司法精神病鉴定的人工智能技术应用

司法精神病鉴定实践中的主要问题表现为鉴定意见的信度不足。这一方面源于涉及精神医学、心理学、法学在内的司法精神病学本身属于交叉学科，学科间话语系统融合存在困难；另一方面，司法精神病鉴定的对象本身存在一因多果、多因一果、多因多果方面的复杂性。随着人工智能技术在执法、司法领域的普及应用，以及算法、算力、数据的不断成熟，遵循新型技术嵌入精神病学、心理学而产生新型理论的“一级嵌入”与新型理论嵌入司法精神病鉴定实践“二级嵌入”的“双嵌入”路径，采用“分块开发”“系统整合”“流程整合”三大操作程序，并借鉴人工智能技术中的自然语言处理技术、心理计算技术和智能辅助决策技术资源，能够直接回应并一定程度解决司法精神病鉴定实践中信度不足的问题。这为人工智能辅助鉴定系统的研发，赋能司法精神病鉴定实践提供了可能。     

Diagnosis of antisocial personality disorder and criminal responsibility

The present study empirically investigates whether personality disorders and psychopathic traits in criminal suspects are reasons for diminished criminal responsibility or enforced treatment in high security hospitals. Recently, the tenability of the claim that individuals with personality disorders and psychopathy can be held fully responsible for crimes has been questioned on theoretical bases. According to some interpretations, these disorders are due to cognitive, biological and developmental deficits that diminish the individual's accountability.The current article presents two studies among suspects of serious crimes under forensic evaluation in a Dutch forensic psychiatric observation clinic. The first study examined how experts weigh personality disorders in their conclusions as far as the degree of criminal responsibility and the need for enforced forensic psychiatric treatment are concerned (n = 843). The second study investigated associations between PCL-R scores and experts' responsibility and treatment advisements (n = 108).The results suggest that in Dutch forensic practice, the presence of a personality disorder decreased responsibility and led to an advice for enforced forensic treatment. Experts also take characteristics of psychopathy concerning impulsivity and (ir)responsibility into consideration when judging criminal accountability. Furthermore, they deem affective deficiencies sufficiently important to indicate suspects' threat to society or dangerousness and warrant a need for forensic treatment.     

Patient characteristics related to length of stay in Dutch forensic psychiatric care

Create an overview of characteristics of patients in long-term forensic psychiatric care (LFPC) with a higher length of stay (LOS) care compared to patients in regular forensic psychiatric care (RFPC) with a shorter LOS. Data were collected from 139 patient records. This study examined whether patients in LFPC differ from patients in RFPC on sociodemographic data, legal data and clinical data and whether those characteristics are able to predict LOS. Patients in LFPC were more often born in a Dutch Caribbean country, less often had a substance abuse disorder, were more often emotionally neglected during childhood, had a higher HCR-20 risk item score, a higher security needs score, a higher (less successful) recovery score, were more often recidivist and had absconded more often than RFPC patients. Certain characteristics were able to distinguish the longer LOS group which might be useful to establish sequel services and enhance treatment efficiency.     

Self‐reported Mental Health Issues Among Arrestees in the Paris,France Area

We studied (May–September 2014) all arrestees who reported mental health issues during the medical examination performed by a forensic physician for the assessment of fitness for detention. Among 4814 arrestees, 420 (9%) reported a current mental health issue. The suspected crimes among arrestees reporting a current mental health issue were more often related to violent behaviors (physical assault, 23% vs. 16%, p < 0.001, sexual assault, 3% vs. 1%, p = 0.01) and less often drug offenses (18% vs. 29%, p < 0.001). Among arrestees reporting mental health issues, 80% reported psychiatric or psychological care, of whom 33% reported previous mental health care. Decisions of unfitness for detention were more frequent among arrestees reporting mental health issues than in other detainees (3% vs. 1%, p < 0.001). The high proportion of patients with interrupted mental health care among those reporting mental disorders suggests that the medical examination during custody could be a significant opportunity to restore psychiatric care.     

