Interventions with women offenders: a systematic review and meta-analysis of mental health gain

Currently, a conjunction of policy, legislative change in health and social care and the criminal justice system, combined with funding for innovative services make it opportune to assess the evidence base for interventions with women offenders. Women offenders have a distinctive criminological, health and social profile and a gender specific approach to their difficulties is advocated. This systematic review and meta-analysis focus on mental health gain in adult women offenders in forensic health settings, criminal justice institutions and in the community, following therapeutic interventions. Interventions were assessed in terms of specific outcome measures of depression, trauma symptomatology and global mental health status. Comprehensive search strategies yielded 3018 articles, from which we obtained 199 full text articles. Seventeen articles were included in the final review, of which six were excluded from the meta-analysis as there was no comparator group. There is a modest, but increasing, body of evidence for the utility of some interventions, notably those addressing the consequences of earlier trauma, including interventions which also address comorbid substance misuse. This does not amount, to date, to a robust evidence base. Limitations of these studies are discussed and include small sample sizes, their restriction mainly to prison populations and that they were substantially undertaken in the US. Variations in outcome measures follow-up and the difficulties inherent in measuring change in this complex population are also detailed. However, the review delineates definite avenues for further work. To achieve this, those responsible for policy, practice and purchase of services should both be mindful of existing evidence and promote additional, high quality research into interventions which are designed around a coherent, theoretical approach.     

Target Selection Models with Preference Variation Between Offenders

Objectives

This study explores preference variation in location choice strategies of residential burglars. Applying a model of offender target selection that is grounded in assertions of the routine activity approach, rational choice perspective, crime pattern and social disorganization theories, it seeks to address the as yet untested assumption that crime location choice preferences are the same for all offenders.

Methods

Analyzing detected residential burglaries from Brisbane, Australia, we apply a random effects variant of the discrete spatial choice model to estimate preference variation between offenders across six location choice characteristics. Furthermore, in attempting to understand the causes of this variation we estimate how offenders’ spatial target preferences might be affected by where they live and by their age.

Results

Findings of this analysis demonstrate that while in the aggregate the characteristics of location choice are consistent with the findings from previous studies, considerable preference variation is found between offenders.

Conclusions

This research highlights that current understanding of choice outcomes is relatively poor and that existing applications of the discrete spatial choice approach may underestimate preference variation between offenders.

     

Undiagnosed progressive supranuclear palsy in a patient with neuroleptic malignant syndrome due to use of neuroleptics: the utility of autopsy in deaths due to known drug reactions

Medical examiners must decide whether or not a complete autopsy is warranted in evaluation of deaths that have been referred to their office. This decision is influenced by many factors. In most cases, the choice to perform only an external examination occurs in deaths where the decedent had previously documented potentially lethal natural disease or well-documented trauma. We report a patient who apparently died of the sequelae of a well-known complication of pharmacotherapy (neuroleptic malignant syndrome following Haldol administration). The death was referred to the medical examiner's office, where, based upon the history, an external examination was performed. Subsequently, the family requested an autopsy by the treating hospital. The autopsy established the diagnosis of progressive supranuclear palsy (PSP). The patient's presenting signs and symptoms were not typical of the disease; however, PSP most likely played a role in the neuroleptic malignant syndrome-like manifestations the patient exhibited following the Haldol administration. The results of the complete autopsy highlight its importance in identifying and enhancing our understanding of the underlying conditions in natural disease-based causes of death involving known therapeutic complications.     

“To This Day She Continues to Struggle with the Terror Imposed upon Her”: Rape Narratives in Victim Impact Statements

This study locates the victim impact statements of raped women in the sociolegal context of significant sentencing law reforms introduced in Canada to address an ascendant victim’s rights movement. We examine 38 reported sentencing decisions in sexual assault cases in Ontario, Canada (1999–2010). Our objectives are to discern (a) whether the archetype of the ideal victim continues to influence juridical discourse after conviction and (b) what narratives of harm intersect with sentencing objectives and aggravating factors. Our findings suggest women express profound fear of re-victimization and traumatic effects of sexual violence regardless of the relational context of their rape experience. Most surprisingly, our data show sentencing judges view the sexual assault of an intoxicated rape victim as an aggravating factor. Future consideration for victim impact statements in sexual assault cases is discussed.