Patterns of Practice in Mental Health Courts: A National Survey

Mental health courts (MHCs) represent an important new development at the interface of the criminal justice and mental health systems. MHCs are criminal courts for persons with mental illness that were in part created to divert this population from jail/prison into community treatment. MHCs are proliferating rapidly despite limited knowledge regarding their characteristics or their efficacy. We surveyed the entire population of adult MHCs in the United States, n = 90. In the past 8 years, MHCs have been created in 34 states, with an aggregate current caseload of 7,560 clients in MHCs nationally. Most courts (92%) reported using jail as a sanction for noncompliance, if only rarely. Further, jail sanction use was significantly predicted by increased judicial supervision and number of felons in the court. Implications for MHCs and social monitoring are discussed.     

The relationship between mandated community treatment and perceived barriers to care in persons with severe mental illness

OBJECTIVE: In recent decades debate has intensified over both the ethics and effectiveness of mandated mental health treatment for persons residing in the community. Perceived barriers to care among persons subjected to mandated community treatment, and the possibility that fear of involuntary treatment may actually create or strengthen such barriers rather than dissolve them, are key issues relevant to this debate but have been little studied. This article explores the link between receipt of mandated (or "leveraged") community treatment and reasons for avoiding or delaying treatment reported by persons with severe mental illness. It also examines the potential moderating effect of social support on the association between mandated treatment experiences and barriers attributable to fear of involuntary commitment or forced treatment. METHOD: Data are presented from a survey of 1011 persons with psychiatric disorders being treated in public-sector mental health service systems in five U.S. cities. Logistic and negative binomial regression analyses were used to examine the association between mandated community treatment and perceptions of barriers to care, controlling for demographic and clinical characteristics. RESULTS: Across sites, 32.4% to 46.3% of respondents reported barriers attributed to fear of forced treatment. Whereas 63.7% to 76.1% reported at least one non-mandate-related barrier to care; the mean number of non-mandated barriers to care ranged from 1.6 to 2.3 (range 0-7). Between 44.1% and 59.0% of participants had experienced at least one type of leveraged treatment. Persons experiencing multiple forms of mandated treatment were more likely to report barriers to care in comparison to those not reporting mandated treatment. Findings also indicated that social support moderates the relationship between multiple leverages (three or four forms) and mandate-related barriers to care. CONCLUSIONS: Perceived barriers to care associated with mandated treatment experience have the potential to adversely affect both treatment adherence and therapeutic alliance. Awareness of potential barriers to care and how they interact with patients' perceived social support may lead to improved outcomes associated with mandated treatment.     

Understanding the risk factors for violence and criminality in women: the concurrent validity of the PCL-R and HCR-20

This study explores the performance of 132 female maximum-security inmates on the Psychopathy Checklist-Revised (PCL-R) and the HCR-20 (Historical, Clinical, and Risk Management Scheme) to examine the concordance between these two risk assessment instruments, and to assess their potential usefulness in determining level of risk for violent behavior and other forms of criminality. The two instruments demonstrated consistent and highly significant correlations across total scores, factor scores, and subscale scores. When the two instruments were entered into a multiple regression analysis to predict violent and non-violent crime, the HCR-20 did not add to the variance explained by the PCL-R. These results confirm earlier research that suggests that there is little or no difference between these two risk assessment instruments in their relationship to community or institutional violence. Further, Receiver Operating Characteristics (ROC) analyses show that both instruments demonstrated an inverse ability to predict convictions for murder, a close to chance ability to predict violent crime, but a shared ability to predict property and minor crime. Broadly, these results suggest that psychopathic women are involved in chronic patterns of non-violent criminality, while women charged and convicted of murder generally do not have elevated scores on the PCL-R or HCR-20. The relevance of these findings to rehabilitation and treatment is discussed.     

