Why do mental health courts work? A confluence of treatment,support & adroit judicial supervision

The article contributes to the understanding of ‘what works’ in mental health courts (MHCs). There are now almost 400 MHCs in the US and more worldwide. A substantial body of evidence demonstrates that MHCs can succeed in reducing recidivism among offenders who suffer mental disorders. This article argues that MHCs succeed when they have achieved the right confluence of essential elements, including providing evidence-based treatment and psychosocial supports and using adroit judge-craft. After a brief review of some of the studies demonstrating MHC success, this article discusses the research into the necessary foundations of rehabilitation programs. It is argued that, although treatment and psychosocial services should be supplied within an evidence-based framework, neither of the two leading conceptual models – Risk–Needs–Responsivity and the Good Lives Model – are empirically proven with offenders who suffer from mental disorders. Despite the absence of proof, the Good Lives Model is argued to be appropriate for MHCs because it is normatively consonant with therapeutic jurisprudence. The MHC judge is another essential element. The judicial role is assayed to elucidate how it functions to promote the rehabilitation of offenders with mental disorders. It is argued that the role of the MHC judge during supervisory status hearings is to establish a therapeutic alliance and practice motivational psychology with each MHC participant.     

Suicide behind bars: trends, inconsistencies, and practical implications

The results of two comprehensive approaches are compared: the nationwide surveys of suicides in U.S. jails by Hayes and the international meta-analyses of suicides in jails and prisons by Fazel et al. Factors are classified as demographic, situational, clinical, and methodical. More than 50% of U.S. jail suicide victims were men, white, unmarried, under 28 years of age, charged with minor or drug-related offenses, and intoxicated with drugs or alcohol. Suicides significantly occurred in isolation. Suicide victims in the international study were significantly (p < 0.001) men, white, married, pretrial, and charged with or convicted of violent offenses. Psychiatric diagnosis, alcohol abuse, taking psychotropic medication, and suicidal ideation were also positively correlated in the international study, but suicide victims were distributed more evenly over age-groups. Results of other studies illustrate the near universality of some findings. Three theories of suicide are briefly discussed.     

温针灸联合Kegel盆底康复训练对产后压力性尿失禁的临床研究

目的 观察温针灸联合Kegel盆底康复训练对产后压力性尿失禁的疗效。方法 将66例产后压力性尿失禁患者按随机数字表法分为治疗组与对照组,每组33例。对照组予以Kegel盆底康复训练,观察组予以温针灸联合Kegel盆底康复训练,观察两组患者治疗前后的漏尿量、尿失禁程度评分、盆底肌力、生活质量评分及临床疗效。结果 两组患者治疗后漏尿量、尿失禁程度评分、盆底肌力、生活质量评分与治疗前比较,差异均有统计学意义（P<0.05）;观察组漏尿量、尿失禁程度评分降低程度大于对照组（P＜0.05）,生活质量评分增加程度大于对照组（P＜0.05）。观察组临床疗效优于对照组（P<0.05）。结论 温针灸联合Kegel盆底康复训练治疗压力性尿失禁比单一Kegel盆底康复训练的疗效更好。