Accountability and psychiatric disorders: How do forensic psychiatric professionals think?

Swedish penal law does not exculpate on the grounds of diminished accountability; persons judged to suffer from severe mental disorder are sentenced to forensic psychiatric care instead of prison. Re-introduction of accountability as a condition for legal responsibility has been advocated, not least by forensic psychiatric professionals. To investigate how professionals in forensic psychiatry would assess degree of accountability based on psychiatric diagnoses and case vignettes, 30 psychiatrists, 30 psychologists, 45 nurses, and 45 ward attendants from five forensic psychiatric clinics were interviewed. They were asked (i) to judge to which degree (on a dimensional scale from 1 to 5) each of 12 psychiatric diagnoses might affect accountability, (ii) to assess accountability from five case vignettes, and (iii) to list further factors they regarded as relevant for their assessment of accountability. All informants accepted to provide a dimensional assessment of accountability on this basis and consistently found most types of mental disorders to reduce accountability, especially psychotic disorders and dementia. Other factors thought to be relevant were substance abuse, social network, personality traits, social stress, and level of education.     

Prisoners with psychosis in England and Wales: diversion to psychiatric inpatient services?

The prevalence of psychosis among prisoners in England and Wales is ten times that in the household population and UK government policy is that prisoners should receive equivalent care to those in the community. This study investigated the implications of policy to divert more from the criminal justice system for psychiatric treatment. Psychotic prisoners were compared with psychotic persons in households and with other prisoners in two surveys of psychiatric morbidity in representative samples of the UK population. Psychotic prisoners were younger, more from ethnic minorities, with comorbid anxiety, substance misuse, ASPD, and childhood behavioural problems compared to psychotic persons in households. Less than a third had received previous inpatient treatment. Psychotic prisoners had similar criminal histories and higher psychopathy scores than non-psychopathic prisoners. Diversion is unfeasible without improved screening for psychosis and increasing bed numbers at higher levels of security to accommodate more patients who would pose high risk to the public. Future research should investigate why UK psychiatric services fail to identify psychotic prisoners and provide aftercare.     

How do professionals experience working with offenders diagnosed with personality disorder within a prison environment?

To explore the different experiences of a Multidisciplinary Team working with offenders diagnosed with personality disorder (PD) and produce a substantive model of the Offender PD Pathway strategy from a staff perspective. Fourteen participants were recruited from ‘Unit A’ located within a high security prison. Semi-structured interviews were conducted with participants and the data collected were analysed using constructivist grounded theory. A model was constructed depicting the experiences of those working with offenders with PD. Main themes identified were: prison environment; synergy of the workforce; understanding of the client; individual perceptions; support; and personal change. Although there was enough similarity within the participants’ responses to consider them to be a homogenous population, there were some noticeable differences in trends of responses evident between the two sub-groups of health service-based clinical staff and prison staff as expressed in the model. There is interplay between factors which influence an individual’s experience of working with offenders with PD. How a member of staff experiences working with offenders with PD depends on more than just the nature of the client and the challenges they pose. These factors external to the client group appear to have a significant impact on the professional and their emotional experiences of their work.     

How do Rights Become Probable in the Global Context?

Liverpool Law Review - In this article is analysed how is the emergence of rights in favour of people with less power in the global context probable and is explored what could be the most integral...     

Who’s going to leave? An examination of absconding events by forensic inpatients in a psychiatric hospital

Absconding is a potentially risky event that has wide reaching consequences both for the institution and greater community; however, few studies have examined the characteristics of clients who abscond, their motivations, and details about their absconding event, especially within a forensic context. The purpose of this research was to determine if risk factors could be identified that might predict absconding behavior. A retrospective chart review was conducted of all reported absconding events between 1 January 2012 and 31 August 2015 by clients on forensic units in a public psychiatric hospital in Ontario, Canada. In addition, these clients were matched with a comparison group. Categories of motivations for absconding including goal-directed, frustration/boredom, symptomatic/disorganized, and impulsive/opportunistic were identified. The best indicator of a client’s risk for absconding was having experienced a stressful, significant event in the two weeks prior to the absconding event. Additionally, total scores on the HCR-20 and the presence of a co-occurring substance use disorder differentiated the absconders from the comparison group. This research contributes to our knowledge base regarding absconding events by forensic psychiatric patients and highlights specific targets for clinical staff in assessing risk for absconding and managing privileges leading to more effective care planning.     

How do parents experience relocation disputes in the family courts?

