者对此问题的探索,总结在押犯人中各种精神障碍的流行病学研究及特征,结合我国实际情况,建立专门的精神障碍治疗机构和对其进行医疗服务。     

Bioethics from a social perspective: European Biopolitics Conference]

The European Congress on biopolitics entitled "Connecting civil society implementing basic values" was held in March 2006 in Berlin. It was organised by the Heinrich B?ll foundation and the Institut Mensch, Ethik und Wissenschaft. The aim of the Congress was to provide a forum for discussion on the ethical and social aspects derived from biotechnology and genetics on human beings. This work summarises some of the aspects that reveal the international interest and relevance of this meeting.     

Prevalence of mental disorders and deliberate self-harm in Greek male prisoners

The aim of this survey was to determine the prevalence of current and lifetime mental disorder and deliberate self-harm among male prisoners in Greece. The subjects were 80 randomly selected remanded and sentenced prisoners in a Greek prison. They were assessed for mental disorder including suicidality and substance misuse using the Mini International Neuropsychiatric Interview (MINI). We also collected information regarding contact with psychiatric services, previous deliberate self-harm as well as physical health and conducted a brief assessment of their intellectual functioning. Mental disorder was diagnosed in 63 (78.7%) prisoners. The main diagnoses were: anxiety disorder, 30 (37.5%); major depression, 22 (27.5%); antisocial personality disorder, 30 (37.5%); alcohol dependence, 21 (26.3%) and opiate dependence 22 (27.5%) and schizophrenic or bipolar disorder 9 (11.2%). Deliberate self-harm prior to and during imprisonment was reported by 15% and 2.5% of prisoners, respectively, and 12 prisoners (15%) had IQ below 75. This survey identified a significant level of need for specialist mental health services in prison. Further studies are required to assess the specific needs of those patients who are too unwell to remain in prison, the need for specific treatments for substance misuse and improved assessment/treatment of common psychiatric disorders.     

Physical victimization in prison: the role of mental illness

This study compares prison physical victimization rates (inmate-on-inmate and staff-on-inmate) for people with mental disorder to those without mental disorder in a state prison system. Inmate subjects were drawn from 14 adult prisons operated by a single mid-Atlantic State. A sample of 7,528 subjects aged 18 or older (7,221 men and 564 women) completed an audio-computer administered survey instrument. Mental disorder was based on self-reported mental health treatment ever for particular mental disorders. Approximately one-quarter of the sample reported some prior treatment for schizophrenia, bipolar disorder, depression, PTSD, or anxiety disorder. Rates of physical victimization for males with any mental disorder were 1.6 times (inmate-on-inmate) and 1.2 times (staff-on-inmate) higher than that of males with no mental disorder. Female inmates with mental disorder were 1.7 times more likely to report being physically victimized by another inmate than did their counterparts with no mental disorder. Overall, both males and females with mental disorder are disproportionately represented among victims of physical violence inside prison.     

The effect of a social reintegration (parole) program on drug-related prison inmates in Japan: a 4-year prospective study

Social reintegration has been known to protect against recidivism, but its effects against drug-use relapse have previously remained unclear. To address this gap, the present study sampled 196 inmates imprisoned for drug-related offenses in Japan. We examined the protective effects of a social reintegration (parole) program against recidivism and drug-use relapse using a 4-year prospective design. During the 4-year follow up, 79 (40.3 %) of the participants reoffended and 61 (31.1 %) relapsed into drug use. The results suggest that the parole program was significantly associated with a decreased risk of recidivism, even if participants’ age, sentence length, number of prison terms, educational levels, and gang membership were controlled for. However, the effects of the parole program on drug relapse disappeared when the above variables were controlled for. To decrease the risk of relapse, drug-related inmates may need both prosocial communities and rehabilitative environments. The Japanese criminal justice system needs to introduce drug treatment courts for drug users.     

Of Eggshells and Thin-skulls: a consideration of racism-related mental illness impacting Black women

Recent research has indicated that the prevalence of mental disorders is estimated to be higher among Blacks than among Whites, most likely due to the nexus of race and socioeconomic disparity. Blacks are under-represented in in-patient populations and more likely than Whites to use the emergency rooms for mental health treatment. Numerous studies confirm that Blacks drop out of mental health services at a significantly higher rate than Whites and use fewer treatment sessions for mental health issues. Furthermore, Blacks enter mental health treatment at a later, more advanced stage than Whites, under-consume community mental health services of all kinds, are misdiagnosed more often than Whites, and are more often diagnosed with a severe mental illness than Whites. People from diverse ethnic backgrounds often are prevented from receiving adequate mental health treatment due to misdiagnoses and lack of access to the services they need. Factors contributing to this disparity include a general mistrust of medical health professionals, cultural barriers, co-occurring disorders, socioeconomic factors, and primary reliance on family and the religious community during times of distress. Unfortunately, the traditional institutions of racialized research largely ignore the disparate social and political exposures confronting people of color, such as residential and occupational segregation, racial profiling, tokenism, discrimination, racism, and the consequential physiological and psychological effects flowing from the macro and micro effects of such interactions and intersectionalities. This article explores these issues and proposes civil law legal frameworks for addressing these disparities. In particular, it is suggested that renewed consideration be made of the Thin-skull and Eggshell doctrines in the United States and comparable traditional international doctrine.