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Rafiee M, Karamouzian M, Sharifi M, Mirzazadeh A, Khezri M, Haghdoost AA, Mehmandoost S, Sharifi H. Non-injection drug use among incarcerated people in Iran: Findings from three consecutive national bio-behavioral surveys. Harm Reduct J 2024; 21:147. [PMID: 39138501 PMCID: PMC11323345 DOI: 10.1186/s12954-024-01072-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 08/02/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND Prisons often serve as high-risk environments for drug use, and incarcerated people are at a high risk for substance use-related mental and physical harms. This study aimed to determine the prevalence of non-injection drug use inside the prison and its related factors among incarcerated people in Iran. METHODS We utilized data from three national bio-behavioral surveillance surveys conducted among incarcerated people in Iran in 2009, 2013, and 2017. Eligibility criteria were being ≥ 18 years old, providing informed consent, and being incarcerated for over a week. Overall, 17,228 participants across all surveys were recruited through a multi-stage random sampling approach. Each participant underwent a face-to-face interview and HIV test. The primary objective of the study was to assess self-reported non-injection drug use within the prison environment within the last month. A multivariable logistic regression model was built to determine associated covariates with drug use inside prison and an adjusted odds ratio (aOR) with 95% confidence intervals (CI) were reported. RESULT The prevalence of non-injection drug use inside the prison was 24.1% (95% CI 23.5, 24.7) with a significant decreasing trend (39.7% in 2009, 17.8% in 2013, 14.0% in 2017; p-value < 0.001). Overall, 44.0% of those who used drugs were also receiving opioid agonist therapy (OAT) and we noted that in 2017, 75.1% of those on OAT used stimulants. In the multivariable logistic regression model, the year of interview (2013: aOR = 1.43 and 2009: aOR = 5.60), younger age (19-29: aOR = 1.14 and 30-40: aOR = 1.37), male sex (aOR = 3.35), < high school education (aOR = 1.31), having a history of previous incarceration (aOR = 1.26), and having a history of lifetime HIV testing (aOR = 1.76) were significantly and positively associated with recent non-injection drug use inside the prison. CONCLUSIONS Approximately one in four incarcerated people in Iran reported drug use within the last month inside prisons. While a declining trend in non-injection drug use was noted, substantial gaps persist in harm reduction programs within Iranian prisons. In particular, there is a pressing need for improvements in drug treatment programs, focusing on the integration of initiatives specifically designed for people who use stimulants.
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Affiliation(s)
- Mahkameh Rafiee
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Karamouzian
- Centre on Drug Policy Evaluation, MAP Centre for Urban Health Solutions, St. Michael's Hospital, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Mohammad Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Mirzazadeh
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Mehrdad Khezri
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, USA
| | - Ali Akbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Soheil Mehmandoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
- Institute for Global Health Sciences, University of California, San Francisco, CA, USA.
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Kilic-Demir B, Kizilpinar SC, Polat S. The violence profile of male mentally disordered offenders in a high secure unit in Turkiye. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2024; 94:101983. [PMID: 38537541 DOI: 10.1016/j.ijlp.2024.101983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 02/13/2024] [Accepted: 03/15/2024] [Indexed: 06/15/2024]
Abstract
Our knowledge of the severity and reoffending is limited for mentally disordered offenders, and studies generally evaluate without separation between different diagnostic groups. It was aimed to determine the general profile of mentally disordered offenders who are inpatients in a high secure psychiatry unit from Turkiye and to evaluate the factors associated with violence profiles among different diagnostic groups. According to the results the schizophrenia patients committed the most severe crimes, and intellectual disability patients had some different features from schizophrenia and bipolar disorder patients. History of substance misuse in the intellectual disability group (p = 0,045) and comorbid antisocial personality disorder in the bipolar disorder group (p = 0,015) were associated with increased crime severity. Substance misuse history, history of substance use during the crime, and the existence of comorbid antisocial personality disorder were associated with increased offenses in each of the three diagnosis groups. Living alone (p = 0,004) and having a suicide history (p= 0,052) were associated with the high number of offenses in the schizophrenia group. This study is the first study that compares three diagnostic groups to involve a large patient group. We believe that clinicians must evaluate these parameters for the violence risk assessment of patients.
