Screening for severe mental disorder in jails

Despite the demonstrated prevalence of severe mental disorder among jail detainees and the legal mandate to provide mental health services, most jails do not have the resources to incorporate traditional, time-consuming psychological assessment techniques into their routine intake process. As a result, a number of mentally ill jail detainees remain undetected and untreated. This study outlines the development of the Referral Decision Scale (RDS), which detects persons who have a high probability of having a severe mental disorder so that they can be given a complete diagnostic evaluation. The 14-item RDS was statistically derived using discriminant analysis from data collected via the NIMH Diagnostic Interview Schedule on 728 randomly selected male jail detainees and then validated on 1,149 prison inmates. The final validated version of the RDS had an overall sensitivity of 0.791, specificity of 0.987, and positive and negative predictive value of 0.791 and 0.013, respectively. Since these statistics far exceed current detection rates, the RDS is likely to facilitate the diversion of mentally ill detainees in situations where it is impractical to administer psychological examinations to all incoming inmates. Training requirements for the RDS and directions for future research are discussed.This research was supported in part by National Institute of Mental Health under grant No. R01MH37988. We would like to thank Karl Kilgore, Stuart Michaels, John Lyons, Karen Abram, Richard White, and Christine Davidson for their statistical insights and helpful comments. James Collins is due special thanks for making his North Carolina prison data available. We are also grateful to Philip Hardiman, Thomas Monahan, and Ronald Simmons for their cooperation with the data-collection process.     

Reviews

Seweryn Bialer, The Soviet Paradox: External Expansion, Internal Decline. London: I. B. Tauris, November, 1986, xx + 396 pp. £16.50.

Frank Füredi, The Soviet Union Demystified: A Materialist Analysis. London: Junius Publications, 1986, 271 pp. £12.50 h/b, £5.95 p/b.

R. Furtak, The Political Systems of the Socialist States: an Introduction to Marxist‐Leninist Regimes, Wheatsheaf Books Ltd., Brighton, 1986, xi + 308 pp. £32–50.

Peter Jones and Sian Kevill (Compilers) China and the Soviet Union 1949–84, Keesing's International Studies; Longman, London: 1986, 202 pp. £20.00.

Roy Medvedev, China and the Superpowers, Basil Blackwell, Oxford; 1986, 234 pp. £17.50.

Gail Schlachter (ed.) Sino‐Soviet Conflict: A Historical Bibliography, ABC‐Clio Distribution Services, Clio Press, Oxford; 1985, xii + 190 pp. £30.50.

Károly Attila Soós, Terv, Kampany, Penz. Szabalyozas es Konjunkturaciklusok Magyarorszagon es Jugoszlaviaban, Közgazdasagi es Jogi Könyvkiado‐Kossuth Könyvkiado, Budapest, 1986, 533 pp. 142 Ft.

William V. Wallace and Roger A. Clarke, Comecon, Trade and the West, Frances Pinter (Publishers), London, 1986, xi + 176 pp. £18.50.

Alec Nove, Socialism, economics and development, Allen & Unwin, London, 1986, 243 pp. £25.00 US $29.95.

Klaus Fritsche, Blockfreiheit aus sowjetischer Sicht, Deutsches Übersee‐Institut, Munich, Cologne, London, Weltforum Verlag, 1986, 299 pp.

Winrich Kühne, Sowjetische Afrikapolitik in der ‘Ara Gorbatschow’. Eine Analyse ihrer grundlegenden Probleme Mitte der 80er Jahre, ausgehend von den Entwicklungen in Mozambique, Angola und Äthiopien. Stiftung Wissenschaft und Politik, Ebenhausen, 1986, 146 pp.     

Conflict in Trade Policy: The Role of the Congress and the Provinces in Negotiating and Implementing the Canada-U.S. Free Trade Agreement

The provincial role in trade policy has until recently beenlimited, but the increasing impact of international trade negotiationson domestic policy issues has come into direct conflict withprovincial jurisdiction. At the same time, Congress has handedsome of its constitutional authority over trade matters to theexecutive branch through the granting of "fast track" negotiatingauthority. The paper argues that, as a result of these developments,the functional roles that Congress and the provinces playedin the negotiation of the FTA were not significantly differentin the two countries. However, in the implementation of thetrade agreement, roles again became clearly defined by constitutionaljurisdiction.     

The power of small-scale solar: gender,energy poverty,and entrepreneurship in Tanzania

Energy poverty is a major challenge in the developing world, with an estimated 1.2 billion people lacking household electricity. Although energy poverty affects both men and women, the burden of household energy supply disproportionately affects women in low-income countries in the developing world. This article examines the impact of a women-oriented solar lighting social enterprise, Solar Sister, in Tanzania for both solar entrepreneurs and customers, demonstrating that solar lanterns positively impact household savings, health, education and women’s economic productivity and empowerment. Our study argues that Solar Sister’s approach is successful because of its explicit gender lens. Providing energy access to women translates to a pro-woman, pro-child, and pro-family development intervention.     

Protecting the living: Managerialism and professional turf wars in risk regulatory death investigations

This paper demonstrates how general trends in the management of public institutions, and a specific turf war between the doctors and lawyers in Ontario, Canada, have combined to shape an important risk regulatory decisionmaking process: the coroner's inquest. Drawing on ethnographic evidence, I show how the priorities of managerialism, and the collateral effects of physician coroners battling with lawyers, have reduced the number of public inquests convened in Ontario by 80 per cent over a 20‐year period. Where many public safety decisions affecting the province's legal, policy, and physical environments were once made at public inquests, they appear now more likely to be made in private. The paper examines the implications of reduced public participation in the analysis of, and response to, death.     

Long-term care: common issues and unknowns

All industrialized countries are grappling with a common problem—how to provide assistance of various kinds to their rapidly aging populations. The problem for countries searching for models of efficient and high-quality long-term care (LTC) policies is that fewer than a dozen countries have government-organized, formal LTC policies. Relatively new surveys focused on the elderly populations of about 25 countries could become the basis for research on which LTC policy design choices have desired outcomes for individuals and society and might be replicable in other countries. As in earlier decades when U.S. researchers created the Current Population Survey (CPS) modules and the Survey of Income and Program Participation to answer policy questions, researchers and policy analysts are now at a point where a concerted effort is needed to generate questions that international comparative research on LTC could answer as well as the data needed to address the questions.