Unfitness for Detention Among Arrestees with Suspected Mental Disorders in Paris,France

In this retrospective study (11/2013–04/2014), we aimed to identify the factors associated with psychiatric hospitalization among detainees in police custody. We included 137 patients (M/F, 74%/26%; median age, 37 years), and 125 (91%) had a mental disorder. Seventy‐seven patients (56%) had involuntary hospitalization. Sixty patients (44%) were declared fit for detention, and 48 (80%) of these patients had a mental disorder. All patients who required urgent psychiatric care and could not provide valid consent for care were declared as requiring involuntary hospitalization. Forty‐nine of the 62 patients (79%) who required urgent psychiatric care and were suspected to have committed serious crimes were involuntarily admitted. In conclusion, we commonly found that some individuals with mental disorders were considered fit for detention in police cells.     

Red-teaming the panopticon* (mobilising adaptive change in secure and forensic settings)

In England and Wales, secure and forensic psychiatric institutions provide a high-cost, low-volume service that imposes significant restrictions upon detainees. Patients may be detained under the Mental Health Act in such settings for several years or even life, as they are deemed to present a significant risk to themselves or the public. Patients under s37/41 require the Home Office to approve any increase in their freedom. Best practice requires reoffending risk to be assessed before a patient is discharged. Evaluation of risk is an inexact actuarial science operating in a political arena, and research has indicated risk assessment tools have little positive predictive validity. There is concern amongst the wider psychiatric and judicial communities about the ethics of current practice. We examine these issues and consider means of improving risk assessment through red-teaming, increased collaboration between clinician and patient and a paradigm shift towards greater emphasis on patient self-agency.     

Psychiatric symptoms and mental health court engagement

People with mental illnesses are overrepresented in the criminal justice system. Many interventions have been implemented to treat the underlying causes of criminal justice involvement and prevent people with mental illnesses from recidivating. Mental health courts (MHC) are one of these programs. This analysis examines the relationship between psychiatric symptoms and MHC engagement. Eighty MHC participants from two Midwestern MHCs were interviewed. Symptom severity was assessed at baseline using the Brief Psychiatric Rating Scale. MHC engagement was estimated by treatment adherence, substance use, days spent in jail, probation violations, and MHC retention during a six-month follow-up period. Using nonparametric statistical tests and logistic regression, results indicate symptoms of depression, anxiety, and guilt are more severe at baseline for those people who are incarcerated during the follow-up period. Symptoms of anxiety are more severe for people who are terminated or went missing during the follow-up period. Further research is needed to determine the directionality and causality of these relationships. MHCs professionals should be aware of the relationship between symptom severity and MHC engagement and attempt to connect participants with treatment and services as early as possible and individualize treatment plans based on current symptoms and need.     

Suicidal Ideation Among Women Court-Referred to Batterer Intervention Programs

Identifying the prevalence and correlates of suicidal ideation in women mandated to batterer intervention programs is necessary to prevent suicide in this greatly understudied population. This study used cross-sectional, self-report survey methodology to identify the prevalence and correlates of suicidal ideation among 79 women attending batterer intervention programs. Of the sample, 33% reported experiencing suicidal ideation during the two weeks prior to entering the program. Multiple linear regression analysis indicated that (while controlling for number of batterer intervention sessions attended) symptoms of depression and borderline personality disorder, but not symptoms of antisocial personality disorder, were associated with suicidal ideation.     

“Is There a Getting Better From This,or Not?” Examining the Meaning and Possibility of Recovery From Mental Disorder

The concept of “recovery” from mental disorder is widely used in the national conversation about youth and adult mental health treatment as if everyone is on the same page about what it means. Fundamental disagreements among researchers and practitioners exist, however, on a variety of issues related to the precise nature and meaning of recovery from mental, emotional, and behavioral disorder generally. Among these issues are: (a) The meaning of recovery; (b) The possibility of full recovery; and (c) Effective support for recovery. After reviewing diverging responses for each of these three issues, we then trace practical implications of competing interpretations for treatment and recovery itself. As demonstrated throughout, the stance taken on these questions can have profound and lifelong consequences for youth and children in treatment.