The Effectiveness of a Mental Health Court in Reducing Recidivism in Individuals with Severe Mental Illness and Comorbid Substance Use Disorder

The current study examined the efficacy of a specialized mental health court in reducing recidivism for severely mentally ill defendants with comorbid substance use disorders. There is a wealth of research supporting the efficacy of mental health courts in reducing recidivism for those with severe mental illness; however, the benefit of these courts for individuals with severe mental illness and comorbid substance use disorders has received limited empirical attention. Participants were 514 defendants enrolled in either a traditional adversarial court or a specialized mental health court. Recidivism was assessed across different outcome variables, including frequency of reoffending, severity of new offenses, and length of time to reoffend. When compared to participants in the traditional adversarial court, enrollment in mental health court was associated with a greater length of time to rearrest and fewer participants were rearrested in the mental health court than the traditional court. Group differences between those with and without comorbid substance use disorders who were enrolled in the mental health court were not found across recidivism outcome metrics. Results of the current study are particularly promising given that defendants with substance use disorders are at a greater risk for reoffending.     

The Importance of Mental Illness Education

Until our legal community–both lawyers and judges–understands basic truths about the medically based and highly treatable mental illnesses, (depression, manic‐depression [bipolar disorder], schizophrenia, and the anxiety disorders, including obsessive compulsive disorder) our nation does not offer “justice for all” for the more than 27 million Americans who have one or more of these common brain problems. With accurate information, our legal community can restore justice to millions of Americans, children to seniors, and do much to improve health, prosperity, stability, and safety to our nation, through actions and decisions which promote public education and understanding, early recognition and treatment, and which replace stigma, discrimination, wrongful punishment, and failure with understanding, recovery, productivity, and justice.     

Consumer Racial Profiling and Perceived Victimization: A Phone Survey of Philadelphia Area Residents

This paper explored the perceived prevalence of consumer racial profiling (CRP) (also known as “Shopping While Black”) among residents in Philadelphia. Based on data collected from a random digit dialing (RDD) phone survey, the authors examined the characteristics of those persons who believed they had been profiled in retail establishments. The research found that African Americans were ten times more likely than non-African Americans to believe they had been profiled in a retail establishment. As for gender differences, males were nearly two times more likely than females to report that they had been experienced CRP. Educated respondents were more likely than those with less education to report having experienced CRP. There were no significant findings regarding income. The authors conclude by noting the policy implications of the research findings. This project was jointly funded by Penn State’s Africana Research Center and Penn State Harrisburg’s School of Public Affairs. The authors thank Auden Thomas, Stephanie Hintz, and the interviewers from Penn State Harrisburg’s Center for Survey Research who assisted in the completion of this project.     

Violence and Mental Illness: A New Analytic Approach

Empirical studies of violence and mental illness have used many different methods. Current state-of-the-art methods gather information from both subject and collateral interviews as well as official records. Typically these sources are treated as additive. Any report of a violent incident from any source is treated as true and all reported incidents are added to generate estimates of frequency. This paper presents a new statistical technique that uses the level of agreement between the sources of data to adjust those estimates. The evidence suggests that, although the additive technique for using multiple sources correctly estimates how many people are involved, it substantially underestimates the number of incidents. The new technique substantially reduces both false negatives and false positives.     

A Comparison of Defendants with Mental Illness Represented by Public Defenders and Private Attorneys: an Analysis of Court-Ordered Pretrial Psychiatric Evaluations

This study compared the characteristics and court-ordered evaluation questions and responses among 4,430 defendants to determine if differences existed between those represented by public defenders and private attorneys when receiving trial competency or responsibility psychiatric evaluations from a state department of mental health. Defendants represented by public defenders were more likely to be younger, to have less education, to have psychotic disorders, to have a history of inpatient psychiatric treatment, to live in urban or rural counties, and to be jailed at the time of the evaluation. In addition, defendants represented by public defenders were less likely to have a request for a criminal responsibility evaluation and more likely to be evaluated as having a mental illness, to be incompetent to stand trial, and to need hospitalization pending trial. Consideration of whether defendants with public defenders receiving less requests for responsibility evaluations was indicative of a therapeutic jurisprudence approach is discussed. Implications for research on types of legal representation of defendants with mental illness are discussed.     