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Affiliation(s)
- Baris Kilic-Demir
- Department of Psychiatry, Adana City Research and Training Hospital, Adana, Turkiye
| | | | - Selim Polat
- Department of Psychiatry, Adana City Research and Training Hospital, Adana, Turkiye
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Van Deinse TB, Mercier MC, Waters AK, Disbennett M, Cuddeback GS, Velázquez T, Lichtman AM, Taxman F. Strategies for supervising people with mental illnesses on probation caseloads: results from a nationwide study. HEALTH & JUSTICE 2023; 11:41. [PMID: 37824043 PMCID: PMC10570184 DOI: 10.1186/s40352-023-00241-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/26/2023] [Indexed: 10/13/2023]
Abstract
Probation officers are tasked with supervising the largest number of people living with mental illnesses in the criminal legal system, with an estimated 16-27% of individuals on probation identified as having a mental health condition. While academic research has recently focused on building the evidence base around the prototypical model of specialty mental health probation, less focus has been directed to the individual components of specialized mental health caseloads and other strategies agencies use to supervise people with mental illnesses. More specific information about these strategies would benefit probation agencies looking to implement or enhance supervision protocols for people with mental illnesses. This article describes the results from a nationwide study examining (1) probation agencies' mental health screening and identification methods; (2) characteristics of mental health caseloads, including eligibility criteria, officer selection, required training, and interfacing with service providers; and (3) other strategies agencies use to supervise people with mental illnesses beyond mental health caseloads. Strategies for identifying mental illnesses varied, with most agencies using risk needs assessments, self-report items asked during the intake process, or information from pre-sentencing reports. Less than a third of respondents reported using screening and assessment tools specific to mental health or having a system that tracks or "flags" mental illnesses. Results also showed wide variation in mental health training requirements for probation officers, as well as variation in the strategies used for supervising people with mental illnesses (e.g., mental health caseloads, embedded mental health services within probation, modified cognitive behavioral interventions). The wide variation in implementation of supervision strategies presents (1) an opportunity for agencies to select from a variety of strategies and tailor them to fit the needs of their local context and (2) a challenge in building the evidence base for a single strategy or set of strategies.
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Affiliation(s)
- Tonya B Van Deinse
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB#3550, Chapel Hill, NC, 27599, USA.
| | - Mariah Cowell Mercier
- Utah Criminal Justice Center, University of Utah, 395 S 1500 E, Salt Lake City, UT, 84112, USA
| | - Allison K Waters
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB#3550, Chapel Hill, NC, 27599, USA
| | - Mackensie Disbennett
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB#3550, Chapel Hill, NC, 27599, USA
| | - Gary S Cuddeback
- School of Social Work, Virginia Commonwealth University, Academic Learning Commons, 3rd Floor, 1000 Floyd Avenue, P.O. Box 842027, Richmond, VA, 23284, USA
| | - Tracy Velázquez
- Safety & Justice Research, The Pew Charitable Trusts, 2005 Market Street, Suite 1700, Philadelphia, PA, 19103, USA
| | - Andrea Murray Lichtman
- School of Social Work, University of North Carolina at Chapel Hill, 325 Pittsboro Street, CB#3550, Chapel Hill, NC, 27599, USA
| | - Faye Taxman
- Schar School of Policy and Government, George Mason University, 3351 Fairfax Drive Van Metre Hall, Arlington, VA, 22201, USA
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Kappl U, Sakr AM, Huppertz B, Stöver H, Stich H. Relapses in Illicit Drug Use Among Probationers: Results in a Risk Group of Public Health Services in Bavaria. Int J Public Health 2023; 68:1605955. [PMID: 37885768 PMCID: PMC10598279 DOI: 10.3389/ijph.2023.1605955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Objective: We aimed to identify in this study time trends of relapses in the illicit consumption of narcotics in a special at-risk population of former drug users under a public health perspective. Methods: In a pooled dataset of 14 consecutive calendar years (2006-2019), the use of seven different narcotic substances was studied in 380 persons with a total of 2,928 urine samples which were analyzed using a valid marker system for narcotic residues. Results: During the entire observation period, the relapse rate for cannabinoids and opiates was the highest despite abstinence requirements. It was noticeable that the relapses across all narcotics groups occurred primarily during the first 3 years of the probation period (90%) with a decrease in illegal consumption during the following years of the observation period. Conclusion: Special attention should be paid to probationers at the beginning of the probation period to develop more effective prevention strategies for substance abstinence by all involved actors in public health services.
