Addressing Systemic Bias in Violence Risk Assessment.

Criminal history plays a prominent role in violence risk assessments. For people in nondominant groups, disproportionate criminal justice involvement may unfairly and inaccurately elevate violence risk in evaluations. Criminal justice reports continue to document higher rates of arrest and convictions for those in minoritized racial groups.

Applying Collaborative Justice to Sexually Violent Predator Civil Commitment.

Sexually violent predator (SVP) statutes are unique in that these laws allow for the indefinite civil psychiatric commitment of sex offenders after their criminal sentences have been served. In addition to the high cost of psychiatric hospitalization, recently observed low base rates of sexual recidivism of sex offenders released from custody suggest that, in select SVP cases, a collaborative justice model of outpatient placement may be feasible in lieu of lengthy and costly placement in state hospitals. Given its position as one of the states with a large number of SVP commitments, California offers an opportunity to implement a collaborative justice model for adult sex offenders found to meet SVP criteria.

Case Law Considerations in the Use of ASPD in SVP/SDP Evaluations.

The use of antisocial personality disorder (ASPD) as a qualifying mental disorder for a sexually violent predator (SVP) or a sexually dangerous person (SDP) commitment continues to arouse controversy. Two common questions arise. Is ASPD considered a qualifying mental disorder in statutory or case law definitions? Can ASPD be the sole qualifying mental disorder? We review case law for guidance as to when ASPD may serve as a sole qualifying diagnosis in SVP/SDP evaluations.

Deinstitutionalization and other factors in the criminalization of persons with serious mental illness and how it is being addressed.

One of the major concerns in present-day psychiatry is the criminalization of persons with serious mental illness (SMI). This trend began in the late 1960s when deinstitutionalization was implemented throughout the United States. The intent was to release patients in state hospitals and place them into the community where they and other persons with SMI would be treated.

Linking Mental Disorder and Risk in Sexually Violent Person Assessments.

A common criticism of sexually violent person (SVP) laws is that psychiatric commitment has been co-opted to continue the incarceration of dangerous criminals, not dangerous individuals with mental illness. This opinion may have credence because some forensic clinicians use a "silo" approach (i.e.

Understanding and Treating Offenders with Serious Mental Illness in Public Sector Mental Health.

This article begins with the history of the rise and fall of the state hospitals and subsequent criminalization of persons with serious mental illness (SMI). Currently, there is a belief among many that incarceration has not been as successful as hoped in reducing crime and drug use, both for those with and those without SMI. Moreover, overcrowding in correctional facilities has become a serious problem necessitating a solution.

Rediscovering the Concept of Asylum for Persons with Serious Mental Illness.

Treating persons with serious mental illness is a complex and challenging endeavor. One intervention that has received little attention in recent years is the need for asylum. Asylum means a sanctuary, a place that lowers levels of stress and provides protection, safety, security, and social support, as well as an array of treatment services.

Decarceration of U.S. jails and prisons: where will persons with serious mental illness go?

Decarceration (decreasing the number of persons incarcerated in U.S. jails and prisons) has begun.

Some perspectives on criminalization.

In recently published articles, there has been an underemphasis on the role serious mental illness (SMI) plays in causing persons to be in the criminal justice system. Increasing attention has been paid to other factors, including criminogenic needs. While these needs may be present and contribute to criminal behavior, persons with SMI who are at greatest risk of criminalization are those who are not receiving adequate treatment, structure, social control, and, when necessary, 24-hour care in the mental health system.

Meeting the needs of those persons with serious mental illness who are most likely to become criminalized.

Persons with serious mental illness are a heterogeneous group. A large majority recognize that they are mentally ill, and they are treatment adherent, often able to work, and do not have major problems with substance abuse and violence. However, a substantial minority exists who receive little attention in the literature.

Alice in actuarial-land: through the looking glass of changing Static-99 norms.

The Static-99, an actuarial rating method, is employed to conduct sexual violence risk assessment in legal contexts. The proponents of the Static-99 dismiss clinical judgment as not empirical. Two elements must be present to apply an actuarial risk model to a specific individual: sample representativeness and uniform measurement of outcome.

Normative versus consequential ethics in sexually violent predator laws: an ethics conundrum for psychiatry.

Nineteen states and the federal government have statutes for the civil commitment of sexually violent predators (SVP). The American Psychiatric Association has vigorously opposed SVP laws, citing the abuse of both individual civil rights and of psychiatry in forwarding preventive detention. Those who support the laws underscore that the statutes target highly dangerous sex offenders.