Dating Violence Victimization,Relationship Satisfaction,Mental Health Problems,and Acceptability of Violence: A Comparison of Men and Women

Two of the most common reported consequences of dating violence are its impact on the victim’s satisfaction with their romantic relationship and its impact on the victim’s mental health. Recent research suggests that the strength of these relationships may be moderated by the degree to which the dating violence is acceptable to the victim. However, studies of these relationships have been limited to samples of women. The purpose of the present research was to examine the relationships among dating violence victimization, relationship satisfaction, mental health problems, and acceptability of violence for a sample that includes not only female victims, but also male victims. Using a sample of 155 male and 417 female college students, hierarchical regression analyses found that dating violence victimization is associated with relationship satisfaction and mental health problems for both men and women. For men, acceptability of violence moderated the relationship between dating violence victimization and the mental health problems of depression, anxiety, and somatization. For women, acceptability of violence moderated the relationship between dating violence victimization and relationship satisfaction only.

Correctional Policy for Offenders with Mental Illness: Creating a New Paradigm for Recidivism Reduction

Offenders with mental illness have attracted substantial attention over the recent years, given their prevalence and poor outcomes. A number of interventions have been developed for this population (e.g., mental health courts). They share an emphasis on one dimension as the source of the problem: mental illness. Their focus on psychiatric services may poorly match the policy goal of reducing recidivism. In this article, we use research to evaluate (a) the effectiveness of current interventions, and (b) the larger viability of psychiatric, criminological, and social psychological models of the link between mental illness and criminal justice involvement. We integrate theory and research to offer a multidimensional conceptual framework that may guide further research and the development of efficient interventions that meaningfully reduce recidivism. We hypothesize that the effect of mental illness on criminal behavior reflects moderated mediation (i.e., the effect is direct in the case of one subgroup, but fully mediated in another); and that the effect of mental illness on other “recidivism” is partially mediated by system bias and stigma. We use this framework to propose three priorities for advancing research, articulating policy, and improving practice.     

Victimization and Poly-Victimization in Adolescent Outpatients from Mental Health Centers: A Case-Control Study

The aims of the present study were to establish interpersonal victimization rates in a clinical sample and to analyze this sample’s risk of victimization relative to the general population. The sample was composed of 472 adolescents (12–17 years of age): 118 outpatients from public mental health centers and 354 students who were matched by age and sex. Following previous studies, this research defined poly-victimization as four or more victimization types occurring during the previous year. The clinical group was more likely to report sexual victimization (OR = 9.540), conventional crime (OR = 3.120), caregiver victimization (OR = 3.469), witnessing and indirect victimization (OR = 3.466), electronic victimization (OR = 2.809), and poly-victimization (OR = 4.319) compared with the control group. Clinical samples present an increased risk of interpersonal poly-victimization compared with the general population. The influence of poly-victimization on mental health should be considered in the evaluation and treatment of adolescent outpatients.     

时代呼唤统一的刑事责任能力鉴定标准

阐述了我国制定《精神障碍者刑事责任能力评定大纲》必要性、可行性和历史意义，对如何统一精神疾病刑事责任能力鉴定的评定标准，如何有利于同行专家和司法机关对司法精神病学鉴定结论可采信性的审查提出见解。     

时代呼唤统一的刑事责任能力鉴定标准

阐述了我国制定《精神障碍者刑事责任能力评定大纲》必要性、可行性和历史意义,对如何统一精神疾病刑事责任能力鉴定的评定标准,如何有利于同行专家和司法机关对司法精神病学鉴定结论可采信性的审查提出见解。     

Stressful Childhood Experiences and Clinical Outcomes in People with Serious Mental Illness: a Gender Comparison in a Clinical Psychiatric Sample

Objective: This study examines stressful childhood experiences (SCE) including childhood abuse and family context in a cohort of 183 people diagnosed with serious mental illness (SMI) and compares gender specific rates of SCE and clinical outcome variables. Methods: 111 men and 72 women with SMI were interviewed regarding SCE and posttraumatic stress disorder (PTSD) symptoms, dissociative symptoms, risk for self-harm, and adult re-victimization. Results: Both genders endorse high rates of SCE. Cumulative SCE (the sum of seven SCE) are linked to increased levels of all four outcome variables after adjusting for demographic factors. Conclusions: The study addresses the need to assess cumulative SCE in a population with SMI and its effects on clinical outcomes in both genders.     