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Affiliation(s)
- U. Kappl
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - A. M. Sakr
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
| | - B. Huppertz
- Department of Toxicology and Drug Monitoring, MVZ Laboratory Dr. Quade & Colleagues GmbH, Cologne, Germany
| | - H. Stöver
- Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - H. Stich
- Institute for Medical Information Processing, Biometry, and Epidemiology, Faculty of Medicine, Ludwig Maximilian University of Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
- Department of Public Health Medicine, Landshut, Germany
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Weber K, Morier S, Lesaffre L, Menu C, Bertschy P, Herrmann FR, Giannakopoulos P. Court-ordered inpatient psychiatric care in Switzerland: determinants of length of stay and treatment outcome. Front Psychiatry 2023; 14:1222337. [PMID: 37854441 PMCID: PMC10579584 DOI: 10.3389/fpsyt.2023.1222337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 09/18/2023] [Indexed: 10/20/2023] Open
Abstract
IntroductionIn several European countries, offenders with decreased or abolished responsibility and high risk of recidivism due to long-lasting mental disorders are compulsory admitted for court-ordered treatments (COT) that take place in high and medium-security hospitals. As a rule, length of stay in these structures is very long implying major restrictions for the inmate and high societal cost. Despite intensive research, the predictors of length of stay and treatment outcome in long stay forensic services is still matter of debate.MethodsWe report here a detailed analysis of the demographic, psychiatric and offense predictors of length of stay and discharge locations of 204 mentally disordered offenders convicted to COT in a new medium-security forensic psychiatry clinic in Geneva, Switzerland. Kaplan-Meier survival estimates were performed to determine time to release. Length of stay was predicted by Cox regressions, and discharge locations were predicted by multinomial logistic regressions.ResultsThe typical inpatient was a 35-age single male re-offender, submitted to COT after a conviction for physical violence (78.9%) or property violation (64.2%), with drug trafficking (52.9%), in relation to psychotic (67.2%), antisocial or borderline personality disorder (35.8%) with comorbid substance use disorders (60.3%). Sex offenses were found in 24.5% of cases and were associated with Cluster B personality disorders. The median length of stay was of 2.5 years and was independent of demographic variables, severity of crime recidivism and psychiatric diagnosis. Longer COT at admission, and type of offense (in particular drug traffic and sexual violence) predicted longer stays. At discharge, 32.8% of cases were transferred to sheltered educational housing, 23.1% to open low-security wards, while 30.6% returned to regular prisons and 9.7% to their country of origin.DiscussionYounger age and conviction for property violation rather than physical violence increased the chances to be discharged to sheltered educational housing. Longer COT at admission, personality disorders, and conviction for sexual offense increased the risk to return to prison. These data suggest that sex offenses determine not only longer stays under COT but also drastically decreases the chance of freedom for inmates with Cluster B personality disorders.
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Affiliation(s)
- Kerstin Weber
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sandrine Morier
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Lise Lesaffre
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
| | - Christophe Menu
- Department of Institutions and Information Technology, Republic and State of Geneva, Geneva, Switzerland
| | - Philippe Bertschy
- Department of Institutions and Information Technology, Republic and State of Geneva, Geneva, Switzerland
| | - François R. Herrmann
- Department of Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Panteleimon Giannakopoulos
- Division of Institutional Measures, Medical Direction, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Maynard BR, Vaughn MG, Prasad-Srivastava S, Alsolami A, DeLisi M, McGuire D. Towards more accurate classification of risk of arrest among offenders on community supervision: An application of machine learning versus logistic regression. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2023; 33:156-171. [PMID: 37101327 DOI: 10.1002/cbm.2289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/08/2023] [Indexed: 06/03/2023]
Abstract
BACKGROUND Although there is general consensus about the behavioural, clinical and sociodemographic variables that are risk factors for reoffending, optimal statistical modelling of these variables is less clear. Machine learning techniques offer an approach that may provide greater accuracy than traditional methods. AIM To compare the performance of advanced machine learning techniques (classification trees and random forests) to logistic regression in classifying correlates of rearrest among adult probationers and parolees in the United States. METHOD Data were from the subgroup of people on probation or parole who had taken part in the National Survey on Drug Use and Health for the years 2015-2019. We compared the performance of logistic regression, classification trees and random forests, using receiver operating characteristic curves, to examine the correlates of arrest within the past 12 months. RESULTS We found that machine learning techniques, specifically random forests, possessed significantly greater accuracy than logistic regression in classifying correlates of arrest. CONCLUSIONS Our findings suggest the potential for enhanced risk classification. The next step would be to develop applications for criminal justice and clinical practice to inform better support and management strategies for former offenders in the community.
