The implementation of case formulation by probation officers: service user and carer views

Background: The recent UK Government strategy on high-risk offenders with personality disorders (PD) proposes improved identification of this group, assessment of their treatment needs through case formulation (CF) and the subsequent provision of treatment pathways. Little is known about service user and carer views on this strategy. Aims/Hypotheses: This study sought to identify the views of personality-disordered (PD) offenders and carers on the proposed role of Probation staff in CF. Methods: Three focus groups were carried out, two with service users and one with carers, with a total of 10 participants overall. Results: Five themes emerged: ‘power’, ‘conflicting roles’, ‘trust’, ‘building a relationship through consistency of care’ and ‘hope and possibility’. Conclusions/Practical implications: Offenders and carers were sceptical regarding the proposed role of Offender Manager (OMs) in CF and this could pose a potential barrier to the successful implementation of the strategy.     

Regulation, risk assessment, and the Supreme Court: the case of OSHA's cancer policy

As a case study of policy distortion in the legal and regulatory processes, this article first establishes the incongruities among the political, scientific, and legal issues surrounding OSHA's Cancer Policy and then examines the political consequences of ignoring these incongruities in judicial and administrative decisions about that policy. By delineating the political, scientific, and legal issues involved, we develop a basis for assessing the Supreme Court's difficulties in reviewing the Cancer Policy. These difficulties are related to the issue of regulatory reform, as indicated by the subsequent fate of OSHA's Cancer Policy under the Reagan administration. This article concludes with reflections upon regulatory reform in the light of the current status of OSHA's regulation of workplace carcinogens.     

Offender personality disorder pathway: the impact of case consultation and formulation with probation staff

The latest government policies for personality disordered offenders emphasise the importance of a formulation-based approach to rehabilitation and pathway planning. However, research into forensic case formulation is limited. This paper examines the impact of consultation and formulation, on probation staff working with personality disordered offenders. Staff rated their knowledge, confidence, motivation, and understanding (of offenders), and satisfaction with management plans at three stages: pre-consultation, post-consultation and after receiving a written formulation. The analyses revealed that ratings on all variables examined increased after attending a consultation meeting, with no additional increase in scores following receipt of the formulation letter. The findings provide evidence that consultation has a range of benefits for probation staff, and offer support for the current model of joint-agency working. Further research is needed to clarify the benefits of providing written formulations after consultations, and to explore what features of a formulation are most useful to probation staff.     

Differential patterns of partner-to-woman violence: A comparison of samples of community,alcohol-abusing,and battered women

This paper compared a sample of women in treatment for alcoholism (N = 45) with a randomly selected sample of women from the local community (N = 40), and a sample of women receiving services for victimization by severe partner violence (N = 38). Conflict Tactics Scale (CTS) items were dichotomized into low frequency of partner violence (twice per year or less) and high frequency of violence (once per month or more), and then summed to yield separate low frequency and high frequency scores for each CTS subscale. Results showed that at the high frequency level, battered women reported the highest scores on each subscale, alcoholic women the second highest, and the community sample of women reported the lowest level of violence. A multiple regression analysis revealed that being in the alcoholic sample significantly predicted high frequency negative verbal interaction and moderate violence, controlling for presence of a partner with alcohol-related problems and demographic differences among the samples.     

The violence of silence: some reflections on access to information, public participation in decision-making, and access to justice in matters concerning the environment

The proposition put forth in this paper is that whether—and the extent to which—harm or potential harm to the environment (its natural resources, living beings, and their ecosystems) is identified, resisted, mitigated, or prevented is linked to the nature and scope of public access to information, participation in governmental decision-making, and access to justice—which are often referred to as “environmental due process” or “procedural environmental rights.” Using examples in the United States of attacks on law school clinics and denial of standing in court, this paper argues that restrictions on public access to information, participation in decision-making, and access to justice create legacies and “cultures of silence” that reduce the likelihood that future generations will be willing and able to contest environmental harm.     

Legitimacy and online proceedings: Procedural justice,access to justice,and the role of income

Courts have long struggled to bridge the access-to-justice gap associated with in-person hearings, which makes the recent adoption of online legal proceedings potentially beneficial. Online proceedings hold promise for better access: they occur remotely, can proceed asynchronously, and often rely solely on written communication. Yet these very qualities may also undermine some of the well-established elements of procedural-justice perceptions, a primary predictor of how people view the legal system's legitimacy. This paper examines the implications of shifting legal proceedings online for both procedural-justice and access-to-justice perceptions. It also investigates the relationship of both types of perceptions with system legitimacy, as well as the relative weight these predictors carry across litigant income levels. Drawing on online traffic court cases, we find that perceptions of procedural justice and access to justice are each separately associated with a litigant's appraisal of system legitimacy, but among lower-income parties, access to justice is a stronger predictor, while procedural justice dominates among higher-income parties. These findings highlight the need to incorporate access-to-justice perceptions into existing models of legal legitimacy.     

