Attitudes among medical and law students toward decision-making in regard to involuntary psychiatric hospitalization

Background

The management of individuals with mental illnesses sometimes requires involuntary hospitalization. The Israel Mental Health Act requires that cases of involuntary psychiatric hospitalization (IPH) be periodically reviewed by the district psychiatric committee. The discussion in the committee often leads to debate regarding the need for an IPH potentially depriving the patient of his freedom. Little is known about the way in which the psychiatrists and attorneys on these committees arrive at their decisions. The present study was designed to examine the views of future doctors and attorneys concerning cases of possible IPH to determine whether their decisions would be influenced by their respective professional educational backgrounds.

Methods

After compiling demographic data, we asked 170 students from each of the two disciplines what their decision would be in two hypothetical cases that dealt with the question of a prolongation of a psychiatric hospitalization. Questionnaires examining social distance and possible stigmatizing views concerning psychiatric patients were also distributed and collected.

Results

The response rates for the medical and law students were, respectively, 90% and 85%. We found no differences between the medical and law students regarding their views on prolongation of a psychiatric hospitalization. This was consistent regardless of whether the hospitalization was against the patient's will or according to his wish and against the treating physicians' advice. We also found that the medical and law students had similar general views regarding psychiatric patients, but that the latter evidenced greater social distance than the former.

Conclusions

Academic background and socialization were not found to influence the decisions of students regarding IPH. Educational programs and exposure to psychiatric patients during law studies are proposed to lessen psychiatric stigma and promote better understanding between members of the two disciplines.     

Obligatory dangerousness criteria in the involuntary commitment and treatment provisions of Australian mental health legislation

Objective

Involuntary commitment and treatment (IC&T) of people affected by mental illness may have reference to considerations of dangerousness and/or need for care. While attempts have been made to classify mental health legislation according to whether IC&T has obligatory dangerousness criteria, there is no standardised procedure for making classification decisions. The aim of this study was to develop and trial a classification procedure and apply it to Australia's mental health legislation.

Method

We developed benchmarks for ‘need for care’ and ‘dangerousness’ and applied these benchmarks to classify the mental health legislation of Australia's 8 states and territories. Our focus was on civil commitment legislation rather than criminal commitment legislation.

Results

One state changed its legislation during the course of the study resulting in two classificatory exercises. In our initial classification, we were able to classify IC&T provisions in legislation from 6 of the 8 jurisdictions as being based on either ‘need for care’ or ‘dangerousness’. Two jurisdictions used a terminology that was outside the established benchmarks. In our second classification, we were also able to successfully classify IC&T provisions in 6 of the 8 jurisdictions. Of the 6 Acts that could be classified, all based IC&T on ‘need for care’ and none contained mandatory ‘dangerousness’ criteria.

Conclusions

The classification system developed for this study provided a transparent and probably reliable means of classifying 75% of Australia's mental health legislation. The inherent ambiguity of the terminology used in two jurisdictions means that further development of classification may not be possible until the meaning of the terms used has been addressed in case law. With respect to the 6 jurisdictions for which classification was possible, the findings suggest that Australia's mental health legislation relies on ‘need for care’ and not on ‘dangerousness’ as the guiding principle for IC&T.     

Substance abuse treatment for juvenile offenders: A review of quasi-experimental and experimental research

Purpose

The purpose of this systematic literature review is to assess the effectiveness of substance abuse treatment on alcohol and marijuana use for juvenile offenders based on existing quasi-experimental and experimental research. Additionally, a secondary aim is to compare the effects of individual-based interventions to family-based interventions.

Methods

A systematic search of literature and electronic databases through 2010 generated five experimental or quasi-experimental studies that assessed alcohol outcomes for juvenile offenders and five experimental or quasi-experimental studies that assessed marijuana outcomes for juvenile offenders.