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Affiliation(s)
| | | | | | | | | | - Dyan McGuire
- Saint Louis University, St. Louis, Missouri, USA
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Brooks O, Hayashi K, Cui Z, Milloy MJ, Kerr T, Fairbairn N. Re-incarceration and associated social, structural and behavioural factors among people who use drugs in an urban Canadian setting. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 115:104018. [PMID: 37060885 PMCID: PMC10683765 DOI: 10.1016/j.drugpo.2023.104018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/18/2023] [Accepted: 03/21/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND People who use drugs (PWUD) are disproportionately incarcerated, however little is known about specific substance use, social and structural factors associated with re-incarceration among PWUD. We aimed to identify the socio-structural and substance use factors associated with re-incarceration among structurally-marginalized PWUD. METHODS We used longitudinal data from two prospective cohorts of PWUD in Vancouver, Canada. We included adults reporting at least one incarceration event in the last six months and who completed at least one additional follow-up study visit. We performed multivariable extended Cox regression to explore factors associated with re-incarceration. RESULTS Among 468 eligible participants, the median age was 40 years (Q1-Q3 = 34-46 years), 346 (73.9%) were men, 177 (37.8%) identified as Indigenous, and 227 (48.5%) experienced at least one re-incarceration event. Incidence rate of re-incarceration was 157 incarceration events per 1000 person years. In multivariable analyses, homelessness (adjusted hazard ratio [AHR] = 2.17; 95% confidence interval [95% CI]: 1.79-2.61), community judicial supervision (AHR = 3.89; 95% CI: 3.21-4.71) and re-incarceration during the study period (once: AHR = 1.95, 95% CI: 1.55-2.44; two or more events: AHR = 1.53, 95% CI: 1.23-1.90) were positively associated with re-incarceration. Among substance use variables that included illicit drugs, only heavy alcohol use remained significantly associated with re-incarceration across analyses after adjustment (AHR = 1.32; 95% CI: 1.06-1.65). Engagement in addiction treatment (AHR = 0.63; 95% CI: 0.53-0.75), mental illness (AHR = 0.70; 95% CI: 0.59-0.84) and age (AHR = 0.96; 95% CI: 0.95-0.97) were negatively associated with re-incarceration. CONCLUSION Access to housing and substance use services, including treatment for alcohol use disorder, following incarceration may reduce re-incarceration among PWUD. The high rates of re-incarceration of PWUD in our sample underscores how structural factors-such as homelessness and criminalization of substance use-drive re-incarceration among PWUD.
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Affiliation(s)
- Olivia Brooks
- British Columbia Centre on Substance Use, Vancouver, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Kanna Hayashi
- British Columbia Centre on Substance Use, Vancouver, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Zishan Cui
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - M-J Milloy
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - Thomas Kerr
- British Columbia Centre on Substance Use, Vancouver, Canada
| | - Nadia Fairbairn
- British Columbia Centre on Substance Use, Vancouver, Canada; Department of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Liu H, Mok YC, Lau KL, Hou WK. Measuring everyday adaptation after imprisonment: The post-release living inventory for ex-prisoners (PORLI-ex). Int J Clin Health Psychol 2023; 23:100352. [PMID: 36467266 PMCID: PMC9712557 DOI: 10.1016/j.ijchp.2022.100352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/31/2022] [Indexed: 12/02/2022] Open
Abstract
Background The number of ex-prisoners worldwide has constantly been increasing in recent years. Currently, little is known about post-release daily adaptation, not to mention valid and reliable instruments for post-release daily routines pertinent to mental health. Objective This study aims to develop and validate a self-report instrument, hereafter referred to as Post Release Living Inventory for Ex-prisoners (PORLI-ex). Methods Three separate samples of ex-prisoners were recruited to complete an online survey (N=1,277, age range=17-89 years, 53.2% male, 72% white). Results The final model evidenced acceptable goodness-of-fit and consisted of 45 items on nine dimensions, which loaded on three second-order factors: Consolidation (three dimensions; e.g., Institutional Routines), Replacement (two dimensions; e.g., Maladaptive Behaviors), and Addition (four dimensions; e.g., Socializing with Ex-prisoner Friends) (α=.695-.915). Convergent validity was demonstrated in the positive correlations with IADL, SOLI, MLQ, GSE-6, and MSPSS. Discriminant validity was demonstrated in the weak correlations with the LEC-5 and perceived social and personal cost of punishment. Criterion-related validity was demonstrated in the correlations with psychiatric symptoms and crime-related outcomes and incremental validity in the correlations with these measures independent of the scores on IADL, SOLI, MLQ, GSE-6, and MSPSS. Conclusion This study calls for more resources on fostering psychological strengths and resilience through regularizing basic daily life experiences on top of traditional interventions for risk management among the ex-prisoners.
