The Alabama Structured Assessment of Treatment Completion for insanity acquittes (The AlaSATcom)

The most complex and risky decisions made by forensic psychiatrists revolve around the decision to release insanity acquittes from custody. This decision has several levels of risk, including the potential liability to the psychiatrist as well as the possible risk to the community. A single bad outcome, even if not predictable, can have disastrous results, not only for victims, but also for the releasing facility. Since predicting violence has so many problems, we chose to look at completeness of treatment instead, so we could say to the Court, "We don't know about violence, but we do know that he has vastly improved." Since many NGRI (Not Guilty by Reason of Insanity) patients spend years in the hospital, they are also expensive. They have rights, as well; therefore the complex assessment must be done as quickly and as accurately as possible. We have developed a spread sheet program to compare these multiple factors, and have compared it against the clinical decisions we have made in more than 100 discharges. We believe this gives a framework for decision-making that will increase the consistency of this process.     

Urban homicide: Still the same

We use 1984–1986 data to estimate lifetime risks of being murdered in each of 50 large American cities and then compare these projections to others made earlier from 1971–1972 and 1976–1977 data. We find strong constancy over time in the average urban resident's murder risk (essentially a 1 in 68 chance of eventually being slain). Moreover, we find a high stability in the dispersion of risk by region, race, and city size and in the relative rankings of the 50 cities by murder risk. We comment briefly about such recent phenomena as the proliferation of crack and the resumption of capital punishment.Throughout this paper, we use the words murder, homicide, killing, and slaying interchangeably, meaning in all cases murder and nonnegligent manslaughter as defined by the FBI.     

Minimizing the social cost of drug abuse: An economic analysis of alternatives for policy

The use of heroin, with its concomitant social problems, is facilitated by an illicit market process which functions similarly to economic markets in general. The analysis of this process, incorporated in a model embodying the interacting relationships of crime generation and control, permits evaluation of three fundamentally different strategies for social control. These are controlling supply through law enforcement and other strategies, controlling demand by detaining addicts, or reducing illicit market activitity by introducing an effective substitute for the services of that market. When all the social costs of addiction are taken into account and when minimizing the total of those costs is taken to be the objective, the authors conclude that the best solution will lie with the establishment of a drug maintenance program. Properly administered, such a program would undermine the illicit market by reducing demand. Furthermore, it can be expected to reduce levels of drug related crimes and to moderate factors encouraging addiction.The authors wish to acknowledge the helpful comments of Perry Shapiro and an unnamed referee and the support of the Russell Sage Foundation during the writing of this analysis.     

The Southern Presidential Primary: Regional Intentions With National Implications

Fifteen southern and border states have decided to hold presidentialprimaries around the second Tuesday in March 1988. Democraticparty reformers have backed this regional primary in hopes thatit will advantage politically moderate candidates for the presidency.This article discusses how enactment of the southern primarycame about and why this reform seems unlikely to achieve theintentions of the reformers. Four major criticisms of the reformsare discussed: 1) Republicans, not Democrats, could benefit;2) the importance of earlier primaries and caucuses—Iowaand New Hampshire in particular—could grow dramatically;3) the desired moderating influence on Democratic candidatescould be frustrated by plurality wins; and 4) the southern regionalprimary is not southern or regional but national.