Defining mental disorder when it really counts: DSM-IV-TR and SVP/SDP statutes.

Civil commitment under the sexually violent predator (SVP) statutes requires the presence of a statutorily defined diagnosed mental disorder linked to sexual offending. As a consequence of broad statutory definitions and ambiguously written court decisions, a bright line separating an SVP mental disorder from ordinary criminal behavior is difficult to draw. Some forensic evaluators reject whole categories of DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders: Text Revision) diagnoses as qualifying disorders (e.

Four-facet PCL-R structure and cognitive functioning among high violent criminal offenders.

High violent inmates (N = 126) were administered the Psychopathy Checklist-Revised (PCL-R; Hare, Clark, Grann, & Thornton, 2000; Hare et al., 1990) and neuropsychological measures. No significant correlations were present between the overall PCL-R score and 14 cognitive measures.

Predicting the likelihood of future sexual recidivism: pilot study findings from a California sex offender risk project and cross-validation of the Static-99.

Pilot findings on 137 California sex offenders followed up over 10 years after release from custody (excluding cases in which legal jurisdiction expired) are presented. The sexual recidivism rate, very likely inflated by sample selection, was 31 percent at five years and 40 percent at 10 years. Cumulatively, markers of sexual deviance (multiple victim types) and criminality (prior parole violations and prison terms) led to improved prediction of sexual recidivism (receiver operating characteristic [ROC] = .

Treatment prospects for persons with severe mental illness in an urban county jail.

Objective: A retrospective study of inmates with severe mental illness in a large, urban county jail aimed to obtain information about their psychiatric and criminal histories and status, the psychiatric services they used while incarcerated, and the challenges they might present in psychiatric treatment after release.

Methods: The authors ascertained demographic characteristics, diagnoses, psychiatric and legal histories, and current psychiatric condition and treatment from jail psychiatric records of a random sample of 104 male inmates with mental illness and from electronic county mental health records and state records of criminal histories.

Results: Seventy-eight inmates (75%) were diagnosed as having a severe mental illness.

The shift of psychiatric inpatient care from hospitals to jails and prisons.

Far-reaching structural changes have been made in the mental health system. Many severely mentally ill persons who come to the attention of law enforcement now receive their inpatient treatment in jails and prisons, at least in part, because of a dramatic reduction of psychiatric inpatient beds. While more high-quality community treatment, such as intensive case management and assertive community treatment, is needed, the authors believe that for many, 24-hour structured care is needed in the mental health system for various lengths of time to decrease criminalization.

The impact of surgical castration on sexual recidivism risk among sexually violent predatory offenders.

The relationship of surgical castration to sexual recidivism in a sexually violent predator/sexually dangerous person (SVP/SDP) population is reviewed. A review of the literature on castrated sex offenders reveals a very low incidence of sexual recidivism. The low sexual recidivism rates reported are critiqued in light of the methodologic limitations of the studies.

One-year follow-up of persons discharged from a locked intermediate care facility.

Objectives: This study examined outcomes during a one-year follow-up for persons who were discharged from a locked intermediate care facility in an urban area in California. The purpose of this study was to determine the extent to which persons with severe mental illness can be successfully transferred from an intermediate care facility to lower levels of care.

Methods: A total of 101 persons consecutively discharged were studied by record review and by obtaining information from facility staff members, therapists, case managers, and other community caretakers.

Mentally ill persons in the criminal justice system: some perspectives.

There is an increasing number of severely mentally ill persons in the criminal justice system. This article first discusses the criminalization of persons with severe mental illness and its causes, the role of the police and mental health, and the treatment of mentally ill offenders and its difficulties. The authors then offer recommendations to reduce criminalization by increased coordination between police and mental health professionals, to increase mental health training for police officers, to enhance mental health services after arrest, and to develop more and better community treatment of mentally ill offenders.

Expert testimony in sexually violent predator commitments: conceptualizing legal standards of "mental disorder" and "likely to reoffend".

The most recent type of civil commitment for dangerous sex offenders is found under the sexually violent predator laws. Forensic psychiatrists or psychologists must render an opinion as to whether the sex offender has a diagnosed mental disorder and, as such, represents a risk to public safety if released from custody into the community. Thus, expert testimony provided by these professionals has taken a central role in the commitment determinations.