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Affiliation(s)
- Huinan Liu
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
| | - Yuen Chi Mok
- The Society of Rehabilitation and Crime Prevention, Hong Kong SAR, China
| | - Ka Lok Lau
- The Society of Rehabilitation and Crime Prevention, Hong Kong SAR, China
| | - Wai Kai Hou
- Department of Psychology, The Education University of Hong Kong, Hong Kong SAR, China
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong SAR, China
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Norman EM, Starkey NJ, Polaschek DLL. The association between self-reported traumatic brain injury, neuropsychological function, and compliance among people serving community sentences. BRAIN IMPAIR 2023; 24:69-85. [PMID: 38167582 DOI: 10.1017/brimp.2021.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Traumatic brain injury is overrepresented in incarcerated samples and has been linked to a number of poor correctional outcomes. Despite this, no research has explored the impact of a recent TBI on compliance outcomes for individuals serving community-based. METHOD We screened for a history of TBI in 106 adults on community sentences and collected compliance (arrests, sentence violations) and related variables (e.g., risk scores, substance use) over 6 months. Sixty-four participants also completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Comprehensive Trail Making Test and Color-Word Inference Test. RESULTS A TBI in the last year predicted a significantly higher likelihood of arrest, even when controlling for risk of reconviction and current substance use, but was not associated with non-compliance with sentence conditions nor with performance on the neuropsychological tests. In addition, no significant associations were found between performance on neuropsychological tests and measures of non-compliance. CONCLUSIONS TBI in the last year was an independent predictor of arrest. This result suggests that those with a recent TBI on a community sentence may need additional monitoring or support to reduce the risk of reoffending.
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Affiliation(s)
- Emily M Norman
- University of Waikato Faculty of Arts and Social Sciences, Hamilton, New Zealand
| | - Nicola J Starkey
- University of Waikato Faculty of Arts and Social Sciences, Hamilton, New Zealand
| | - Devon L L Polaschek
- University of Waikato Faculty of Arts and Social Sciences, Hamilton, New Zealand
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Walters GD, Loftus JM, Wright SC, Ernest KD. Predicting Day Treatment Program Completion with the Psychological Inventory of Criminal Thinking Styles taking Defensiveness into Account. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2023. [DOI: 10.1007/s10862-023-10024-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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11
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Yukhnenko D, Blackwood N, Lichtenstein P, Fazel S. Psychiatric disorders and reoffending risk in individuals with community sentences in Sweden: a national cohort study. Lancet Public Health 2023; 8:e119-e129. [PMID: 36669512 PMCID: PMC10914666 DOI: 10.1016/s2468-2667(22)00312-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/07/2022] [Accepted: 11/21/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Community sentences are widely used in many countries, often comprising the majority of criminal justice sanctions. Psychiatric disorders are highly prevalent in community-sentenced populations and are thus potential targets for treatment interventions designed to reduce reoffending. We examined the association between psychiatric disorders and reoffending in a national cohort of individuals given community sentences in Sweden, with use of a sibling control design to account for unmeasured familial confounding. METHODS We did a longitudinal cohort study of 82 415 individuals given community sentences between Nov 1, 1991, and Dec 31, 2013, in Sweden using data from population-based registers. We calculated hazard ratios (HRs) for any reoffending and violent reoffending with Cox regression models. We compared community-sentenced siblings with and without psychiatric disorders to control for potential familial confounding. Additionally, we calculated population attributable fractions to assess the contribution of psychiatric disorders to reoffending behaviours. The primary outcomes of the study were any (general) reoffending and violent reoffending. FINDINGS Between Nov 1, 1991, and Dec 31, 2013, those given community sentences who were diagnosed with any psychiatric disorder had an increased reoffending risk in men (adjusted HR 1·59, 95% CI 1·56-1·63 for any reoffending; 1·60, 1·54-1·66 for violent reoffending) and women (1·71, 1·61-1·82 for any reoffending; 2·19, 1·88-2·54 for violent reoffending). Risk estimates