Workplace Sexual Harassment in Policing: Perceived Psychological Injuries by Source and Severity

Relatively little is known about employee perceptions of workplace psychological injuries following sexual and nonsexual harassment. In quasi-military occupational organizations, such as policing, the rate of sexual harassment to workplace injuries from other sources is comparatively high. In an exploratory 5?×?2 between-subjects factorial experimental projection study, 220 New South Wales Police Force officers responded to one of ten experimental vignettes in which sources of psychological injury and the gender of the injured worker were systematically varied. Results revealed an unexpected effect of experience. Employees aged 30 years and older were significantly more likely to anticipate psychological consequences and clinically diagnosable symptoms than their younger counterparts. As hypothesized, a main effect of injury source, but not gender of the target, emerged for the severity of psychological consequences: a physical injury was perceived to produce significantly more severe psychological injuries than sexual harassment in the form of coercion and unwanted sexual attention. Contrary to the hypothesis, participants rated gender-based hostility higher than other types of sexual harassment as a source of severe psychological harm. Participants believed that gender-based hostility requires more professional intervention and predicted more negative workplace consequences than other psychological injuries caused by other workplace events. As hypothesized, women employees were generally viewed as significantly more vulnerable to negative workplace outcomes than men. The police officers who participated in this study considered women as more likely to experience workplace problems following sexual coercion than other types of workplace injury. Physical injuries, gender-based hostility, and sexual coercion were distinguished from nonsexual harassment and unwanted sexual attention as significantly more likely to produce clinically diagnosable injuries, irrespective of target gender. Implications of these findings for research, practice, and legal policy are discussed.     

Psychiatric and Forensic Differences Between Men Charged with Sex Offences and Men Charged with Other Offences

Studies on differences between individuals convicted of sexual offences and nonsexual offences are sparse and there is an on-going debate as to whether sexual offenders differ from other offenders. The primary aim of this study was to determine demographic characteristics, prevalence of mental disorders, alcohol and drug use at the time of the crime and the criminal responsibility of individuals charged with sexual offences, compared to nonsexual crimes, with the aim of bringing awareness to the similarities and differences between men charged with sex offences and those charged with other crimes. This is a single-institution retrospective study of subjects charged with sexual offences and sent for institutional psychiatric evaluation to a Forensic Psychiatric Centre in an urban, academic, tertiary-care center. The control group consisted of individuals charged with nonsexual offences referred to the same center. Results showed significant differences between individuals charged with sexual offences and nonsexual offences. Men charged with sex offences more frequently committed their crimes alone and victimized children equally as often as adults. They also less frequently pleaded guilty in court. They were more likely to be abused in childhood and more often had antisocial personality disorder and paraphilias and less often substance-related disorders. The majority were considered criminally responsible. Our results show that sex offenders are different from nonsex offenders in many characteristics of their personal history, offence characteristics and forensic evaluations and these particular differences warrant different approaches to the prevention of future re-offending, compared to nonsex offenders.     

PROTECTING YOUTH PLACED IN UNLICENSED,UNREGULATED RESIDENTIAL “TREATMENT” FACILITIES

Throughout the country, there is considerable inconsistency in how states regulate residential treatment programs for youth. In states with little oversight, the health and safety of youth are unprotected and they may be subject to substandard treatment, rights violations, and/or abuse. Three initiatives to address this issue are reported: (1) an Internet survey of youth who are former residents, (2) a four‐state pilot study of how states regulate and monitor residential programs, and (3) a bridge‐building conference between residential treatment providers and mental health leaders. Recommendations address the next steps for lawmakers, lawyers, judges, mental health and education professionals, and parents.     

