Using the Referral Decision Scale to Screen Mentally Ill Jail Detainees: Validity and Implementation Issues

The prevalence of serious mental illnesses in jail populations is significantly greater than in the general population. Identifying individuals who warrant psychiatric evaluations is important and benefits correctional staff as well as detainees. One widely used screening instrument intended for this task is the Referral Decision Scale (RDS). This paper reviews the development and validation of the RDS. Using data from a multisite study which assessed postrelease outcomes for detainees with mental illness, various types of validity are addressed. The results confirm that the RDS has some inherent characteristics that seriously limit its practical application as a screening instrument for use by correctional staff.     

TRICARE; Changes included in the John Warner National Defense Authorization Act for Fiscal Year 2007; authorization of anesthesia and other costs for dental care for children and certain other patients. Final rule

This final rule implements section 702 of the John Warner National Defense Authorization Act for Fiscal Year 2007, Public Law 109-364. The rule provides coverage of contracted medical care with respect to dental care beyond that care required as a necessary adjunct to medical or surgical treatment. The entitlement of institutional and anesthesia services is authorized in conjunction with non-covered dental treatment for patients with developmental, mental, or physical disabilities or for pediatric patients age 5 or under. This final rule does not eliminate any contracted medical care that is currently covered for spouses and children. The entitlement of anesthesia services includes general anesthesia services only. Institutional services include institutional benefits associated with both hospital and in-out surgery settings. Patients with developmental, mental, or physical disabilities are those patients with conditions that prohibit dental treatment in a safe and effective manner. Therefore, it is medically or psychologically necessary for these patients to require general anesthesia for dental treatment.     

Family Law,Parents with Disabilities,and the Americans with Disabilities Act

Parents with disabilities contend with bias within the family law system, often threatening their custody and visitation rights. The overarching goal of this article is to explore the experiences of parents with disabilities involved in custody and visitation disputes and the application of the Americans with Disabilities Act (ADA) in these cases. This article begins with an overview of parents with disabilities and their interactions with the family law system. Next, the article examines the ADA and its applicability to custody and visitation disputes. Finally, the article offers thoughts about strategies that can be utilized by attorneys to ensure that the rights of parents with disabilities are protected.     

Competency to stand trial: description and initial evaluation of a new computer-assisted assessment tool (CADCOMP).

The authors describe a Computer-Assisted Determination of Competency to Proceed (CADCOMP), a new instrument that collects data directly from the defendant through an interactive computer program and renders a report covering relevant historical, psychopathological, and legal information. The comprehensive report could be utilized by the clinician to focus the clinician's interview with the defendant on areas requiring further probing, thus reducing the time required to assess competency. Preliminary reliability and validity assessment studies are reported. The results support the predictive validity of CADCOMP used as a screening instrument and found the CADCOMP to be sufficiently reliable to be used for screening purposes.     

Psychometric validation of the Brief Symptom Inventory 25 Forensic (BSI-25-F)

The Brief Symptom Inventory 25 Forensic (BSI-25-F) is a screening instrument for measuring the psychophysical distress of prisoners and forensic patients. The aim of the study was to validate the instrument. For this purpose, 165 forensic patients, 312 general psychiatric patients, and 1359 people from the general population completed the BSI-25-F. In addition, the data of the long-term prisoners who were studied when the instrument was originally developed were used for comparison. The item analyses revealed acceptable to very good item characteristics within the target samples of the prisoners and the forensic patients for the majority of the items. Reliability tests also showed acceptable to good values for the target samples. The differential validity but not the factorial validity could be proved. To conclude, the new BSI-25-F represents an economic, practicable, and reliable screening instrument for identifying prisoners who are in a need of treatment.     

A Case Management Instrument for Use in Juvenile Justice Systems

The Youth Level of Service/Case Management Inventory (YLS/CMI) is a standardized instrument designed to assist juvenile justice system personnel in assessing risk and needs in their clients and in case planning. The measure is presented as an alternative to the unstructured informal assessments that so often guide decisions in these systems. It is relevant to all phases of the judicial process, including decisions regarding pretrial detention, transfers and waivers, preadjudicatory diversion, and sentencing. It is particularly relevant to case planning in community and institutional settings. The instrument is described, issues in application discussed, and the available psychometric information reviewed.     

Scaling archetypal criminals

The current study introduces an exploratory postdiction scale whose elements are derived from Moffitt’s (2001) developmental taxonomy, specifically her idea of the life-course persistent offender. Using data obtained from a probability sample of 500 adult arrestees in the western United States, this 7-item additive scale postdicts such criminal behavior as violent and property Index arrests, felony convictions, and prison sentences with overall accuracy ranging from 85% to 92%. Unlike other efforts, this scale suggests that most criminals are benign, low-level offenders, a finding anticipated by Moffitt’s theory. Like prior criminological scales, the current measure has difficulty correctly identifying highrate offenders. The merits of using theory to influence scale construction are expressed and suggestions for refining this instrument are offered.     