remained elevated after adjustment for familial confounding. Schizophrenia spectrum disorders, personality disorders, and substance use disorders had stronger associations with violent reoffending than did other psychiatric disorders. Assuming causality, the adjusted population attributable risk of psychiatric disorders on violent reoffending was 8·3% (95% CI 6·6-10·0) in the first 2 years of community follow-up in men and 30·9% (22·7-39·0) in women. INTERPRETATION Psychiatric disorders were associated with an increased risk of any reoffending and violent reoffending in the community-sentenced population. The magnitude of the association between psychiatric disorders and reoffending varied by individual diagnosis. Substance use disorders had the highest absolute and relative risks. Most of the increased risk for any reoffending in individuals with psychiatric disorders could be attributed to comorbid substance misuse. Given their high prevalence, substance use disorders should be the focus of treatment programmes in community-sentenced populations. FUNDING Wellcome Trust.
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Affiliation(s)
| | - Nigel Blackwood
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK.
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Duan W, Wang Z, Yang C, Ke S. Are risk-need-responsivity principles golden? A meta-analysis of randomized controlled trials of community correction programs. JOURNAL OF EXPERIMENTAL CRIMINOLOGY 2023; 20:1-24. [PMID: 36644318 PMCID: PMC9825096 DOI: 10.1007/s11292-022-09550-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Objectives Using meta-analysis to determine the effect size of the recidivism rate of participants in community correction programs that are conducted entirely in community settings. Methods Following the Preferred Reported Items for Systematic Reviews and Meta-analyses (PRISMA), 25 qualified studies contributed 35 independent effect sizes. Results Full participation in a program significantly reduced the recidivism rate. Participant age was a significant moderator of heterogeneity. Those aged over 18 have lower recidivism rates. Interventions that fully follow the Risk-Need-Responsivity (RNR) design principles achieved similar results to those that did not. Recidivism rates increase more than 12 months after the program ends. Conclusions The effectiveness of community correctional programs varies depending on the participant's age. The RNR principles are not golden. The above factors should be carefully considered when conducting intervention design in the future. Results should be interpreted with caution due to the literature's high heterogeneity and low quality. Supplementary Information The online version contains supplementary material available at 10.1007/s11292-022-09550-w.
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Affiliation(s)
- Wenjie Duan
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - Zichuan Wang
- School of Social and Public Administration, East China University of Science and Technology, Shanghai, China
| | - Caiyun Yang
- Department of Sociology, School of Philosophy and Law & Political Science, Shanghai Normal University, Xuhui District, 100 Guilin Road, Shanghai, 200234 China
| | - Shuting Ke
- Department of Sociology, School of Philosophy and Law & Political Science, Shanghai Normal University, Xuhui District, 100 Guilin Road, Shanghai, 200234 China
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Miller WT, Campbell CA, Papp J, Ruhland E. The Contribution of Static and Dynamic Factors to Recidivism Prediction for Black and White Youth Offenders. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:1779-1795. [PMID: 34075791 DOI: 10.1177/0306624x211022673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Scholars have presented concerns about potential for racial bias in risk assessments as a result of the inclusion of static factors, such as criminal history in risk assessments. The purpose of this study was to examine the extent to which static factors add incremental validity to the dynamic factors in criminogenic risk assessments. This study examined the Youth Level of Service/Case Management Inventory (YLS/CMI) in a sample of 1,270 youth offenders from a medium-sized Midwestern county between June 2004 and November 2013. Logistic regression was used to determine the predictive validity of the YLS/CMI and the individual contribution of static and dynamic domains of the assessment. Results indicated that the static domain differentially predicted recidivism for Black and White youth. In particular, the static domain was a significant predictor of recidivism for White youth, but this was not the case for Black youth. The dynamic domain significantly predicted recidivism for both Black and White offenders, and static risk factors improved prediction of recidivism for White youth, but not for Black youth.
