Making Judgments: How Blame Mediates the Influence of Rape Myth Acceptance in Police Response to Sexual Assault

As research continues to describe negative experiences and high case attrition within sexual assault cases reported to the police, it is important to better understand the role of first-responding police officers. This study surveyed a sample of sworn police officers ( N = 174) from one department in a midsized city in the Great Lakes region to examine the effect of individual police officer characteristics, rape myth acceptance (RMA), attributions of blame, and case characteristics from a hypothetical vignette, on officer perceptions of a "good" case and behavioral intentions. Results found that although RMA predicts both perceptions of the case and behavioral intentions to respond in ways indicative of perceived seriousness, RMA is mediated by attributions of suspect blame. Victim alcohol use was found to decrease an officer's likelihood of responding more vigorously, showing less likelihood of calling a detective or arresting the suspect, if identified. Future research should begin to connect not only case characteristics but also individual police officer characteristics, attitudes, and attributions of blame, with real case outcomes, in addition to hypothetical scenarios.

The nature and extent of police use of force in encounters with people with behavioral health disorders

Previous research studies have examined the treatment of people with mental illnesses by the police. Much available data support the adoption of the Crisis Intervention Team (CIT) model. A key issue in CIT development has been reduction in the use of force by CIT officers, and it is suggested that such adoption does accomplish such reduction. However, to date, scant research compares variation in police use of force by CIT officers across populations with mental illnesses, co-occurring disorders, and substance abuse disorders, as compared to their non-disordered peers. Using data from the Portland Police Bureau, a police agency in which all patrol officers have been trained in the CIT model, we analyze whether police use-of-force differs across these groups. Police use-of-force data were collected for 4211 incidents from the Portland Police Bureau from 2008 to 2011. Results indicate that people perceived as having comorbid behavioral health disorders were generally more likely to have force used against them, and more likely to be perceived as resistant, than people that were perceived as having only substance use disorder, only mental health disorders, or no apparent behavioral health disorders. People with co-occurring disorders are more likely to be perceived as violently resisting police officers and have force used against them. Further, people with no perceived disorders are more likely to have a firearm pointed at them in use-of-force encounters, but also the least likely to be perceived as resisting.

Police Officer Schema of Sexual Assault Reports: Real Rape, Ambiguous Cases, and False Reports

While extensive research has studied sexual assault reporting behaviors and described negative experiences with the criminal justice system among victim-survivors, fewer studies have explored police officer attitudes, knowledge, and thought processes that may affect victims' perceptions of negative interactions and unsatisfactory outcomes within reported sexual assault cases. This study explores police officer understanding of the definition of sexual assault and characteristics that influence their perceptions and response. Ten police officers were interviewed within one police department in a midsized city in the Great Lakes region. The study uses a modified grounded theory approach. Findings suggest that officers employ distinct schema of reported sexual assaults. Case characteristics, perceived credibility of the victim, and types of evidence formed categorizations of false reports, ambiguous cases, and legitimate sexual assaults. Police officers describe the ways in which perceptions of the case may or may not influence the response and point to areas for improvement within police procedure. The study findings provide insight into recommendations for improved police interviewing and response to reported sexual assaults.

Psychiatric Boarding in Washington State and the Inadequacy of Mental Health Resources

Psychiatric boarding is a term derived from emergency medicine that describes the holding of patients deemed in need of hospitalization in emergency departments for extended periods because psychiatric beds are not available. Such boarding has occurred for many years in the shadows of mental health care as both inpatient beds and community services have decreased. This article focuses on a 2014 Washington State Supreme Court decision that examined the interpretation of certain sections of the Washington state civil commitment statute that had been used to justify the extended boarding of detained psychiatric patients in general hospital emergency departments. The impact of this decision on the state of Washington should be significant and could spark a national debate about the negative impacts of psychiatric boarding on patients and on the nation's general hospital emergency services.