Results

Overall, substance abuse treatment appears to have a small to moderate effect on alcohol and marijuana reduction for juvenile offenders. Interventions that showed the most promise were Multisystemic Therapy, Multidimensional Treatment Foster Care, Teaching Family, and Life Skills Training. Individual-based interventions and family-based interventions had similar small to moderate effects on alcohol and marijuana use.

Conclusion

This review highlights several promising interventions for this high-risk population; however, further rigorous study is desperately needed to provide a better understanding of what works best in reducing substance use among juvenile offenders.     

Not by accident: An analytical approach to traffic crash harm reduction

Purpose

This study examines whether a problem-oriented approach used by police in Cincinnati, Ohio called the Crash Analysis Reduction Strategy (CARS) corresponded with a change in the number of traffic crashes that resulted in injuries after implementation onset. Under the CARS model, police developed tactics that focused on targeting high-risk driving behaviors, impaired drivers, and crash hotspot locations within the city.

Methods

Using a two-phase strategy we first assess local impact by examining injury-related traffic crash patterns at targeted locations. Second, we examine whether traffic crashes that resulted in injuries in Cincinnati significantly diverged relative to similar outcomes across a number of comparison sites.

Results

Difference-in-difference negative binomial regression analyses indicates that traffic crashes were significantly lower in Cincinnati - down roughly 5.7% to 10.3% in the post-intervention period - when contrasted with comparison sites.

Conclusions

Our findings suggest that comprehensive problem solving approaches can significantly reduce the risk of life changing events such as automobile crashes that result in injuries beyond traditional policing efforts that explicitly focus on crime and violence.     

The relationship between shift work, perceived stress, sleep and health in Swiss police officers

Purpose

This study examined how a specific shift system was associated with stress, sleep and health among police officers. Moreover, this study investigated whether gender moderated the association between shift work and stress, sleep and health. Additional analyses were performed to find out how stress and shift work interact in explaining sleep and health.

Methods

The findings are based on a cross-sectional survey. A written questionnaire was sent to all employees of a local police force. 460 police officers (M = 40.67 years, SD = 9.66; 25.2% females) volunteered to take part in the study. 251 subjects were shift workers (54.6%). Police officers filled in a series of validated instruments assessing stress (TICS), perceived health (SF-12, somatic complaints, health care use) and sleep (ISI, PSQI).

Results

Shift work was associated with increased social stress, work discontent and sleep complaints. In turn, shift workers reported decreased use of primary health care. Moreover, stress was associated with increased sleep complaints and lower scores in perceived health. The interplay between stress and shift work did not produce any significant effects.

Conclusions

Workforce health promotion should make attempts to reduce chronic stress, while occupational health physicians should emphasize the diagnosis of undetected sleep disorders.     

The strains of maternal imprisonment: Importation and deprivation stressors for women and children

Purpose

This study links General Strain Theory, criminal justice models of inmate adaptation, and life course stress models to examine (1) the influence of importation and deprivation strains on maternal health while imprisoned; and (2) the intergenerational consequences of maternal strains for child outcomes.

Methods

Qualitative and quantitative data were gathered from an incarcerated sample of mothers in a Federal prison (n = 120). Qualitative data were used to identify strains in mothers' lives. Multivariate quantitative analyses were also conducted to test the associations of maternal importation and deprivation strains with maternal health problems and child subjective weathering, or a sense of growing up faster than one's peers.

Results

The deprivation strain of a lack of contact with the mother's minor child is positively associated with her mental and physical health problems and children's subjective weathering. Maternal importation strains in the form of childhood traumas also increase mental health problems and subjective weathering.

Conclusions

This study finds that maternal deprivation and importation strains are associated with mother and child adjustment. Reducing strains mothers face while imprisoned may benefit both inmates and families. Furthermore, deprivation strains are influential net of pre-imprisonment stressors.     

Assessing the effectiveness of mental health courts: A quantitative review

Purpose

The purpose of this review is to quantitatively review the accumulating MHC studies that have been conducted of both peer-reviewed and non-peer-reviewed studies. The primary objective of the current study is to provide a clearer picture as to whether MHCs are an empirically efficacious intervention for a significant health and criminological problem.