Insane Sex Offenders: Psychiatric and Legal Characteristics of Sexual Offenders Found Not Guilty by Reason of Insanity

There is little known about sexual offenders hospitalized under forensic commitment statutes such as not guilty by reason of insanity (NGRI). We conducted a chart review to delineate the demographic, clinical, and legal characteristics of NGRI sexual offenders (n = 68) committed to the California Department of State Hospitals—Napa, including 41 found NGRI for a sexual offense and 27 found NGRI for a nonsexual offense. The two groups did not differ significantly in their demographics, psychiatric diagnoses, victim characteristics, or recidivism risk as measured by the Static‐99R. Those found NGRI for a sexual offense were older at the time of their first criminal and first violent offense, younger at the time of their committing offense, and had fewer prior total convictions and sexual offense convictions. These findings may indicate that sexual offenders found NGRI for a sexual offense are less antisocial than those found NGRI for a nonsexual offense.     

Understanding how sexual offenders compare across psychiatric and correctional settings: examination of Canadian mentally ill sexual offenders

Abstract

Much of what is known about sexual offenders is based on correctional samples and then applied across settings based on the assumption that this group is homogeneous. In this study, 149 files were compared, including 108 cases from the forensic mental health system (FMH) and 41 cases from the correctional system (COR). Although many similarities were observed between the FMH and COR groups, the results also revealed important differences. The FMH group was characterised by more frequent hospitalisations, higher rates of major mental illness and single status. The COR group was characterised by a history of physical and sexual abuse, family history of addictions, more intrusive sexual offences and higher rates of offending. These results highlight different profiles for sexual offenders in forensic mental health and correctional settings and challenge us to consider the implications for assessment, treatment and risk management of this unique group of sexual offenders.     

Female Sexual Homicide Offenders: A Descriptive and Comparative Study

Research on female sexual homicide has been very scarce. In Europe, it has rarely been examined, and in Scotland, it has never previously been studied. This exploratory study aims to examine the characteristics of sexual homicides involving female offenders between 1990 and 2015 in Scotland. Using data from the Scottish Homicide Database between 1990 and 2015, female sexual homicides (n = 7) were compared to nonsexual homicides committed by females (n = 106) and to sexual homicides committed by men (n = 89) using Fisher's exact tests. The findings show that although female sexual homicide offenders are similar to both female nonsexual homicide offenders and male sexual homicide offenders in certain aspects, there are important differences that distinguish sexual homicides involving female offenders from both groups. Female sexual homicide offenders can arguably be seen as a distinct group of offenders, with specific characteristics and specific needs.     

Relationships and sexuality of imprisoned men in the German penal system--a survey of inmates in a Berlin prison

The lack of concrete scientific data on the sexual behavior of inmates in German prisons is surprising, especially given the extant international scholarship on prison culture and sexual violence. Historically, the most influential publications were Clemmer's "The Prison Community", and Sykes's "The Society of Captives", which both addressed the importance of sexual deprivation and analyzed the impact of sexual victimization on prisoners. Different forms of homosexual contact between inmates include prostitution and "protective pairing", both characterized as "dark" issues--nonconsensual sexual acts--which still have not been scientifically researched. The United States enacted the Prison Rape Elimination Act, 2003, revealing nationwide data on the prevalence of sexual assault within correctional facilities. Prison inmates suffer not only from separation from their spouses or partners, but also from sexual harassment, extortion, and the threat of rape, which has multiple implications for their mental and physical health. This article presents the first German study to record data about the relationships and sexuality of imprisoned men, and was conducted in an adult correctional facility for long-term prisoners in Berlin-Tegel. The survey, which is based on results from a questionnaire taken by voluntary study participants, had a special focus on the occurrence of consensual homoerotic contacts between heterosexual inmates. The emphasis was on the potential impact of such contact on role behavior during confinement, as well as the impact on sexual identity after release. The survey revealed the first data on the incidence and prevalence of sexual violence and coercion within correctional facilities. This article presents the results of this survey for the first time.     

