Mentally Ill Offenders Research Articles

Public's Attitudes Toward Mentally Ill Offenders in Greece.

Mentally ill offenders constitute a vulnerable population group with unique characteristics, and have endured multiple public stigmatizations, which has not been sufficiently studied. The purpose of this study was to capture attitudes of the public toward mentally ill offenders in relation to their perceptions of mental illness in general, as well as their degree of familiarity with it. Our sample of 2059 people can be overall described as a men preponderance, married, with mean value age of 26years, higher educational level, and medium or higher socio-economic status. Participants completed the ATMIO, CAMI, and Familiarity scales online. The total familiarity index value with mental illness was found to be 4.88, which counts as moderate to low. It was also concluded that women and those with a high educational level sustained more positive attitudes toward mentally ill offenders. However, negative stereotypes (with a mean value of 26.20), stigmatizing attitudes related to risk in the community (mean 16.10), and reduced responsibility for actions (mean 9.45) were recorded, while some (mean 16.50) showed compassion and emphasized on the mentally ill need of rehabilitation. The youngest people were the ones who recorded the most absolute and harsh attitudes. These findings validate the need of raising awareness and informing, especially, the young public about issues of mental health, including the need to oppose prejudices with everyday measures, which can be accessible to the new generation. Besides, we should extend research to various professional groups that come in contact with mentally ill offenders in order to collect data, which could contribute for intervening policies and formulating different sets of strategies for those people.

Assessing symptom exaggeration of psychopathology in incarcerated individuals and mentally ill offenders within forensic contexts.

In forensic contexts, there is a high probability that offenders may exaggerate illness to avoid legal punishment. Since very few empirical studies presently exist on this matter in Thailand, the objectives are to explore the prevalence rate of the exaggeration of psychopathological symptoms and to examine the detection strategy response styles for Thai version of the Symptom validity test (SVT-Th). An analysis of the factors that influence symptom exaggeration would also be included. Mixed participants included 608 individuals consisting of 528 Incarcerated individuals and 80 Mentally Ill Offenders (MIOs). SVT-Th indicated the prevalence rates of feigned psychopathology among overall offenders were 8.88%, 3.20% for incarcerated individuals, and 46.30% for MIOs. As expected, the endorsed average scores of the psychopathological symptoms using the Amplifier and Unlikely response style were recorded at similar amounts. Offenders with a history of mental illness exaggerated their symptoms to a greater degree than those without a history of mental illness. With regard to the type of crime and the number of offenses, no discrepancies of statistical significance were found. Interestingly, offenders who committed violent crimes, and with more than four times the number of offenses, were more likely to exaggerate their symptoms than the other subjects.

Integrated care for mentally ill offenders in Belgium: an analysis of a mandated collaboration

Background : In 2016 The Belgian government launched a Masterplan to improve healthcare for Mentally Ill Offenders (MIO). The Plan aims at improving collaboration between different organizations to guarantee integrated healthcare trajectories. The core question of this contribution is to assess to what extent the policy framework and guidance facilitates or hampers the implementation of collaboration and integrated care for MIO’s. Methods : Qualitative data were collected using document analysis of the Reform program and semi structured interviews with representatives of hospitals, justice houses and regional coordinators. Data-analysis was done with a continuous comparative method of coding and analysis including researcher triangulation. Results : The Masterplan, the general reference text on the Reform, mandates locoregional steering groups to implement the reform. These groups are supported by formally appointed and funded regional coordinators. Locoregional actors get leeway to implement the reform within the overall framework. The interviews learn that intersectoral collaborations are needed to tackle problems on offering healthcare for MIO. Implementation problems emerge from the heterogeneous composition of steering groups and diverging interests, power struggles and differences in culture. Some participating organizations focus on forensic thinking while others have a broader overall mental health care approach. The steering groups need to find a balance between mutual interdependence and organizational interests. Historical partnerships versus integrating new services in this MIO-field challenge the definition of common goals and working practices. Moreover participating organizations are represented by different professional backgrounds (managers vs clinical professionals) which affects the view on the problem and collaboration. At last, the interactions are affected by the regulations of the partners from different policy sectors. Discussion : Heterogeneity and complexity challenges collaboration. Policy implementation networks need learning time and mutual adaptations in order to become sustainable. The experiences drawn from the Belgian MIO field converge with findings in network literature, but vary because of the particular MIO field characteristics in Belgium. Conclusion : The choice of the Belgian government to initiate locoregional mandated heterogeneous networks is a potentially useful tool to tackle the complex problem of integrated care for MIO. However because of this heterogeneity governance questions are undervalued. Limitations : This implementation study relies on an inventory of experiences of an ongoing change process. The collaborative networks have not matured yet. Therefore we could not yet address the issue of the life circle of a reform program and the maturing of networks. Suggestions for further research : Further research is needed on steering mechanisms. It currently lacks research on how facilitating instruments like coaching sessions, exchange programs etc. could support the development of innovative networks aiming at integration of care.

Involuntary admission and treatment of patients with mental disorder.