Methods

This study used meta-analytic techniques to assess the effectiveness of MHCs. A systematic search of the literature and electronic databases through July 2009, as well as an e-mail survey of mental health court program directors, generated 18 studies.

Results

Aggregate effects for recidivism outcomes revealed a mean effect size of -0.54 and -0.55 among quasi-experimental studies analyzed separately. There was a positive improvement among a limited number of clinical outcomes.

Conclusions

Our findings suggest that MHCs are an effective intervention but this assertion is not definitive. Methodologically, many of the studies are not as strong as would be ideal thus limiting our conclusions.     

Low Resting Heart Rate and Rational Choice: Integrating Biological Correlates of Crime in Criminological Theories

Purpose

The current work examined the association between low resting heart rate and perceptions of the costs and benefits of criminal behavior.

Methods

Data were gathered from a sample of students in introductory criminal justice classes. Perceptions of the costs and benefits of crime were measured in response to scenarios describing assault, theft and drunk driving.

Results

Those with low resting heart rate perceived a lower likelihood of sanction and were less likely to anticipate a sense of guilt/shame should they commit assault during a confrontation. Those with low resting heart rate were also more likely to indicate that they would commit the act described in the assault scenario. Anticipated guilt/shame mediated the relationship between low resting heart rate and intent to engage in assault.

Conclusions

Low resting heart rate was related to estimations of the costs and benefits of offending. Perceived costs (anticipated guilt/shame) mediated the relationship between resting heart rate and intent to commit assault.     

Problematic alcohol consumption by police officers and other protective service employees: A comparative analysis

Purpose

To examine differences between members of protective service occupations (PSOs) and other occupational groups on indicators of alcohol use/abuse and mental health.

Methods

A subset of 25,622 observations from the 2009 National Survey of Drug Use and Health (NSDUH) are used to evaluate whether PSO members exhibit a higher likelihood of problematic drinking behaviors and if so, whether these behaviors are mediated by mental health problems.

Results

Logistic regression models indicated that PSO members do not consume alcohol more frequently nor do they exhibit higher likelihood of alcohol abuse/dependency when compared to members of other occupational groups. However, PSO members report higher occurrence of binge drinking. The relationship between PSOs and binge drinking behaviors is mediated by gender, not mental health problems.

Conclusion

The results provide direction for the development of evidence-based alcohol related intervention programs that address the specific needs of police officers and other public servants.     

Cross-ethnic generalizability of the three-factor model of psychopathy: the Youth Psychopathic Traits Inventory in an incarcerated sample of native Dutch and Moroccan immigrant boys

Background

Previous research provides support for the existence of the psychopathy construct in youths. However, studies regarding the psychometric properties of psychopathy measures with ethnic minority youths are lacking.

Methods

In the present study, the three-factor structure of the Youth Psychopathic Traits Inventory (YPI) was examined for both native Dutch youth (N = 158) and an ethnic minority group, Moroccans (N = 141), in an incarcerated adolescent population in the Netherlands.

Results

Our results showed that the three-factor structure of the YPI is comparable across an ethnic majority and an ethnic minority group in an incarcerated sample in the Netherlands. Moreover, associations between psychopathic traits and mental health problems were similar for both ethnic groups.

Conclusion

The results support the cross-ethnic generalizability of the three-factor model of psychopathy as measured through the Youth Psychopathic Traits Inventory.     

Naturally Occurring Social Support in Interventions for Former Prisoners with Substance Use Disorders: Conceptual Framework and Program Model

Purpose

Naturally-occurring social support is underutilized in interventions with former prisoners with substance use disorders. This paper proposes a conceptual framework followed by a program model to inform the development of naturally-occurring social support interventions with former prisoners with substance use disorders.

Methods

We reviewed all published social support interventions designed for former prisoners and people with substance use disorders over a ten year period. Building on the implications of this review, empirical literature, professional experience, and theory, we propose a conceptual framework for naturally-occurring social support programs.