Relocation cases are known to be amongst the most difficult decisions for family court judges. This article reports the findings of an empirical study of parents who were involved in relocation disputes, reporting their views on the experience of being involved in one of these difficult cases. We consider the origins of the disputes and parents’ perceptions of how their cases were resolved, as well as some initial discussion of the aftermath of the cases as seen in the first few months.     

How do college students in Ukraine and the United States view criminal offenders?

This paper introduces an original data set that provides insight into how Ukrainian and US college students would punish criminal offenders. Students on four campuses in Ukraine and four in the United States completed surveys that help us better understand these differences. In general, Ukrainian students are more likely than American students to be crime victims than are American students and they are consistently more fearful of being victimised. Ukrainian students are more punitive than American students for some types of crimes (e.g., drug possession) while Americans are more punitive on other crimes (e.g., burglary).     

How do sex offenders think the police should interview to elicit confessions from sex offenders?

Abstract

The purpose of this study is to explore sex offenders' perceptions of how the police should interview suspected sex offenders to facilitate confessions, and to investigate whether there is a relationship between sex offenders' perceptions of how the police interviewed them and their decisions to confess or deny. Forty-three convicted sex offenders were interviewed using two 35-item questionnaires that contained five questions on each of seven interviewing strategies. An additional 20 violent offenders were included for comparison purposes. The strategies were evidence presenting strategies, ethical interviewing, displays of humanity, displays of dominance, use of minimization and maximization techniques, and demonstrating an understanding of sex offenders' cognitive distortions. One questionnaire concerned how the police should interview sex offenders and the other concerned how they perceived the police who interviewed them. Generally speaking, evidence presenting strategies, ethical interviewing, and displays of humanity were perceived to increase the likelihood of a confession. Interviewer dominance was perceived to be associated with a reduction in the likelihood of a confession.     

How do uncompensated care pools affect the level and type of care? Results from New York State

Uncompensated care pools have been used by several states in their attempt to aid hospitals and increase the volume of care provided to patients without health insurance. We examined the uncompensated care pool used in New York State between 1983 and 1987. Our primary interest was to estimate the impact of the pools on the level and type of care provided to uninsured patients. Our results indicate that hospitals responded to the pools by increasing the volume of care provided to uninsured patients. Without the pools, over 30,000 fewer adjusted hospital admissions would have been provided to the uninsured in a typical year. Many of these newly purchased admissions were for "nondiscretionary" medical care, suggesting that beneficial care to the indigent was rationed prior to the introduction of the uncompensated care pools.     

How much power do oppositions have? Comparing the opportunity structures of parliamentary oppositions in 21 democracies

A political system cannot be imagined without opposition. Despite this crucial position in politics, political science has largely neglected to study oppositions. Attempting to fill this gap, this article analyses the institutional opportunities of parliamentary oppositions. It offers a parsimonious framework by distinguishing two dimensions of opposition influence: some institutions enable oppositions to control governments, while others offer opportunities to present alternatives. A comparison of oppositions’ opportunities in 21 democracies shows that countries fall into four groups along these dimensions: in majoritarian democracies, weak control mechanisms are countered by excellent opportunities to publicise alternatives. Consociational democracies are characterised by strong control mechanisms, but provide only weak opportunities to present alternatives. Moreover, in Southern Europe, control mechanisms and opportunities to present alternatives are weak, while both are pronounced in Nordic Europe. The results are summarised in three indices that can easily be applied in future research examining oppositions and their power.     

Do R&D strategies in high-tech sectors differ from those in low-tech sectors? An alternative approach to testing the pooling assumption

Most studies investigating the determinants of R&D investment consider pooled estimates. However, if the parameters are heterogeneous, pooled coefficients may not provide reliable estimates of individual industry effects. Hence pooled parameters may conceal valuable information that may help target government tools more efficiently across heterogeneous industries. There is little evidence to date on the decomposition of the determinants of R&D investment by industry. Moreover, the existing work does not distinguish between those R&D determinants for which pooling may be valid and those for which it is not. In this paper, we test the pooling assumption for a panel of manufacturing industries and find that pooling is valid only for output fluctuations, adjustment costs and interest rates. Implementing the test results into our model, we find government funding is significant only for low-tech R&D. Foreign R&D and skilled labour matter only in high-tech sectors. These results suggest important implications for R&D policy.     

Self-reported anger among individuals with an autism spectrum disorder detained in high security psychiatric care: do preoccupations have an influence?