Screening offenders for risk of drop‐out and expulsion from correctional programmes

Purpose. The goal of the present research was to develop a screening measure to assist in identifying offenders at risk for drop‐out or expulsion from correctional programmes. Methods. Non‐Aboriginal male offenders (N = 5,247) were randomly divided into a development sample (N = 2,617) and a validation sample (N = 2,630). In the development sample, individual predictors were identified through univariate and multivariate analyses, weighted based on their relationship with drop‐out/expulsion, and combined into a composite measure we called the drop‐out risk screen (DRS). Results. The DRS consists of five items, including static and dynamic risk factors for recidivism as well as motivation for intervention. It significantly predicted drop‐out/expulsion in the development sample (area under the receiver operating characteristic curve [AUC]= .72) and performed similarly in the validation sample (AUC = .70). Conclusions. The results indicate that the DRS is a valid screening instrument for risk of drop‐out/expulsion. Prior to commencement of a treatment programme, offenders with high scores on the DRS could be more thoroughly assessed and, if necessary, targeted with pre‐treatment efforts to increase their motivation and general readiness for treatment.     

Identification of potential juvenile offenders

Conclusion In this article, we have reviewed the guidelines, from the criminological prediction tradition, that should be followed while developing a screening device for the identification of potential juvenile offenders. We were also able to recognize an appropriate screening strategy for prevention, even if more validation studies have to be conducted. Screening of juvenile offenders should rest on multiple stages, informants, methods, and variable domains. In addition, it was not possible to identify a satisfactory instrument for prevention screening. The candidate devices all have significant methodological deficiencies. Also, it was not possible to identify the particular predictors to retain for screening, even if there is a large consensus about the variable domains that are most important. To summarize, there is much technical work still to be done before we can develop appropriate screening instruments for the identification of potential offenders. Some screening strategies and instruments are promising, but none can be recommended for immediate use to policy-makers and practitioners. The state-of-the-art for the identification of potential juvenile offenders is such that the research community can only indicate how to develop good screening instruments. The research for this article was commissioned by the Study Group on Serious/Violent/ Chronic Offenders of the Office of Juvenile Justice and Delinquency Prevention of the Department of Justice of the United States of America. This paper is an adaptation of a more comprehensive review on screening for that study group.     

Improving the quality of drug court clinical screening: a call for performance measurement policy reform

Despite the widespread use of the drug court model, standardized performance measures for drug courts are not uniformly utilized, and rarely include process measures. To ensure that drug courts are being implemented in the most effective manner, the use of performance measurement tools should be considered for wide scale adoption. Drug court effectiveness is moderated by participant characteristics, and is most effective for individuals with the highest substance use needs. Therefore, having quality clinical screening processes is crucial to ensuring that drug courts are serving the population for which they are effective. This paper examines clinical screening in drug courts, to answer the following 1) what is the current state of screening, 2) what works, and 3) why measurement matters. It also proposes a clinical screening performance measure to improve fidelity and ensure appropriate participant enrollment. The creation of a performance measure would create opportunities to improve drug court outcomes, and leverage pay-for-performance models.     

Adapting measures of social climate for use with individuals with intellectual developmental disability in forensic settings

The social climate of forensic settings is thought to impact on a number of important clinical and organisational outcomes and is, therefore, an important construct in relation to the successful functioning of forensic units. A variety of self-report questionnaires have been developed to objectively measure the social climate of forensic settings (e.g. the Correctional Institutions Environment Scale and the Essen Climate Evaluation Schema), however these questionnaires have not been validated for individuals with intellectual developmental disabilities (IDD). Given the prevalence of IDD in prison and forensic psychiatric settings and the potential impact of such cognitive deficits on the ability to complete a range of self-report questionnaires, it is important to consider the potential reliability and validity of existing social climate measures in IDD populations. This article will, therefore: (1) examine the cognitive, linguistic and response format difficulties that may arise when administering self-report measures of social climate in IDD populations; (2) consider potential adaptations to existing measures of social climate that might make them more suitable for use with IDD populations; and (3) identify important directions for future research in the area.     

CURRENT TRENDS IN THE DEVELOPMENT OF THE CHINESE SOCIAL SECURITY SYSTEM FOR PEOPLE WITH DISABILITIES

The Law on the Protection of Disabled Persons is the first social security legislation in China, with more than 50 laws directly related to the legal protection of the rights of persons with disabilities and career development for people with disabilities. In terms of employment protections for people with disabilities, it is important to focus on effective legal implementation, utilizing legal rulings to limit employment discrimination against people with disabilities. Educational protections are an important precondition for enabling people with disabilities to live with dignity; it should be guaranteed that people with disabilities are provided “reasonable accommodation” in educational conditions. A barrier-free environment is a necessary condition for social integration of people with disabilities. At the same time, it also benefits other members of the society such as the elderly. Through rehabilitation and exercise, most people with disabilities can return to the society to a significant degree. China should gradually expand the legislative scope of rehabilitation service fee reductions and legal categories of auxiliary appliances, issuing guiding documents that provide specifications for the relevant “dormant” legal provisions.     