Results

Few published programs exist that actively incorporate social support providers into the program model. Of these, even fewer use naturally-occurring support. Expanding on gaps in theory and program approaches, the conceptual model posits that it is the appropriate match of support needs and provision that reinforces emotions, cognitions, and behaviors, that in turn, promote adaptive outcomes.

Conclusions

With mounting pressure to identify interventions that will reduce high re-incarceration rates, this paper draws attention to a neglected, potentially effective, and low cost resource - naturally-occurring social support. The described program, Support Matters, illustrates how social support interventions can be used with former prisoners to promote reduced relapse to substance misuse and crime.     

Prison gang integration and inmate violence

Purpose

Gang membership has been linked in a number of prior studies with inmate misconduct; known gang members are more prone than non-gang members to act violently behind bars. Theories of intergroup conflict suggest, however, there is reason to expect that broader within-prison gang dynamics, not just gang membership alone, are associated with the incidence of violence.

Methods

We collected data on inmates from a large southern state and estimated multilevel models of inmate-on-inmate violence. Included in our models were a variety of common individual-level correlates of violent misconduct, among them gang membership. Substantive prison-level correlates included the percentage of gang members and “gang integration,” the latter being a measure of gang heterogeneity.

Results

We found a modest association between both gang variables and inmate-on-inmate violence, with gang integration being the most significant of the two.

Conclusions

Gang membership is an important correlate of inmate violence, but attention to broader prison gang dynamics is clearly necessary. We discuss the implications of this finding for theories of inmate violence.     

Physical health and crime among low-income urban women: An application of general strain theory

Purpose

Although studies of General Strain Theory (GST) typically include measures of physical health in multi-item indices of strain, no work has investigated the independent influence of physical health on criminal offending. The current research explores the relationship between physical health and criminal offending among low-income women living in disadvantaged neighborhoods.

Methods

Using data from the Welfare, Children, and Families (WCF) project, criminal behavior is predicted over two years with measures of physical health, depression, anxiety, competing strain, and relevant background factors.

Results

Poorer physical health at baseline and declines in physical health increase the odds of offending onset among previous non-offenders and reduce the odds of decreased offending among previous offenders. In offending onset models, higher levels of anxiety and depression at baseline and increases in these symptoms partially mediate the effect of poorer baseline health and fully mediate the effect of the loss of physical health. In decreased offending models, increases in anxiety and depression fully mediate the effect of poorer baseline health and partially mediate the effect of the loss of physical health.

Conclusions

The data suggest that poor health and declines in physical health influence both offending onset and offending escalation directly and indirectly through increases in anxiety and depression.     

Can financial incentives reduce juvenile confinement levels? An evaluation of the Redeploy Illinois program

Purpose

Assessments of ongoing fiscal restructuring of juvenile justice system processes and the impact such restructuring has on juvenile incarceration rates are limited. When impacts of fiscal restructuring efforts have been assessed, researchers have focused on systemic, macro level changes in incarceration rates but avoided more focused, micro level impacts. This study fills this knowledge gap by examining the recent implementation of the Redeploy Illinois program in two pilot sites. In the Redeploy Illinois program, financial incentives were provided to select counties to develop community based alternatives to incarceration. The goal was to alleviate over reliance on state funded residential facilities for evaluation and confinement purposes.

Methods

Agency data were analyzed using qualitative methods to examine the effects of this change.

Results

Results of this study demonstrated that counties participating in the pilot test of the Redeploy Illinois program were able to reduce their levels of juvenile commitment to the state. Peoria County exceeded their reduction benchmark for all but two years, and St. Clair County well exceed their reduction benchmark for all full calendar years subsequent to implementation.

Conclusions

Findings are consistent with the limited literature exploring fiscal restructuring efforts designed to reduce county levels juvenile commitments.     