Despite the efforts of the World Health Organization to internationally standardize strategies for mental-health care delivery, the rules and regulations for involuntary admission and treatment of patients with mental disorder still differ markedly across countries. This review was undertaken to describe the regulations and mental-health laws from diverse countries and districts of Europe (UK, Austria, Denmark, France, Germany, Italy, Ireland, and Norway), the Americas (Canada, USA, and Brazil), Australasia (Australia and New Zealand), and Asia (Japan and China). We outline the criteria and procedures for involuntary admission to psychiatric hospitals and to community services, illustrate the key features of laws related to these issues, and discuss their implications for contemporary psychiatric practice. This review may help to standardize the introduction of legislation that allows involuntary admission and treatment of patients with mental disorders in the mainland of China, and contribute to improved mental-health care. In this review, involuntary admission or treatment does not include the placement of mentally-ill offenders, or any other aspect of forensic psychiatry.

Treatment perspectives on interned mentally ill offenders in a forensic psychiatric center (FPC): a Delphi study on experts' opinions

The study aims to map the treatment perspectives of international experts on treating mentally ill offenders (MIO) in a forensic psychiatric centre (FPC) using the Delphi method. The four-round Delphi study reveals high conformity on the proposed treatment-related issues. However, some points of divergence remain. Three controversies underpinning these disagreements are discussed. The first regards the treatment and control debate, the second concerns the dual role of assessment in forensic mental health care and the third describes potential entry conditions for treatment in a FPC. Further research is needed to scientifically underpin the above mentioned debates. In this regard, the study suggests a close collaboration between practitioners and researchers.

Mental health legislation and human rights in England, Wales and the Republic of Ireland

In 2005, the World Health Organization (WHO) published its Resource Book on Mental Health, Human Rights and Legislation (Geneva: WHO) presenting a detailed statement of human rights issues which need to be addressed in national legislation relating to mental health. The purpose of this paper is to determine the extent to which revised mental health legislation in England, Wales (2007) and Ireland (2001) accords with these standards (excluding standards relating solely to children or mentally-ill offenders). Legislation in England and Wales meets 90 (54.2%) of the 166 WHO standards examined, while legislation in Ireland meets 80 standards (48.2%). Areas of high compliance include definitions of mental disorder, relatively robust procedures for involuntary admission and treatment (although provision of information remains suboptimal) and clarity regarding offences and penalties Areas of medium compliance relate to competence, capacity and consent (with a particular deficit in capacity legislation in Ireland), oversight and review (which exclude long-term voluntary patients and require more robust complaints procedures), and rules governing special treatments, seclusion and restraint. Areas of low compliance relate to promoting rights (impacting on other areas within legislation, such as information management), voluntary patients (especially non-protesting, incapacitated patients), protection of vulnerable groups and emergency treatment. The greatest single deficit in both jurisdictions relates to economic and social rights. There are four key areas in need of rectification and clarification in relation to mental health legislation in England, Wales and Ireland; these relate to (1) measures to protect and promote the rights of voluntary patients; (2) issues relating to competence, capacity and consent (especially in Ireland); (3) the role of “common law” in relation to mental health law (especially in England and Wales); and (4) the extent to which each jurisdiction wishes to protect the economic and social rights of the mentally ill through mental health legislation rather than general legislation. It is hoped that this preliminary analysis of mental health legislation will prompt deeper national audits of mental health and general law as it relates to the mentally ill, performed by multi-disciplinary committees, as recommended by the WHO.

Recidivism of Offenders with Mental Illness Released from Prison to an Intensive Community Treatment Program

ABSTRACT An intensive case management treatment program for mentally ill offenders (MIOs) is outlined, and subsequent recidivism of participants is evaluated. Features of the program and its development are discussed. Sixty-four (64) participants released from state prison between 1998 and 2003 were matched with a group of MIOs released earlier on eight established predictors of recidivism and followed for a period of two years. Significant results indicate felony recidivism for program participants was just over half the rate of matched controls (23% vs 42%.) More impressive results were found (15% vs 38%) when only data for participants enrolled after the first year were analyzed. Limitations and implications are discussed.

Forecasting Recidivism in Mentally Ill Offenders Released From Prison.

Little research has focused on assessing the risk of mentally ill offenders (MIOs) released from state prisons. Here we report findings for 333 mentally ill offenders released from Washington State prisons. Logistic regression identified sets of variables that forecasted felony and violent reconviction as accurately as state-of-the-art risk assessment instruments. Sums of simple recoded versions of these variables predicted reoffense as well as complex logistic regression equations. Five of these 9 variables were found to be relative protective factors. Findings are discussed in terms of the value of stock correctional variables in forecasting risk, the need to base actuarial risk assessments on local data, the importance of protective factors in assessing MIO risk, and the need for dynamic, situational, and clinical variables that can further sharpen predictive accuracy of emergent risk in the community.

