Can ministries of health support primary health care? Some suggestions for structural reorganization and planning

Patrick Vaughan is Reader in health care epidemiology, Gill Walt is Lecturer in health policy and Anne Mills is Lecturer in health economics, at the Evaluation and Planning Centre for Health Care, London School of Hygiene and Tropical Medicine, Gower Street, London WC1, United Kingdom. A previous version of this paper was prepared for the Commonwealth Secretariat, London, for the Conference of Commonwealth Health Ministers held in Ottawa, Canada, in October 1983.     

Intimate Partner Violence Victims’ Accuracy in Assessing their Risk of Re-abuse

Using four categories of accuracy (true positive, false positive, true negative, false negative), this study explored (1) how accurately intimate partner violence (IPV) victims are able to assess their risk of re-abuse; and (2) potential predictors of accuracy. Women seeking help for IPV (N = 246) rated the likelihood that they would experience physical re-abuse in the coming year and then reported 18 months later whether those risks had been realized. Victim assessments were more likely to be right than wrong, and were subject to neither a pessimistic nor optimistic bias. In the multivariate analysis, significant/marginally significant predictors of the accuracy categories were the history of violence from this and former partners, level of substance use, PTSD symptoms, and the recency of the violence. Among the more robust findings were the connection between level of stalking and true positives, and between substance use and false negatives. This study suggests that victim assessments have significant potential to inform practice, and deserve further exploration.

Dual Arrest and Other Unintended Consequences of Mandatory Arrest in New York City: A Brief Report

In jurisdictions across the United States, the mandated arrest of individuals perpetrating domestic violence crimes termed “mandatory arrest” or “pro-arrest” policies has become a key policy solution to the issue of domestic violence. The purposes of the policies are to standardize the police response to, and increase the number of, arrests stemming from domestic violence incidents by removing or reducing police discretion to arrest. In 1994, the New York state legislature passed the Family Protection and Domestic Violence Intervention Act, which contained provisions enacting a mandatory arrest statute. Using information from 183 callers to a telephone helpline for victims of domestic violence, we describe four unintended consequences of the policy: “unwanted,” “dual,” “retaliatory,” and “no” arrest. Bi- and multivariate analyses are used to identify victim and perpetrator sociodemographic, situational, and legal factors associated with each arrest type. Results are discussed in the context of the effects of mandatory arrest policies and minimizing problems associated with it in the future.

Brown,Governor of California v Plata

This case note examines the controversial decision of the US Supreme Court which, by a majority of 5:4 held that California should reduce its prison population as overcrowding levels gave rise to cruel and unusual punishment. The implications of the case for the interpretation of when prisoners' rights under the Eighth Amendment are breached, the separation of powers are discussed; the possible impact on prison rates in the USA is also examined.     

Maternal Separations During the Reentry Years for 100 Infants Raised in a Prison Nursery

Prison nurseries prevent maternal separations related to incarceration for the small subset of children whose pregnant mothers are incarcerated in states with such programs. For a cohort of 100 children accepted by corrections into one prison nursery, subsequent separation patterns are analyzed. The largest numbers are caused by corrections' removal of infants from the nursery and infants reaching a one-year age limit. Criminal recidivism and substance abuse relapse threaten continued mothering during reentry. Focused and coordinated services are needed during prison stay and reentry years to sustain mothering for women and children accepted into prison nursery programs.     

Treating offenders with mental illness: a research synthesis

The purpose of this research synthesis was to examine treatment effects across studies of the service providers to offenders with mental illness. Meta-analytic techniques were applied to 26 empirical studies obtained from a review of 12,154 research documents. Outcomes of interest in this review included measures of both psychiatric and criminal functioning. Although meta-analytic results are based on a small sample of available studies, results suggest interventions with offenders with mental illness effectively reduced symptoms of distress, improving offender's ability to cope with their problems, and resulted in improved behavioral markers including institutional adjustment and behavioral functioning. Furthermore, interventions specifically designed to meet the psychiatric and criminal justice needs of offenders with mental illness have shown to produce significant reductions in psychiatric and criminal recidivism. Finally, this review highlighted admission policies and treatment strategies (e.g., use of homework), which produced the most positive benefits. Results of this research synthesis are directly relevant for service providers in both criminal justice and mental health systems (e.g., psychiatric hospitals) as well as community settings by informing treatment strategies for the first time, which are based on empirical evidence. In addition, the implications of these results to policy makers tasked with the responsibility of designating services for this special needs population are highlighted.