Patterns of criminal achievement in sexual offending: Unravelling the “successful” sex offender

Purpose

The current study examines significant variations in criminal achievement across sex offenders. To examine the “successful” sex offender, the study proposes a concept of achievement in sexual offending defined as the ability to maximise the payoffs of a crime opportunity while minimizing the costs.

Methods

The study is based on a sample of convicted adult male sex offenders using retrospective longitudinal data.

Results

The study findings show a wide variation in criminal achievement, a variation that is not correlated with the severity of sentences meted out or the actuarial risk scores obtained by these offenders. Those offenders who specialize in sex crimes were shown to be the most productive and least detected offenders. Two types of successful offenders emerge, the first relying on his conventional background in targeting a victim that can be repeatedly abused for a long period without detection. The second is a younger offender that is successful in the sense of being able to complete aggressions on multiple victims.

Conclusions

Results suggest that the successful sex offender is not “detected” once he enters the criminal justice system, nor is he handled in a way that may deter him from sexually reoffending in the future.     

Research Note: Assessing the validity of college samples: Are students really that different?

Objective

The purpose of this research note is to explore the validity of college student samples for criminology and criminal justice research. Some scholars have suggested that college populations are comprised of individuals who are different from the rest of society and that the use of college students for social research may distort our theoretical understanding of crime and criminality.

Method

The National Youth Survey is used to assess, college students’ self-reported behaviors, frequency of behaviors, and attitudes in relation to the general population.

Results

The results indicate that there is almost no statistically significant difference in behaviors and only minor differences in the frequency of behaviors and attitudes.

Conclusion

The findings from this investigation suggest that while college students may be culturally unique, this uniqueness does not seem to affect validity.     

Judicial scrutiny of gender-based employment practices in the criminal justice system

Purpose

This article examines employment practices of criminal justice agencies within state and federal court decisions that have interpreted sex discrimination claims under Title VII of the 1964 Civil Rights Act.

Methods

After collecting and analyzing appellate court cases through the LEXIS-NEXIS and WESTLAW databases, the article examines lower state and federal court decisions that have been applied by the U.S. Supreme Court to criminal justice workplaces.

Results

The findings show that employment practices are valid if the employer can demonstrate: first, the disputed discriminatory action is based on considerations not solely dependent on the plaintiff's gender; and second, such considerations are more than mere pretext, making them justifiable under the circumstances.

Conclusions

Courts have considered a wide range of employer practices in both law enforcement and corrections agencies at various stages of the employment process, such as hiring, assignment of duties, promotion, discipline, and termination. Title VII is violated when the employers’ adverse employment action is motivated by discriminatory intent and is based on gender stereotypes. Even so, employment actions are legal when employers prove their employment actions are not based on sex stereotypes, but are either business-related or justified by “legitimate,” “important,” or “compelling” interests.     

Review on female sexual offenders: findings about profile and personality

Introduction

Although in the past sexual abuse was perceived as an issue connected only with males the contemporary literature is placing increasing emphasis on the role of female sexual perpetrators. There is still disagreement about the definition of sexual abuse, the frequency that it occurs and the characteristics of the women that are sexual abusers.

Methods

Thorough research of the main databases (MEDLINE and PsycInfo), for case reviews and studies along with restriction on European and North American literature, is due to perceived culture differences. Further investigation for relevant studies through web search engines such as Google, locates agencies and organizations that are interested and connected to sexual abuse issues.

Results

Distinction between sexual offense and sexual abuse has as a result difference in the characteristics of female sexual perpetrators. They are mainly young (age up to 36 years old), friends or relatives of the victim, using more persuasion and psychological coercion and legally charged in a lesser extent compared with male abusers. However the psychological consequences for the victim can be more severe.

Conclusion

A unanimous view of what is female sexual abuse is difficult to reach. Often it is under reported, unrecognized or considered ethically more acceptable than male abuse. It is also connected with an increased self-report of history of sexual abuse of the perpetrators. A typology of female sexual abusers should be developed. Treatments focusing on different psychological interventions along with prevention and public awareness can be a powerful tool in reduction of sexual abuse perpetrated by females.