Clinical assessment of adult sexual offenders with learning disabilities

Abstract

Assessment and treatment of adults with learning disabilities who commit sexual offences presents a number of challenges. Much of the professional forensic and psychiatric literature on work with this group concentrates on the development of interventions based on theoretical models of sexual offending originating from the mainstream criminal justice system and have often been adapted and applied to people with learning disabilities. Currently, there is very little evidence to demonstrate the effectiveness or validity of the adaptation and application of mainstream models to this population. The efficacy of such adapted models used to describe sexual offending in people with learning disabilities clearly has an impact of any intervention informed by them. In particular, some researchers suggest that key factors such as cognitive distortions are evident in sexual offenders with learning disabilities; there is, however, no research relating to the prevalence of these or other key factors within the general population of people with learning disabilities. The present literature review highlights some of the clinical issues with a particular focus on the assessment of deviant sexual interest. Specifically, the literature is confused with inconsistencies relating to the definition of the group, the extent and nature of offending and a lack of standardized methodology for assessment and comparison. Consideration is given to the particular needs of this group and the implications for research and treatment.     

Screening of Women in Jail for Health Risks and Needs

Abstract

In order to address the relative lack of services for women who come into contact with the criminal justice system, there is a need to develop quick and easily administered screening tools. This pilot study was conducted with 110 women in two urban county jails in Ohio. The purpose of the project was to develop and pilot a quick multidimensional screening instrument for women in jail to identify risk and rehabilitative needs. The project resulted in a 15-item screening tool which can be used in urban crowded jail settings to identify women at risk for health, substance abuse, mental health, family, employment or housing risks.     

The Family Court–Based Stepping Stones Model of Triage: Some Concerns About Safety,Process, and Objectives*

This article critically evaluates the recommendation that family court–based mandatory mediation incorporated in a tiered service delivery model be replaced by a mandatory screening process incorporated in a stepping stones triage model in which couples are matched with an appropriate conflict resolution proceeding. My conclusion is that implementation of this recommendation should be made contingent upon the willingness of its advocates to address concerns with the safety, process, and objectives as described herein.

Key Points for the Family Court Community:
• Domestic violence screening should be incorporated in the larger triadic process of screening–risk assessment–risk management.
• A Safety First Rule should be followed in screening couples into or out of conflict resolution proceedings.
• Screening decisions must be grounded in an empirically validated method of matching couples with appropriate conflict resolution proceedings.
• Causal mechanisms must be included as items in any risk assessment instrument used in family courts.

     

From Consent to Responsibility, from Pity to Respect: Subtexts in Cases of Sexual Violence Involving Girls and Women with Developmental Disabilities

How might feminist law reform serve all women? The author explores this question within the context of sexual violence involving girls and women with developmental disabilities. She presents the difference impasse as a theoretical tool for understanding how women are positioned in law differently and unequally in relation to each other. She explores how, within the consent framework of a rape trail, competing social narratives or subtexts about race, class, gender, and disability circulate in the courtroom. She also explores the issue of pity in rape traiIs and argues that focusing on interlocking systems of domination and on our complicity in maintaining categories of women in law and law reform is a useful approach for feminist law reformers.     

Sexual offenders with learning disabilities: risk,recidivism and treatment

Abstract

While the literature on the assessment, treatment and management of non-learning disabled sexual offenders is well established, it is only in recent years that researchers and clinicians have focused on sexual offenders with learning disabilities. In contrast to mainstream sex offender treatment programmes, there are few evaluated community-based treatment programmes for sexual offenders with learning disabilities, and of the small number of published studies that describe treatment programmes, most are based on small samples and few have been validated empirically. Sexual offenders with learning disabilities differ from their non-disabled counterparts in several important ways, having implications for management and treatment. Due to methodological differences between studies, the prevalence of sexual offending by men with learning disabilities is not clear. However, in some studies, the sexual recidivism rate of offenders with learning disabilities is 6.8 times and 3.5 times that of non-disabled sexual offenders at 2- and 4-years’ follow-up, respectively. Sexual offenders with learning disabilities are also at greater risk of re-offending in a shorter time period. There remains an urgent need for further research into the assessment of risk and whether components from mainstream treatment programmes can be adapted to meet the needs of learning disabled sexual offenders. Approaches to working with sexual offenders with learning disabilities and programme development are discussed.     

Psychometric Proprieties and Construct Validity of the Brother-Sister Questionnaire in a Sample of Portuguese Adolescents

The Brother-Sister Questionnaire (BSQ; Graham-Bermann and Cutler 1994) is an instrument designed to measure qualities of sibling relationships. Aim: In the present study the main objective was to examine the psychometric properties and validity construct of BSQ - Portuguese version. Data were collected among 197 adolescents. The Cronbach’s alpha of the four domains ranged from .58 to .84. The psychometric characteristics of BSQ Portuguese version were found to be adequate. The results confirm the multi-dimensional model composed of four factors proposed by the authors of this instrument, as well as their suitability to assess quality of Portuguese sibling relationships. The BSQ offers a reliable and valid measure to be used within Portuguese population.