The mental health and substance misuse needs of male ex-armed forces personnel in prison

Ex-armed forces personnel constitute the largest known occupational group in prison but there is little evidence regarding their mental health, or substance misuse, needs. A total of 105 participants were interviewed and measures assessing symptoms of common mental health (CMH) problems and substance misuse were completed along with a review of their health care records. Forty (38%) participants screened for current CMH problems (CCMH) and high levels of dual symptomology and alcohol misuse were assessed. Thirty-nine (37%) had a mental health diagnosis recorded, most commonly for post-traumatic stress disorder (PTSD), depression and personality disorder. Those who screened for a CCMH problem were more likely to have pre-service vulnerability to negative health outcomes and those with dual symptomology were more likely to have experienced deployment during their service. Findings suggest the mental health needs of this group are similar to the general prison population. Potentially higher prevalences of PTSD and alcohol misuse may direct service provision.     

Evaluating integrative services in edge-of-care work

Children living on ‘the edge-of-care’ are typically known to local safeguarding authorities and are considered likely to face risks to their safety. Many are subject to a child protection plan and/or involved in ‘pre-proceedings’ processes. A growing number of their parents face (un)diagnosed mental health difficulties as well as economic and social precarity. This article draws on a mixed methods evaluation of a pilot service in the East of England offering a therapeutically led attachment-based intervention for families. The service cross-cuts health and social care, allowing psychologists and psychotherapists to work alongside social workers and other practitioners. The evaluation examined psychological and safeguarding outcomes and explored practitioner perspectives. A key outcome was that 85.4% of families were enabled to remain, or reunite with their child, compared with an estimated 50% of ‘edge-of-care’ cases nationally. This supports the need for similarly oriented interventions that could help lower the incidence of child removals.     

吸毒行为的法律定性

目前,针对吸毒行为的定性主要有"犯罪说"、"违法说"、"合法化说"、"疾病说"及"受害说"等观点。基于现有研究及国外有关政策,明确吸毒者兼具病人、违法者、受害者三重社会属性,提出我们应正确对待吸毒人员,各部门应形成合力采取有效且人道的戒毒措施,保障戒除毒瘾者的合法权益。     

后现代精神病学对现代精神病学的法哲学反思

中世纪的异教徒"疯子"们被监禁,施以酷刑,流放可谓不堪回首,我们可以说那是因为精神病学的概念还未真正产生。但是,伴随着精神病学的设立,现代精神病学的发展已经由惩罚性收容转变成治疗性措施。精神病人的行为举止让大家感觉到不一样,无法理解。我们对于自己无法理解的事,要么报以莫名的敬畏之心,要么想方设法将它们变得不可见,来获得自己生活的平静,这是对的吗?从法哲学的视角是否应该给予反思和拷问,以探寻精神病学之正义性。本文希望从现代精神病学发展的历史,以法哲学的批判思维分析了现代精神病学的缺陷,并展望后现代精神病学的特质及其替代现代精神病学之发展趋势。     

美国精神卫生制度的发展——兼论我国新《精神卫生法》

美国精神卫生制度的形成经历了从漠视和侵犯人权到尊重和重视人权的发展过程。然而美国现有精神卫生制度领域仍然存在着诸多问题和缺陷,特别体现在医疗服务可获得性缺乏这一问题上。《中华人民共和国精神卫生法》力求在医疗服务可获得性与强制住院之间达到平衡。     

Ben L. Reitman,MD: colorful critical criminologist

Ben Reitman, a medical doctor, fought throughout his life for greater sympathetic understanding of and assistance to American’s underdogs. He spent his early years living among social outcasts and riding the rails with hobos. He then teamed up with Emma Goldman to advance her political agenda of anarchist ideas and in support of free speech. After an amiable split with Goldman, he worked in Chicago, treating prostitutes, performing illegal abortions, combating venereal disease, and battling to make birth control information freely available. Reitman also associated with several of the prominent members of the University of Chicago’s stellar sociology faculty and contributed importantly to their studies of urban life.     

Self-deception and other-deception among admissions to a maximum security hospital and a medium secure unit

Abstract

Other-deception and self-deception are important variables to consider when conducting a forensic psychological evaluation. The main aim of the present study was to investigate the effects of setting on other-deception and self-deception scores. It was hypothesised that patients at a maximum security hospital (Broadmoor) would score lower on an other-deception questionnaire than similar patients at a medium secure unit (Denis Hill Unit). All the patients completed the other-deception (ODQ) and self-deception (SDQ) questionnaires of Sackeim and Gur (1979) on admission to the two security hospitals. The Broadmoor patients (N = 46) obtained significantly lower ODQ score than the Denis Hill Unit (N = 52) patients, after controlling for differences in ethnic background and diagnosis among the two populations. No significant difference in setting was found for the SDQ score. The ODQ and SDQ scores were significantly associated with the type of diagnosis and the ethnic background of the patient, with patients diagnosed as mentally ill scoring higher than those with a diagnosis of personality disorder, and ethnic minority patients scoring higher than Caucasian patients.     

The observation of mental disorder and dangerousness in arsonists: a contemporary appraisal of changes in Dutch forensic mental health cases

In the Netherlands pre-trial forensic mental health assessments are conducted to examine whether a mental disorder was present at the time of the offence that affected the free will of a person, in which case criminal accountability is considered diminished or absent. This study aims to investigate societal changes over time in forensic mental health recommendations in arson cases. Seventy-two reports of male arsonists assessed in 1950–2010 were included in this study, 36 arsonists were assessed in the first time period (1950–1979) and 36 in the second period (1980–2010). Results show an association between DSM classification and the conclusion on criminal accountability only in the first period and an association between recidivism risk and the forensic mental health recommendation only in the later period. It is concluded that mental disorder was of greater influence on the conclusion on accountability in the first time period, whilst dangerousness played a more important role on the forensic mental health recommendation in the later time period. Our findings reflect a shift from paternalistic principles to principles of risk control and show that societal changes influence the field of forensic mental health.     

Mental reinstatement of context with child witnesses: does it matter whether context is reinstated ‘out loud’?

Abstract

In this study we examined the impact of two types of mental reinstatement of context instructions in facilitating children's recall of a staged event across two stages of development. Specifically, a 2 × 3 factorial design was utilised incorporating two age groups (6- and 12-year-olds) and three interview conditions (standard recall, mental reinstatement where the child was instructed to reinstate the context ‘out loud’, and mental reinstatement without the explicit ‘out loud’ instruction). Overall, mental reinstatement instruction led to more correct and fewer incorrect responses than the standard recall instruction. The effect of mental reinstatement was similar across the age groups and irrespective of whether the child was asked to reinstate ‘out loud’. Beneficial effects of the technique, however, were only evident for cued-recall questions as opposed to free-narrative responses. The implications of these findings and directions for future research are discussed.