Exploring Agreement on Appropriate Responses to Domestic Violence and Sexual Trauma Across Victim Advocates,Mental Health Service Providers,and Substance Abuse Treatment Providers

Abstract

Research suggests that survivors of domestic violence and sexual assault are more at risk than the general population for substance abuse and/or mental health disorders (Kendler et al., 2000). Additionally, research suggests that survivors of both crimes are at risk to be “multiply diagnosed-have” a history of victimization, a mental health diagnosis, and abuse of alcohol and drugs (Steele & Rechberger, 2002). While advocates have called for a change in the treatment of trauma survivors to treat their multiple needs, the availability of collaborative care between victim advocates and behavioral health professionals remains questionable. Using survey data collected from victim advocates, mental health service providers, and substance abuse treatment providers, this study assesses the extent to which providers of different backgrounds agree on how to effectively and appropriately serve domestic violence and sexual assault survivors-the first step in achieving the goal of holistic care.     

Barriers to successful treatment completion in child sexual abuse survivors

Child sexual abuse (CSA) often requires psychological treatment to address the symptoms of victim trauma. Barriers to entry and completion of counseling services can compromise long-term well-being. An integrated medical and mental health evaluation and treatment model of a child advocacy center (CAC) has the potential to reduce barriers to mental health treatment. Objective: (a) to describe characteristics between CSA patients who engage versus those who do not engage in mental health treatment and (b) to identify factors associated with successful completion of mental health treatment goals. For design/setting, a retrospective cohort study was conducted of CSA patients (ages 3-16 years) referred to mental health services following a CAC assessment. Outcome variables included linkage with treatment and completion of treatment. Independent variables included demographics, abuse characteristics, and therapist characteristics. Data were abstracted from the CAC and billing databases. Results: Four hundred ninety subjects were evaluated. Subjects were as follows: predominately female (74%), White (60%), and more than half received Medicaid (56%). Mean age was 8.4 years. About 52% linked with mental health services and 39% of patients that successfully linked with mental health services completed therapy. Successful linkage was independently associated with referrals to other counseling services (AOR 8.4 [2.5, 27.7]). Successful completion of therapy was independently associated with caregiver participation in therapy (AOR 3.2 [1.8, 6.0]) and if the patient was referred to other counseling services (AOR 4.1 [1.9, 8.5]). There were no differences between subjects that linked and/or completed therapy and those that did not with regard to demographic characteristics or abuse severity. Conclusion: In contrast to previous reports, efforts at our CAC seem to overcome linkage barriers in this population. However, there remain challenges in achieving successful completion of treatment goals in this population. Engaging caregivers' involvement in therapy services had a positive effect with successfully achieving treatment goals.     

Criminal recidivism in sexual homicide perpetrators

Forensic psychiatric reports on 166 sexual homicide perpetrators in Germany were retrospectively analyzed for criminal risk factors. Follow-up information about release and reconvictions from federal criminal records was available for 139 offenders; 90 (64.7%) had been released. The estimated recidivism rate (Kaplan-Meier analyses) for 20 years at risk was 23.1% for sexual and 18.3% for nonsexual violent reoffences. Three men (3.3%) were reconvicted for attempted or completed homicide. Only young age at the time of sexual homicide resulted in higher sexual recidivism, whereas increased nonsexual violent recidivism was related to previous sexual and nonsexual delinquency, psychopathic symptoms, and higher scores in risk assessment instruments. Increased recidivism with any violent reoffence was associated with age-related factors: young age at first sexual offence, at homicide, and at release and duration of detention. The impacts of the results for risk assessment, relapse prevention, and supervision are discussed.     

Publication of OIG Special Fraud Alerts: home health fraud, and fraud and abuse in the provision of medical supplies to nursing facilities--HHS. Notice

This Federal Register notice sets forth two recently issued OIG Special Fraud Alerts concerning fraud and abuse practices in the home health industry and in the provision of medical supplies to nursing facilities. For the most part, the OIG Special Fraud Alerts address national trends in health care fraud, including potential violations of the Medicare anti-kickback statute. These two Special Fraud Alerts, issued directly to the health care provider community and now being reprinted in this issue of the Federal Register, specifically address fraud and abuse in the provision of (1) home health services and (2) medical supplies to nursing facilities, including the submission of false claims and anti-kickback violations.     

