A silent minority: Battered American Indian women

Sixteen American Indian women requesting counseling for domestic violence at an urban Indian health center were interviewed using standardized measures. The majority of the women were not married, had low family incomes, and both the women and their partners abused substances. All of the women experienced increased depression and stress as a result of the battering. A mental health needs assessment survey of 198 American Indian women is presented for comparison. Women who reported a history of domestic violence on the survey were more likely to be separated or divorced and reported more problems with alcohol than the women with no history of domestic violence. The results of the domestic violence program interviews are compared to the mental health needs assessment survey and studies of battered women in shelters.     

“Keeping Children Safe”: the Child Sex Offender Disclosure Scheme in Scotland

Abstract

This article describes the Child Sex Offender Disclosure Scheme in Scotland known as Keeping Children Safe (KCS), and the wider community engagement strategy developed by the charity Stop it Now! Scotland. The author coordinated the disclosure scheme on behalf of Police Scotland from November 2011 to March 2014. He is employed by Stop it Now! Scotland as a project officer. In 2011, Stop it Now! Scotland took over responsibility for the coordination of the KCS scheme from the Police. This work is embedded within a community engagement strategy known as the Upstream Project. The Upstream Project provides information to “community-facing” agencies to use in their interface with groups or individual adults in the community. To achieve this, a prevention toolkit was developed which includes a range of practical information and resources which adults can use to identify potential risk and take steps to prevent sexual abuse from occurring.     

Pursuing performance and maintaining compliance: Balancing performance improvement and accountability in Ontario's public health system

This article examines the compatibility between performance improvement and compliance‐based accountability in the implementation of a new system of public health performance management in Ontario. Findings from this mixed‐method study show that only minor elements of performance improvement get incorporated into pre‐existing compliance‐based accountability structures, that reinforcement of accountability structures works to the detriment of performance improvement intentions, and that limiting managerial influence in developing performance measures and targets diminish the utility of information for improvement. The study concludes that achieving a better balance requires an alternative to top‐down decision making that goes beyond consultation to include partnership.     

Oregon's Psychiatric Security Review Board: a comprehensive system for managing insanity acquittees

The insanity defense is a particularly controversial aspect of the interaction between law and mental health. During the past decade, many states have revised or abolished their insanity defenses. Oregon, however, chose in 1974 to retain its existing defense and create a new, unique system for the post-adjudication management of insanity acquitees. Oregon's legislature established the Psychiatric Security Review Board (PSRB), which is composed of five part-time members drawn from different disciplines, to conduct periodic hearings to determine the placement and supervision of defendants who successfully raise the insanity defense and remain mentally ill and dangerous. The PSRB has received national attention as a promising approach to managing mentally ill offenders. The authors first describe the structure and operation of the Oregon system. Then they summarize the empirical studies they have conducted of the PSRB in action.