The relationship of interpersonal conflict handling styles and marital conflicts among Iranian divorcing couples

BACKGROUND

Various research studies have suggested that among other variables that couples remain married if they successfully manage their interactions (marital communication based on acceptance of individual differences, problem solving skills, forgiveness, collaborative decision making, empathy and active listening) and constructively manage conflict.

PURPOSE

The study was aimed at examining the relation of conflict handling styles and marital conflicts among divorcing couples.

METHODS

As a descriptive -comparative study 60 couples out of 440 couples referred to the Crisis Intervention Center of the Isfahan Well-being Organization have selected. The tools implemented were Marital Conflicts (Barati & Sanaei, 1996) and Interpersonal Conflict Handling Styles Questionnaires (Thomas-Kilman, 1975). Their total reliabilities were, respectively, 0.74 and 0.87.

RESULTS

Findings showed that there are no significant differences among their conflict handling styles and marital conflicts. Also, there was positive correlation between avoidance and competition styles and negative one between compromise, accommodation, and cooperation styles with marital conflicts. That is, these styles reduced couples' conflicts. Finally, wives had tendency to apply accommodation style and husbands tended to use accommodation and cooperation styles to handle their conflicts.

CONCLUSIONS

It is suggested to be studied couples' views toward their own styles to handle marital conflicts and holding training courses to orient couples with advantages and disadvantages of marital conflict handling styles.

[Systemic reading, another way of thinking to apprehend situations of elderly abuse]

In 2007, a national call number was created to receive reports of ill-treatment for aged or handicapped subjects, and departmental platforms of phone-tapping were organized. Professionals of listening receive the calls for assistance or confidences of distresses related to ill treatments. They should initiate a relationship and assess the danger of the condition, therefore, in a systemic paradigm, performing a double task. According to the systemic approach, ill-treatments are usually the product of interaction and not that of an individual. They do not only concern individuals which suffer or undergo ill treatment but a system including all people leaving at home and social environment. To apprehend the complex relationships of ill treatments by professional of listening requires clarification of the situation together initiating a relation of confidence between the person calling and the professional. Therefore, the requests necessary for clarification should not be intrusive but create conditions of an exchange of information allowing a co-construction with the person calling for help. To accommodate a call for a critic situation, we need to take into account the context and not to be focused on the search of the causes of ill-treatment.

[The possibility or coercion treatment? Anorexia nervosa--legal regulations. A case report]

Anorexia nervosa is diagnosed on the basis of well-defined diagnostic criteria and requires treatment, as it is associated with the highest mortality rate of all mental illnesses. In Poland, anorexia nervosa is not considered a mental illness, although the opinion of researchers and clinicians are divided. To reduce the death rate of AN correct and early diagnosis, appropriate treatment starting immediately and the appropriate regulations to allow people to take the AN treatment against their will are necessary. In our work, we presented the treatment of patients with severe mental anorexia with a predominance of restrictive behavior as well as the issue of regulations relating to the compulsory treatment of people with eating disorders.

[The patient faced with the inescapable ruling of the liberty and detention judge]

Around a hundred of interviews have been carried out with patients hospitalised under restraint before and after their court case. The aim was to assess in particular the understanding of the law and the role of the liberties and detention judge, the experience of the hearing, the motives behind the refusals to appear and the impact of the notification of the ruling. To date, no patients have refused interviews during their hospital stay once they have emerged from the period of crisis.

[Evaluation of outpatient treatment units according to the Crime Victims' Regulation Act]

OBJECTIVE

Over the past years, 35 trauma outpatient units have been established in accordance with the Crime Victims' Compensation Act in the federal state of North Rhine-Westphalia (Germany) for both children and adolescents as well as for adults. They are operated by the social welfare authorities and, since 2008, by the regional authorities of Westphalia-Lippe and Rhineland. They enable victims to receive qualified psychotraumatological help within the first few days after suffering violence. Since trauma units have now been set up across most parts of this federal state, the time has come to assess the effectiveness of their acute care provision to victims of violence.