Normal responses to sexually anatomically detailed dolls

The behaviors and verbalizations of normal, preschool age boys and girls during interactions with sexually anatomically detailed (SAD) dolls were examined. A structured, nonsuggestive interview with each child was videotaped, and five behaviors and five verbalizations were coded for each of five phases of the interview. A two-way ANOVA (gender × phase) showed that during those phases when the dolls were undressed, both boys and girls showed more sexual exploratory play, aggressive behavior which was nonsexual, and active avoidance. Across all phases, nonsexual aggression accounted for 31% of the boys' and 22% of the girls' total responses. Behavioral and verbal sexual exploratory play represented 42% of the boys' responses and 50% of the girls' responses. In contrast, sexually aggressive behavior accounted for only 1% and 2% of the boys' and girls' responses, respectively. Girls interacted with the dolls more than did boys. Additionally, girls demonstrated more affection to the dolls than did the boys, and boys displayed more anxiety with the dolls than did girls. Investigators should be cautious as to inferences about preschoolers' interactions with SAD dolls, especially interactions of a sexual or aggressive nature which do not clearly depict fondling or intercourse.     

The Effect of Clothing on the Rate of Decomposition and Diptera Colonization on Sus scrofa Carcasses

Twenty Sus scrofa carcasses were used to study the effect the presence of clothing had on decomposition rate and colonization locations of Diptera species; 10 unclothed control carcasses were compared to 10 clothed experimental carcasses over 58 days. Data collection occurred at regular accumulated degree day intervals; the level of decomposition as Total Body Score (TBS_surf), pattern of decomposition, and Diptera present was documented. Results indicated a statistically significant difference in the rate of decomposition, (t₄₂₇ = 2.59, p = 0.010), with unclothed carcasses decomposing faster than clothed carcasses. However, the overall decomposition rates from each carcass group are too similar to separate when applying a 95% CI, which means that, although statistically significant, from a practical forensic point of view they are not sufficiently dissimilar as to warrant the application of different formulae to estimate the postmortem interval. Further results demonstrated clothing provided blow flies with additional colonization locations.     

Plea decision-making by attorneys and judges

Objectives

Approximately 95 % of convictions in the United States are the result of guilty pleas. Surprisingly little is known about the factors which judges, prosecutors, and defense attorneys consider in these decisions. To examine the legal and extralegal factors that legal actors consider in plea decision-making, we replicated and improved upon a 40-year-old study by asking legal actor participants to review a variety of case factors, and then make plea decisions and estimate sentences for pleas and trials (upon conviction).

Methods

Over 1,500 defense attorneys, prosecutors, and judges completed an online survey involving a hypothetical legal case in which the presence of three types of evidence and length of defendant criminal history were experimentally manipulated.

Results

The manipulated evidence impacted plea decisions and discounts, whereas criminal history only affected plea discounts (i.e., the difference between plea and trial sentences). Defense attorneys considered the largest number of factors (evidentiary and non-evidentiary), and although legal actor role influenced the decision to plead, it did not affect the discount.

Conclusions

In replicating a landmark study, via technological advances not available in the 1970s, we were able to increase our sample size nearly six-fold, obtain a sample representing all 50 states, and include judges. However, our sample was nonrepresentative and the hypothetical scenario may or may not generalize to actual situations. Nonetheless, valuable information was gained about the factors considered and weighed by legal actors.

     

Identification of organic pigments in automotive coatings using laser desorption mass spectrometry

When one looks at an automotive coating, one sees color due to pigments. Modern organic pigments, with high molar absorptivities, may be only minor components of the mixture. Laser desorption mass spectrometry (LDMS) has been shown to be a useful tool for the analysis of colorants such as pen ink dyes. Here, LDMS is used to determine its utility for the identification of pigments, in simple media and in more complex paints. Small paint chips can be introduced into the LDMS instrument, and when an ultraviolet laser is focused on a portion of a chip, ions representative of the pigment(s) are selectively formed. Some pigments such as quinacridones and copper phthalocyanine are very stable and are desorbed and ionized intact. In contrast, benzimidazolones, which contain some single-skeletal bonds, form fragment ions. This method proves to be sensitive and convenient, as no sample preparation is required. The presence of inorganic pigments in addition to modern organic pigments can be determined, and pigments can be directly identified in actual automotive paint chip samples.