Enhancing prisoner reentry through access to prison-based and post-incarceration aftercare treatment: experiences from the Illinois Sheridan Correctional Center therapeutic community

In an attempt to enhance dramatically the access of Illinois’ prison inmates to substance abuse treatment services within prison and following their release, the Sheridan Correctional Center was opened in 2004 by the Illinois Department of Corrections as a fully-dedicated substance abuse treatment prison operating under a therapeutic community design. During the first 5 years of implementation and operation, the program has improved the rate of aftercare admission and completion through enhanced pre-release planning and coordination, the development of community-based partnerships, and a transformation of the parole model and, in doing so, has overcome many of the barriers to effective offender re-entry. The analyses illustrate how aftercare admission and completion has improved during the course of implementation, and what factors appear to predict aftercare entry and completion. The article discusses the implications of how this improved access to aftercare impacts upon post-release outcomes (i.e., recidivism).     

Equity,access, and outcomes: The status of the art

A rationale for including analyses of outcome in evaluation of the impact and equity of changes in health care policy for the poor is presented. We first discuss problems in defining equity in and access to health care. Equity in access to health care requires equality of access only to those services that are believed to be efficacious. Three cost-containment strategies (restrictions in eligibility, coinsurance, and capitation) are then examined, and their limitations are discussed. Finally, directions for future research focusing on outcomes are suggested. Rather than using access to care to assess outcome, outcome is viewed as the framework for assessing access and equity.     

Barcelona 2002: law, ethics, and human rights. Using the law to improve access to treatments

The XIII International AIDS Conference in Durban, South Africa in July 2000 focused worldwide attention on the problem of accessing treatments in developing countries. In the interim, thanks to the work of activists - from demonstrations to court cases, and from acts of public courage by people living with HIV/AIDS to ongoing lobbying of politicians and trade negotiators - some very significant developments have occurred. But the reality is that the vast majority of people living with HIV/AIDS still lack access to affordable, quality medicines. This article, a summary of a paper presented at "Putting Third First: Vaccines, Access to Treatments and the Law," a satellite meeting held at Barcelona on 5 July 2002 and organized by the Canadian HIV/AIDS Legal Network, the AIDS Law Project, South Africa, and the Lawyers Collective HIV/AIDS Unit, India, explores three approaches for improving access. In the first part, Richard Elliott provides an overview of the state of the right to health as embodied in international human rights law; comments on the experience to date in litigating claims to the right to health; and identifies potential strategies activists can adopt to advance recognition of the right to health. In the second part, Sharan Parmar and Vivek Divan describe price-control and drug-financing mechanisms used by industrialized countries to increase the affordability of medicines; and discuss how some of these mechanisms could be adapted for use in developing countries. Finally, Jonathan Berger describes the use of litigation in the courts by the Treatment Action Campaign in South Africa.     

How research ethics' protections can contribute to public policy: the case of community treatment orders

Though community treatment orders (CTOs) were first used in 1986 in Australia, debate about their clinical and ethical merits continues even today. For some, the benefits of reduced frequency and duration of involuntary hospitalizations are believed to adequately outweigh the harms of restricted liberties in community living. For others, however, such benefits are believed to be achievable by simply arranging integrated, devoted community resources sans any threat of forced re-hospitalization. In response to this enduring controversy, this article examines the ethical merits of community orders using a novel approach. “Novel” because the examination is based on research ethics and its foundational principles.When hospital and community clinicians, family members, consumer/survivors, and advocacy groups discussed the idea of amending Ontario's mental health legislation to permit CTOs in the late 1990s, evidence of their effects and efficacy was very limited. Moreover, an order was characterized much like standard pharmacological or medical therapies because the person or an appropriate substitute decision maker's consent was necessary to authorize the order or make it valid. These two factors prompted this retrospective analysis: if CTOs - as a public policy initiative - had been treated like most other promising therapies, would any different ethics-related concerns have been raised that, in turn, would have benefited the public debate and the legislature's decisions? In other words, if respected safeguards that apply to new drugs and medical devices had applied to CTOs, would anything have changed?     

Criers,liars, and manipulators: Probation officers' views of girls

This study examines the perceptions of girls held by juvenile probation officers, psychologists, and others involved in juvenile court decision making. Through qualitative analysis of girls' probation case files and indepth interviews with juvenile probation officers, we discuss the social construction of gender, race, culture, and class. Our findings suggest that in an environment marked by scarce resources, gender and racial/ethnic stereotypes leave girls few options for treatment and services in the juvenile court. Some probation officers expressed distaste for working with girls and had little understanding of culturally or gender-specific programming. Others were frustrated by the lack of programming options for girls in the state. Based on our findings, we question whether the current ideology or structure of juvenile probation can nurture a holistic approach to justice for girls.     

Medicare program: access to books, documents, and records of subcontractors--Health Care Financing Administration

These regulations implement section 952 of the Omnibus Reconciliation Act of 1980 (Pub. L. 96-499), which conditions Medicare reimbursement for the cost of services performed under certain contracts upon compliance with prescribed criteria. If a contract between a provider and a subcontractor covers services valued at or costing $10,000 or more over a 12-month period, Medicare reimbursement cannot be made for the services unless the contract includes a clause allowing the Secretary of Health and Human Services and the Comptroller General access to the contract and to the subcontractor's books, documents, and records necessary to verify the costs of the contract. The clause in the contract must also permit similar access top any subcontract between the subcontractor and a related organization of the subcontractor when the subcontract is worth or costs $10,000 or more over a 12-month period. These regulations specify the criteria and procedures that the Department will use to obtain access to affected books, documents, and records. The purpose of the legislation and these proposed regulations is to permit the Secretary and Comptroller General to make an accurate determination of the reasonable costs under these contracts.