METHODS

In 2007, on the order of the Ministry of Labour, Health and Social Affairs of the federal state of North Rhine-Westphalia, trauma outpatient units were subjected to scientific evaluation. In 17 trauma outpatient units, a data assessment protocol was officially implemented that included repeat measurements (immediately before the initial contact, after completion of intervention, at follow-up six months after intervention) of traumatized subjects aged 14 and older. Socio-demographic data were gathered, and the scores of the Impact of Event Scale - Revised (IES-R), the Symptom Checkliste-27 (SCL-27), the simplified Beck Depressions Inventory (BDI-V), the Global Assessment of Functioning Scale (GAF) as well as the Cologne Risk Index (CRI) (expert rating) were collected.

RESULTS

Nearly three-fourths (65.9 %) of the traumatic experiences of the 211 patients investigated can be characterized as type-1 traumatisation. 31.8 % of patients were victims of crimes involving violations of the right to sexual self-determination (94.0 % of sexual offences being committed against girls and women). Crimes against physical integrity, which according to crime statistics are the most frequent of crimes against individuals (88.8 %, 34.8 % females), were suffered by 36.0 % of all patients of the trauma outpatient units (63.2 % being females). In 57.1 % of the victims, the interval between the traumatic event and initial intervention was less than a month. In 51.7 % (n = 109), suspicion of PTBS (F43.1) was raised at the initial presentation. The average of all instruments yielded an effect size of d = 1.04 (SD = 0.28) in a pre-post comparison. Pair-wise comparison showed highly significant differences in averages between pre and post (that is, between initial and follow-up measurements) in the sense of marked symptom reduction for all scales.

CONCLUSIONS

The services of the trauma outpatient units are utilized in a timely and targeted fashion. The calculated effects show that the trauma outpatient units offer highly effective services to crime victims seeking help there.

Police interviews of sexual assault reporters: do attitudes matter?

Sexual assault is underreported in the United States. Survivors are often reluctant to make police reports for various reasons; one is fear of revictimization by criminal justice professionals. Conversely, police officers often lack skills for interviewing crime victims. Posttraumatic stress reactions among victims can exacerbate the problem. Although some victims prefer female interviewers, it is not known whether they are more skilled. A sample of 429 police officers completed a written survey testing their rape myth acceptance and knowledge of how to interview rape reporters. A significant relationship between rape myth acceptance and interviewing skill was discovered. Although officer gender was related to interviewing skill, the effect was mediated by rape myth acceptance. Specific officer behaviors related to high rape myth acceptance were identified. Implications for selection of police to conduct victim interviews were discussed.

University students' views on the utility of psychiatric advance directives

OBJECTIVE

Rates of serious mental illnesses (SMIs) among university students are increasing, and universities are struggling with how to respond to students who show SMI symptoms. Psychiatric advance directives (PADs) allow individuals, when well, to document their wishes for treatment during a psychiatric crisis. This project explored the feasibility of using PADs in university settings by examining students' views towards PADs.

PARTICIPANTS

Forty university students with SMIs were recruited for this study from 1 large university.

METHODS

A mixed-methods design was used, with both quantitative survey instruments and qualitative interviews with students.

RESULTS

Respondents were positive about PAD utility for students. Respondents saw PADs as beneficial because PADs gave students control over their treatment. However, students also considered PADs potentially problematic because PAD use raised a risk of breaching student privacy and stigmatizing students with SMIs.

CONCLUSIONS

Although a promising intervention for students with SMI, this approach requires further research.

Covert medication in psychiatric emergencies: is it ever ethically permissible?