Landing in the Cuckoo's Nest: The Hospital Disposition of Guilty Mentally Ill Offenders - Lessons from the United Kingdom

This article explores the current schemes for sentencing guilty mentally ill offenders in Canada and the United Kingdom. The author highlights the deficiencies of the current Canadian scheme, arguing both that it is limited to the traditional sentencing smorgasbord and that principles of sentencing are difficult to balance with respect to guilty mentally ill offenders. In his analysis of the mental health sentencing dispositions available in the United Kingdom, the author assesses how such a scheme could be implemented in Canada and what modifications are necessary in order to better conform with Canadian law and policy, in particular, the areas concerning disposition thresholds, consent to treatment and discharge are examined. The author concludes that implementation of a hospital disposition in the Canadian sentencing regime is necessary to overcome conflicting sentencing principles and correctional aims, to address the lack of correctional programs and infrastructure courts encounter when sentencing guilty mentally ill offenders, and to enhance the protection of society — the primary goal in sentencing.

Pathways to the management of mentally-ill offenders in the criminal justice system : Edited by Adelmo Manna, Ryosuke Kurosawa, and Koichi Hamai United Nations Interregional Crime and Justice Research Institute (via Giulia 52, 00186 Rome, Italy), 1993, 264 pp., softcover — $30.00

The quality of forensic mental health assessment has been a growing concern in various countries on both sides of the Atlantic, but the legal systems are not always comparable and some aspects of forensic assessment are specific to a given country. This paper describes the legal context of forensic psychological assessment in France (i.e. pre-trial investigation phase entrusted to a judge, with mental health assessment performed by preselected professionals called “experts” in French), its advantages and its pitfalls. Forensic psychiatric or psychological assessment is often an essential and decisive element in criminal cases, but since a judiciary scandal which was made public in 2005 (the Outreau case) there has been increasing criticism from the public and the legal profession regarding the reliability of clinical conclusions. Several academic studies and a parliamentary report have highlighted various faulty aspects in both the judiciary process and the mental health assessments. The heterogeneity of expert practices in France appears to be mainly related to a lack of consensus on several core notions such as mental health diagnosis or assessment methods, poor working conditions, lack of specialized training, and insufficient familiarity with the Code of Ethics. In this article we describe and analyze the French practice of forensic psychologists and psychiatrists in criminal cases and propose steps that could be taken to improve its quality, such as setting up specialized training courses, enforcing the Code of Ethics for psychologists, and calling for consensus on diagnostic and assessment methods.

Psychopathic Disordered, Mentally Ill, and Mentally Handicapped Sex Offenders: A Comparative Study

Although there currently exists a large amount of research on the characteristics and treatment of psychopathic disordered (PD) sex offenders, little if any empirical studies have addressed the mentally ill (MI) and mentally handicapped (MH) offender populations. A total of 106 PD, MI, and MH sex offender records from Rampton (Special) Hospital were reviewed for the study. Offender categories were compared by age of first documented sex offence, IQ at the time of admission, sex offence type, frequency of each offence type, history of violence during sex offences, age and gender of sex offence victims and number of victims for age and gender. Results revealed that 88 per cent of PD, 98 per cent of MI, and only 56 per cent of MH offenders' victims were female. Further analysis revealed that PD and MI offenders' victims were primarily female, with the largest proportion being pubescent and adult females. MH offender victims were primarily males and females under the age of 16. IQ correlated positively with history of violence during sexual assault and mean IQs were higher for 'violent' than 'non-violent' offenders in each offender category. A discussion of these and other significant findings, as well as implications for clinical treatment, is presented.

A comparison of the community adjustment of mentally ill offenders with those from the general prison population: An 18-month followup.

In an effort to understand the relationship between crime and mental illness, mentally ill offenders (MIOs) and those from the general prison population (non-MIOs) are compared on their postprison adjustment. MIOs are defined as those individuals who required psychiatric hospitalization during their incarceration. These 547 offenders (147 MIOs and 400 non-MIOs) were then followed for 18 months from date of prison discharge. Information on their adjustment came from several sources, including correctional data, parole reports, incidence of arrests and dispositions, and rates of psychiatric hospitalization. With the exception of drug offenses, no significant differences were found in the rates or types of rearrests between the two groups. Additionally, rearrest among MIOs was found to be associated with the same standard correlates of crime found in nondisturbed offenders: age and prior criminal record. Policy implications derived from these findings are discussed.

Mentally disordered violent offenders

The essential result of our study is that crimes of violence committed by mentally ill and by mentally retarded are quantitatively proportional to the number of crimes of violence committed by the total population. In affective psychoses and mental retardation, the risk of committing an act of violence, which had to be calculated on the basis of inexact data, is about 6 in 100 000 approximately, and is one-tenth ofthat for schizophrenia (5 in 10 000). Factors which do not depend on the disorder, especially family and personality factors, seem to be relevant for the disposition to criminality. The disorder itself has different consequences. It generally seems to postpone the manifestation of the act of violence and thus raises the average age of the mentally-ill offenders. The closest connection between the crime motives and the disease can be assumed in depressed and schizophrenic offenders. The personality of the depressed seems to suppress the disposition to commit aggressive offenses with the exception of extended suicide as a combined act of violence and self-destruction. In schizophrenia, certain disturbances which can be found in chronic systematized paranoid syndromes seem to co-determine the motive of the offense, and are likely to favour its manifestation.