The Prevalence of Mental Illness Among Inmates in a Rural State

A limited number of recent empirical studies suggest that inmates suffer from high rates of serious mental illness. Different explanations are offered depending on the type of institution: jail or prison. The literature is based largely on urban samples and does not offer comparisons of rates across types of institution within a single study. The present study examined a random sample of 213 jail and prison inmates in a rural state using the Diagnostic Interview Schedule (III-R). Among jail inmates there was little evidence of high rates of serious mental illness, suggesting the criminalization of mental illness may not be as evident in rural settings as urban areas. Among prison inmates, however, high rates of mental disorders were found, supporting previous findings in urban and rural jurisdictions. Implications of the findings are discussed in the context of a consolidated correctional system.     

The Effect of Maternal Victimization on Children: A Cross-Informant Study

The impact of maternal victimization on the behavioral, social, emotional, and cognitive development in a group of 206 low-income, predominantly African American children from inner city, pediatric primary health care clinics was explored using mother, teacher, and self-report data. Results revealed that mothers with a victimization history reported more externalizing and internalizing behaviors in their children, compared to mothers who had not been victimized. Maternal victimization history was not related to teachers' ratings of children's behavior, child reports of social competence and depression, or standardized assessments of cognitive development. The relation between mothers' history of victimization and their reports of internalizing and externalizing behavior problems in their children was mediated by pathways through maternal depression and disciplinary practices (verbal aggression). These findings provide evidence for the link between maternal victimization and children's behavior problems. Treatment for victimized mothers that reduces their depressive symptoms and promotes adaptive parenting practices may lead to fewer behavior problems in their children.     

Mothers of Violent Children with Mental Illness: How They Perceive Barriers to Effective Help

The goal of the present study was to understand how mothers perceive and experience barriers to effective help for their violent child with mental illness. Data from ethnographic interviews with 26 self-identified mothers of violent children with mental illness were analyzed using grounded theory and focused coding. Our study identified three themes that represent barriers to help: (1) denial of mental illness and severity of violence by treatment providers, extended family, and non-family members; (2) limited access to quality treatment and supports; and (3) a recurring cycle from optimism to hopelessness. To inform policy makers and practitioners on how best to remove these barriers, we draw comparisons between the current sample and survivors of intimate partner violence. Our paper concludes with recommendations for mental health practitioners and family intervention specialists.     

Prevalence of Criminal Thinking among State Prison Inmates with Serious Mental Illness

To examine the prevalence of criminal thinking in mentally disordered offenders, incarcerated male (n = 265) and female (n = 149) offenders completed measures of psychiatric functioning and criminal thinking. Results indicated 92% of the participants were diagnosed with a serious mental illness, and mentally disordered offenders produced criminal thinking scores on the Psychological Inventory of Criminal Thinking Styles (PICTS) and Criminal Sentiments Scale-Modified (CSS-M) similar to that of non-mentally ill offenders. Collectively, results indicated the clinical presentation of mentally disordered offenders is similar to that of psychiatric patients and criminals. Implications are discussed with specific focus on the need for mental health professionals to treat co-occurring issues of mental illness and criminality in correctional mental health treatment programs.     

The Relationship Between Psychopathic Personality Features and Malingering Symptoms of Major Mental Illness

This study examined the relationship between psychopathy and malingering in a subsample of male prison inmates (n = 55) participating in a larger study of the clinical utility of various assessment measures in correctional settings. Participants' capacity to feign major mental illness successfully was evaluated using standard cutoff scores for the detection of malingering on a variety of instruments, including the Structured Inventory of Malingered Symptomatology (SIMS; G. P. Smith & G. O. Burger, 1997), the Structured Interview of Reported Symptoms (SIRS; R. Rogers, R. M. Bagby, & S. E. Dickens, 1992), and the Personality Assessment Inventory (PAI; L. Morey, 1991). Psychopathic traits were assessed via the Psychopathic Personality Inventory (PPI; S.O. Lilienfeld & B. P. Andrews, 1996). Correlations between the malingering indices and the PPI were low (–.14 to .14) and not statistically significant. These findings fail to support the clinical intuition that individuals with higher levels of psychopathy are likely to be more adept at malingering.     

证明责任与强制鉴定：“精神病”的鉴定问题研究

精神病的刑事责任问题在英美法国家经历由非此即彼的有无向中间环节的妥协,诞生了限制刑事责任;同时精神病证明责任的分配也由控方绝对责任向相对责任缓冲,并逐渐演变为辩方承担证明责任和控方承担说服责任配置方式。我国应当在借鉴精神病证明责任合理分配的基础上,构建强制鉴定制度,以此来促进精神病证明责任的合理配置流向,保证精神病证明责任的程序正当。