Social networks of sexual offenders

Abstract

Despite the extensive research attention directed toward criminal peer groups, there has been little attention to the peer groups of sexual offenders. Sexual offenders are often considered to be loners who offend in isolation, but cases of sex crimes involving peer support are not difficult to find, e.g., child sex rings, gang rapes. To examine the role of peers in sexual offending, sexual offenders and nonsexual offenders were asked whether they knew other people who have committed sexual crimes. In comparison to the nonoffender community comparison group, the sexual offenders reported considerably more association and identification with sexual offenders. The associations also tended to be offence specific, such that child molesters knew other child molesters and rapists knew other rapists. These findings have important implications for the assessment and treatment of sexual offenders.     

Childhood Sexual Abuse and Intimate Partner Violence among Women in Methadone Treatment: A Direct or Mediated Relationship?

Women in substance use treatment report rates of childhood sexual abuse and intimate partner violence that far exceed those reported by women in the general population. Previous research with nonrandom samples of women in substance use treatment suggests that there is a statistically significant relationship between childhood sexual abuse and intimate partner violence; however, little is known about the mechanisms of risk between these two public health concerns among this population of women. To address this gap in knowledge and to inform intervention strategies, this study examined direct and mediated relationships between childhood sexual abuse and intimate partner violence risk among a random sample of 416 women in methadone treatment. In addition to high rates of childhood sexual abuse (57.9%), intimate partner violence (lifetime prevalence, 89.7%; 6-month prevalence, 78.4%), posttraumatic stress disorder (PTSD, 28.6%), and global psychological distress (19.5%), findings suggest that the relationship between childhood sexual abuse and intimate partner violence is mediated by mental health problems and that women experiencing PTSD or global psychological distress are 2.7 and 2.4 times more likely to experience intimate partner violence than women without such experiences, respectively. Although not a mediator in this relationship, financial independence reduced women's risk of partner violence by two-thirds. The paper includes discussion of social learning and stress and coping theories to explicate the findings and to inform intervention strategies. This study is based, in part, on the first author's dissertation. A previous version of this paper was presented at the Society for Social Work and Research Annual Conference held in January 2005 in New Orleans, Louisiana. The following grants provided funding for this study: R01DA11027 and 3T32MH014623-22S1.     

Violence exposure and health related risk among African American adolescent female detainees: A strategy for reducing recidivism

Juvenile crime and violent victimization continue to be significant social problems (Fitzpatrick, Piko, Wright, & LaGory, 2005); in that, adolescents, females in particular, are likely to participate in health related risk behaviors as result of having been victimized or exposed to a violent environment. Specifically, abuse, neglect, sexual molestation, poverty, and witnessing violence are well known risk factors for the development of trauma-related psychopathology and poor outcomes relative to delinquency, drug and alcohol abuse, and HIV risk behaviors (Steiner, Garcia, & Matthews, 1997). HIV infection is a common public health concern disproportionally affecting adolescent African American female detainees. This unique population has a serious history of violence exposure, which subsequently tends to lead to engaging in risky sexual behaviors, mental health problems, and abusing substances. Also, as a result of little to no intervention, this population is recidivating at an alarming rate, a problem that may further exacerbate the expression of health-related risk behaviors among African American adolescent female detainees. The authors briefly describe a pilot program to be implemented in the juvenile justice system that is based on the Model of Accumulated Risk (Garbarino, 1996), Bronfenbrenner's Ecological Model (1994), and the Positive Youth Justice Model (Butts, Bazemore, & Meroe, 2009). The program proposes to reduce risky sexual behaviors, teach alternatives to abusing substances, treat mental health concerns, and reduce the rate of recidivism through "positive youth development", PYD (Butts, Bazemore, & Meroe, 2009). Tying elements of wraparound services and reeducation together, this program addresses salient concerns that may have an impact on an adolescent detainees' success following their release from prison in a holistic manner.     