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Carolan C, O'Flynn A, Guerin S. Exploring Models of Care and the Perceived Impact in an Offender Rehabilitation Program. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2022; 66:914-930. [PMID: 34605305 DOI: 10.1177/0306624x211049201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Offender rehabilitation programs incorporating positive psychology interventions such as a strengths-based model can be effective. This study explores the perceived model of service provided by an offender rehabilitation service and the perceived impact that this service has on the lives of its clients. A qualitative methodology was employed in the context of an action research design, using semi-structured interviews with key stakeholders. The data were analyzed using thematic analysis which is an independent and reliable approach to qualitative analysis. The findings suggest that participants perceive the organization to be operating a strengths-based approach and this is perceived as having the potential to have a range of positive effects for clients. Some contrasting views were also identified within the participant groups and these are discussed in this paper. The results of this study complement the existing research and have several implications for future research in this area.
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Prison inmates with court-ordered treatments: are they really different? Ann Gen Psychiatry 2022; 21:6. [PMID: 35148794 PMCID: PMC8840305 DOI: 10.1186/s12991-022-00382-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/26/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Both the frequency of court-ordered treatments (COT) for offenders and prevalence of mental disorders among regular prison inmates steadily increased in most western countries. Whether there are major sociodemographic and clinical differences between these two populations is still matter of debate. METHODS We compared the sociodemographic and clinical characteristics in a representative sample of 139 regular prison inmates versus 61 offenders with COT admitted during a 5-year period in an acute psychiatric care unit located in the central prison of the Geneva county. Fisher exact, unpaired Student's t and Mann-Whitney U tests were used to compare demographic and clinical variables between COT patients and regular inmates. In addition, univariate and multivariable ordered logistic regression models were built to identify the sociodemographic and clinical determinants of COT. RESULTS COT patients were significantly older, less frequently married, with better education attainment, predominantly French-speaking, of the Christian religious group and with regular religious practice. History of psychiatric outpatient care was significantly more frequent in this group. Unlike the significantly higher occurrence of adjustment disorders in regular prisoners, psychosis was the main diagnosis in COT patients. When all diagnostic categories were taken into account in multivariable models, the presence of personality and psychotic disorders were the stronger predictors of COT status. CONCLUSIONS Our data reveal that offenders with COT represent a clinically distinct group with an overrepresentation of personality and psychotic disorders. Moreover, they show that, at least in the Swiss penitentiary system, COT patients are less exposed to acculturation issues compared to regular inmates.
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Weber M, Baggio S, Gonçalves LC, Nieuwbeerta P, Dirkzwager AJE. Longitudinal trajectories of mental health problems and their association with reoffending in a Dutch pre-trial prison cohort. Front Psychiatry 2022; 13:976832. [PMID: 36159926 PMCID: PMC9504669 DOI: 10.3389/fpsyt.2022.976832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 08/15/2022] [Indexed: 11/26/2022] Open
Abstract
The burden of mental health problems in detained persons is high. At the same time, mental health problems are discussed as possible predictors of criminal recidivism. During detention, mental health tends to improve. The aims of the study were twofold: First, to identify group-based trajectories of mental health problems over the course of detention; second, to test the association between trajectories and criminal recidivism. A prospective cohort of 1,904 adult males detained in Dutch pre-trial detention facilities was assessed at three time points after imprisonment (week 3, month 3, and month 9). Mental health problems were measured using the Brief Symptom Inventory. Recidivism was defined as reconviction and re-incarceration up to 18 months post-release. We used group-based trajectory modeling and logistic regressions for the analyses. On average, self-reported mental health improved during incarceration. Two distinct groups of mental health trajectories were identified: The majority (81%) reported relatively low levels of mental health problems, remaining stable over time. A small group (19%) reported high distress after prison entry with improvements over time. Older age, pre-existing functional impairment due to alcohol or drug use, diagnosis of psychiatric disorders, debts, use of psychiatric care during detention, and a more severe experience of detention were associated with membership in the second group. Group membership did not predict reoffending. The study confirms prior findings illustrating a generally positive change in mental health symptoms during detention. The course of mental health was associated with pre-existing socio-demographic and psychological characteristics that seem worthy to be considered in correctional treatment plans. Changes in mental health did not result in better legal outcomes. An interesting avenue for future research would be to examine changes in specific mental health symptoms or disorders in relation to recidivism risk.
