A tale of two cultures: examining patient-centered care in a forensic mental health hospital

Several questions remain unanswered regarding the extent to which the principles and practices of patient-centered care are achievable in the context of a forensic mental health hospital. This study examined patient-centered care from the perspectives of patients and providers in a forensic mental health hospital. Patient-centered care was assessed using several measures of complementary constructs. Interviews were conducted with 30 patients and surveys were completed by 28 service providers in a forensic mental health hospital. Patients and providers shared similar views of the therapeutic milieu and recovery orientation of services; however, providers were more likely to perceive the hospital as being potentially unsafe. Overall, the findings indicated that characteristics of patient-centered care may be found within a forensic mental health hospital. The principles of patient-centered care can be integrated into service delivery in forensic mental health hospitals, though special attention to providers' perceptions of safety is needed.     

Retributivism and Legal Moralism

This article examines whether a retributivist conception of punishment implies legal moralism and asks what liberalism implies about retributivism and moralism. It makes a case for accepting the weak retributivist thesis that culpable wrongdoing creates a pro tanto case for blame and punishment and the weak moralist claim that moral wrongdoing creates a pro tanto case for legal regulation. This weak moralist claim is compatible with the liberal claim that the legal enforcement of morality is rarely all‐thing‐considered desirable. Though weak moralism has some plausibility, it does not follow from weak retributivism if legitimate state functions are limited in certain ways.     

What Drives the Relationship Between Early Criminal Involvement and School Dropout?

Objective

We examine the relationship between early criminal involvement and school dropout, and analyze which factors underlie this relationship, making use of administrative data from the Netherlands.

Methods

We start by determining the unconditional correlation between early criminal involvement and school dropout, using a basic ordinary least squares model. As this association is likely to be driven by different factors, we proceed by including an extensive set of observable family and individual characteristics into the estimation model. We further proceed to models that account for the influence of unobservable heterogeneity by estimating school, class, sibling and twin fixed effects.

Results

Criminal involvement is associated with an 11 percentage point higher probability of school dropout. The magnitude of this relationship decreases gradually when we account for larger shares of observed and unobserved heterogeneity. The coefficient in the same-gender twin fixed effects model indicates a 3 percentage point higher probability of school dropout, which is statistically significant at a 10 % level. We also find that the association between criminal involvement and school dropout is stronger if juveniles are involved in severe criminal activities.

Conclusions

We conclude that the observable and unobservable factors for which we account explain around 73 % of the unconditional correlation between criminal involvement and school dropout. The remaining variation likely reflects individual-specific characteristics that are different between same-gender twins. A true treatment effect, if existing, is likely to be relatively small. At the same time, serious criminal behavior appears to causally affect school dropout.