Understanding deliberate indifference to suicide in corrections facilities: A review of recent legal cases

The US corrections system is the largest provider of mental health care in the country. Suicide is a leading cause of death in corrections facilities with rates of inmate suicide being far higher than the national average. Suicide is an event that can lead to legal action against the facility, staff, and treating health-care providers. Some claims are based on medical malpractice. In this setting, claims may also be brought based on violations of the detainee's constitutional rights. Pretrial detainees and prisoners, alike, have a constitutional right to adequate medical and psychiatric care through the Fourteenth Amendment and Eighth Amendment, respectively. But, there is limited information on constitutional claims made against correctional health-care providers for cases of inmate suicide. To help bridge this gap, the authors conducted a search of federal legal case decisions involving claims against health-care providers for deliberate indifference to a detainee's serious illness or injury in the event of attempted suicide or death by suicide over a 5 year period from 2016 to 2021. Fifteen cases were identified. Five themes emerged from the cases, which could serve as bases for claims against health-care professionals: receiving screening, mental health assessment, treatment, documentation, and attention to facility policies. The cases and their clinical significance are summarized in this article. The materials provide an overview of the problems surrounding correctional suicides and can serve as practice pointers in the corporeal setting.     

The Effect of Coercion on Aggression and Mental Health Among Reciprocally Violent Couples

Researchers have not investigated mental health outcomes among couples who are reciprocally violent towards each other. The present study investigated differences in partner violence (psychological, physical, and sexual) and mental health symptoms (depression, anxiety, hostility, and somatic) between two types of reciprocally violent couples: situational couple violence (SCV) and mutual control violence (MVC). SCV couples use violence to address stressful family conflicts, while MVC couples use violence as a tool to control each other. Participants (N = 609) completed surveys that contained several instruments that measured past violence, coercive behaviors, physical injuries, and mental health symptoms. Results revealed that MVC reported significantly higher levels of violent perpetration and worse physical and mental health than SCV. These findings have implications for understanding the role of coercion in partner violence and mental health, which can be used for the development of appropriate mental health services for couples who are mutually violent towards each other.     

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); mental health services--DoD. Final rule

This final rule is to reform CHAMPUS quality of care standards and reimbursement methods for inpatient mental health services. The rule updates existing standards for residential treatment centers (RTCs) and establishes new standards for approval as CHAMPUS-authorized providers for substance use disorder rehabilitation facilities (SUDRFs) and partial hospitalization programs (PHPs); implements recommendations of the Comptroller General of the United States that DoD establish cost-based reimbursement methods for psychiatric hospitals and residential treatment facilities; adopts another Comptroller General recommendation that DoD remove the current incentive for the use of inpatient mental health care; and eliminates payments to residential treatment centers for days in which the patient is on a leave of absence.     

Criminal diversity and paraphilic interests among adult males convicted of sexual offenses against children

Official demographic and offense history data (n = 362) and confidential self-report data on paraphilic interests and behavior (n = 221) obtained on adult males convicted of sexual offenses against children were analyzed. Considerable criminal diversity was observed, with all standard categories of offenses represented in offenders' criminal histories. Most (86%) of the offenders' previous convictions were for nonsexual offenses, and most (92%) of the recidivist offenders had previously been convicted of at least one nonsexual offense. The prevalence of diagnosable paraphilias was low, with only 5% meeting formal diagnostic criteria for multiple (two or more) paraphilias other than pedophilia. Sexual offenders' paraphilic interests were unrelated to the extent of their sexual offense convictions but were significantly related to the extent of their nonsexual offense convictions. The results are better explained by a general theory of crime than by traditional clinical conceptions linking sexual offenses specifically with sexual psychopathology.