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Affiliation(s)
- Michael Weber
- Department of Psychology, University of Konstanz, Konstanz, Germany.,Canton of Zurich, Department of Justice and Home Affairs, Office of Corrections and Rehabilitation, Zurich, Switzerland
| | - Stéphanie Baggio
- Division of Prison Health, Geneva University Hospitals, University of Geneva, Geneva, Switzerland.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Leonel C Gonçalves
- Division of Prison Health, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Paul Nieuwbeerta
- Institute of Criminal Law and Criminology, Leiden University, Leiden, Netherlands
| | - Anja J E Dirkzwager
- Netherlands Institute for the Study of Crime and Law Enforcement, Amsterdam, Netherlands
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Ross T, Fontao MI, Bulla J. Rising inpatient numbers in forensic security hospitals of German federal state of Baden-Württemberg: Background and explanatory approaches. BEHAVIORAL SCIENCES & THE LAW 2020; 38:522-536. [PMID: 32827339 DOI: 10.1002/bsl.2481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/23/2020] [Accepted: 07/30/2020] [Indexed: 06/11/2023]
Abstract
In this article, we describe critical epidemiological trends in forensic psychiatric care in the German federal state of Baden-Württemberg. For some years, there has been a marked increase in the number of patients with psychoses and with a migration background in the high-security hospitals of Baden-Württemberg. We present a number of studies exploring hypotheses as to why this is the case. Taking into account a set of person-related and non-person (forensic system)-related variables, we suggest that rising treatment figures may be understood in terms of system variables rather than individual patient characteristics. Findings regarding predictors of treatment length and legal outcome, as well as characteristics of migrant patients and patients assigned to forensic aftercare, are discussed.
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Affiliation(s)
- Thomas Ross
- University of Ulm, Ulm, Germany
- Reichenau Psychiatric Centre, Reichenau, Germany
| | | | - Jan Bulla
- Reichenau Psychiatric Centre, Reichenau, Germany
- Department of Psychology, University of Konstanz, Konstanz, Germany
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Welland S, Duffy LJ, Baluch B. Rugby as a rehabilitation program in a United Kingdom Male Young Offenders' Institution: key findings and implications from mixed methods research. J Exerc Rehabil 2020; 16:78-87. [PMID: 32161738 PMCID: PMC7056485 DOI: 10.12965/jer.1938726.363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/27/2019] [Indexed: 11/22/2022] Open
Abstract
There is a growing body of research on the effectiveness of rehabilitation programs in a Young Offenders' Institution (YOI). The aim of the present study is to investigate the effectiveness of rugby training as a rehabilitation intervention in a YOI in the United Kingdom. Young adult males (n=46) currently serving sentences at the YOI were split into two groups, intervention (n=25; mean age, 19.64±0.81 years) and no intervention (n=21; mean age, 19.76±0.89). Participants completed the Criminal Attitudes and Associates (MCAA) instrument at three different time cycles and then pre/post for intervention group. Additionally, qualitative interviews (one to one and focus groups) were carried out with the intervention and no intervention groups during the same cycles of the study. The results of questionnaire analysis showed no significant difference in MCAA measures taken before and after rugby intervention. Interestingly, the intervention group showed more procriminal attitudes on their responses compared to the no intervention group. Finally, analysis of the 3 cycles of data collected showed that the time of the year the questionnaire was completed has a significant impact on the responses given. In contrast, the qualitative interviews showed a very positive change of attitude towards rehabilitation from the intervention group after rugby training. The implications of the results in relation to studies aimed at evaluation of the intervention programs in YOI are discussed.
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Affiliation(s)
- Sarah Welland
- School of Science and Technology, Middlesex University, London, UK
| | - Linda J Duffy
- School of Science and Technology, Middlesex University, London, UK
| | - Bahman Baluch
- School of Science and Technology, Middlesex University, London, UK
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