The State Trait Anger Expression Inventory (STAXI 2) is a widely used measure of the experience and expression of anger within forensic populations. Despite anger expression difficulties being common among individuals with an Autism Spectrum Disorder (ASD), little is known as to how those who offend perform in the STAXI 2. In exploring the application of the STAXI 2 to individuals with an ASD, two groups detained in high security psychiatric care were compared. Results suggest that whilst those with offending unconnected to a preoccupation have more complex psychiatric presentations, MANOVAs revealed no differences in demographic and cognitive characteristics. Within the Autism Spectrum Quotient, those with offending linked to a preoccupation score higher in the attending to details scale and in the STAXI 2 reported significantly lower levels of ‘anger expression out’. It is proposed that an examination of anger is useful for all individuals with an ASD who offend.     

How do firms use innovations to hedge against economic and political uncertainty? Evidence from a large sample of nations

The Journal of Technology Transfer - Using data on 135 countries, this paper studies the determinants of process innovation introduction, focusing on the impacts of economic and political...     

How do universities shape founding teams? Social proximity and informal mechanisms of knowledge transfer in student entrepreneurship

This paper investigates informal mechanisms of knowledge transfer (KT) from a local university to entrepreneurial teams comprising students and recent graduates. While the extant literature on university-industry KT largely focuses on formal mechanisms aimed at stimulating entrepreneurial initiatives in high-tech (HT) sectors, it overlooks the effect of university-industry KT on nascent entrepreneurship in low-medium tech (LMT) sectors. To fill this gap in the literature, we carry out a mixed-method analysis that exploits a dataset of 154 new business ideas (and 535 team members) presented at a business plan competition in Rimini from 2010 to 2017. Our findings highlight a robust relationship between educational field and the R&D intensity of entrepreneurial projects: students take advantage of the knowledge acquired at university to develop entrepreneurial projects with higher technological content than those planned by non-graduates. Furthermore, the empirical evidence shows that the local university nurtures the formation of ties among students and recent graduates enrolled in the same courses and fosters their efforts to launch new ventures. Finally, the qualitative analysis identifies relevant and non-traditional mechanisms of KT that are being exploited by nascent entrepreneurs to develop their business ideas in the LMT and HT sectors.

     

What can we learn from the first community-based epidemiological study on stalking in Germany?

There is a lack of community-based studies on prevalence rates of stalking and the impact of stalking on victims in continental European countries. The authors published the first community-based epidemiological study on stalking in Germany. The purpose of this paper is to discuss possible implications of these epidemiological data for the mental health system, forensic psychiatry and legal regulations in Germany. For these reasons some data of our epidemiological study are outlined and reanalyzed. To examine lifetime and point prevalence rates of stalking, behavioural and psychological consequences for victims and the impact of stalking on current psychological well-being in a German community sample, a postal survey was conducted with 2000 inhabitants randomly selected from Mannheim (response rate 34.2%, n=679). The survey included a stalking questionnaire and the WHO-5 well-being scale. Almost 12% of the respondents reported having been stalked. This study identified a high lifetime prevalence of stalking in the community. Effects on victims' psychological health were significant and there was a high rate of physical (31%) and sexual (19%) violence in the context of stalking. Our data suggest that the phenomenon deserves more attention in future forensic psychiatric research and practice. Implications for forensic psychiatric assessment and treatment of stalkers as well as for management of stalking victims are discussed.     

Special report on reimbursement. The safe harbor for small investment interests: where do joint ventures go from here?

There is no specific federal self-referral legislation presently proposed or in effect that statutorily prohibits providers from referring Medicare or other patients to entities in which the referrers have an investment interest, except for existing "Stark" legislation, which applies only to clinical laboratory services, effective January 1, 1992. (See Newsletter, Vol. 6, No. 1, January 1991, at 3.) Thus, health care joint ventures are not per se illegal. The publication of the Safe Harbor Regulations does nothing to change this fundamental fact, and it should not cause providers to abandon existing joint ventures, or planned ones, in a "knee-jerk" fashion, without careful analysis. Of course, there is no guarantee that expanded "Stark" legislation, or some other new self-referral legislation, will not be enacted in the future to prohibit providers from referring patients to entities in which they have an investment interest. Because of this uncertainty, all health care joint ventures should contain "unwinding" provisions to govern the rights and obligations of investors in the event that the venture is required to, or the participants voluntarily elect to, dissolve. Any new venture being contemplated should plan for dissolution, and existing ventures should undertake an internal review of their charter documents to assess whether the rights and duties of all participants upon dissolution are properly spelled out. If not, amendments should be made now, while all participants are on good terms. A failure to agree in advance upon such important issues is an invitation to discord, and possibly even litigation.