Covert administration of medications to patients, defined as the administration of medication to patients without their knowledge, is a practice surrounded by clinical, legal, ethics-related, and cultural controversy. Many psychiatrists would be likely to advocate that the practice of covert medication in emergency psychiatry is not clinically, ethically, or legally acceptable. This article explores whether there may be exceptions to this stance that would be ethical. We first review the standard of emergency psychiatric care. Although we could identify no published empirical studies of covert administration of medicine in emergency departments, we review the prevalence of this practice in other clinical settings. While the courts have not ruled with respect to covert medication, we discuss the evolving legal landscape of informed consent, competency, and the right to refuse treatment. We discuss dilemmas regarding the ethics involved in this practice, including the tensions among autonomy, beneficence, and duty to protect. We explore how differences between cultures regarding the value placed on individual versus family autonomy may affect perspectives with regard to this practice. We investigate how consumers view this practice and their treatment preferences during a psychiatric emergency. Finally, we discuss psychiatric advance directives and explore how these contracts may affect the debate over the practice.

The Colorado Crisis Education and Response Network: an analysis of policy and practices

The Federal government has recognized the importance of including behavioral health in disaster response plans and policies. Many states have responded to these directives with the development and implementation of disaster behavioral health response teams. The Colorado Crisis Education and Response Network (CoCERN) is a statewide asset that is based in community partnerships formed to deliver effective, efficient, and professional disaster behavioral health services to communities impacted by a disaster Using the K. McInnis-Dittrich model of policy analysis, this paper analyzes this approach to disaster behavioral health response. Strengths and weaknesses of the program, as well as implications for practice are discussed.

Alternative work and world. Chronicity of emergencies and the work in crisis unit

We describe the legal framework within which we carry out consultations, otherwise called expertises, with view to considering involuntary admissions to hospital for the treatment of mental illness (here called confinements). We note that in our area only 40% of consultations lead to involuntary admissions to hospital, and we believe that this number is related to our consideration of alternative methods of care in the community. We suggest a multi-centric study to evaluate what specific skills are required to properly carry out these assessments and to establish the extent to which the increased workload of assessments is influencing the rate of involuntary admissions.

Partnerships for effective campus crisis responses

Violence on college campuses has spurred administrators and campus safety officials to devise effective crisis management and threat assessment strategies. The college community lends itself to a systematic multi-component model of crisis intervention primarily due to its self-contained and widespread interconnected social networks. The CISM model for a crisis response is an empirically supported program that would inform practice prior to, during, and following university-based crises. Ultimately, best practices in the world of academia should rest on a foundation of detailed preparation, interdepartmental collaboration and coordination, extensive specialized training, and periodic review of campus protocols to assess for systemic changes.

The domestic violence home-visit intervention: impact on police-reported incidents of repeat violence over 12 months

The domestic violence home-visit intervention (DVHVI) provides home visits by police-advocate teams within 72-hours of domestic incident to provide safety, psychoeducation, mental health, legal, or additional police assistance. Clinical and police record data were collected for 512 cases, and repeat calls to the police were tracked for 12 months. Analyses revealed that women who engaged with the DVHVI were more likely to contact the police for subsequent events than those who received no or minimal DVHVI contact. Hispanic women served by Spanish-speaking advocate-officer teams were the most likely to utilize services and call the police for subsequent incidents.

Elder abuse in Europe: an overview of recent developments

Elder abuse is a global phenomenon. Despite recognition and action several decades ago in a number of countries, in many others the phenomena of abuse and neglect have been much more recently identified as in need of attention. This brief will discuss the situation relating to responses to and interventions in elder abuse that have been evolving in a number of countries in the European region, which are at different stages of development. The examples provided will assist in meeting the worldwide challenge that elder abuse presents.

Overriding psychiatric advance directives: factors associated with psychiatrists' decisions to preempt patients' advance refusal of hospitalization and medication

Psychiatric advance directives (PADs) are intended to support patients' treatment decisions during a crisis. However, PAD statutes give clinicians broad discretion over whether to carry out patients' advance instructions. This study uses data from a survey of psychiatrists (N=164) to examine reasons for overriding PADs. In response to a hypothetical vignette, 47% of psychiatrists indicated that they would override a valid, competently-executed PAD that refused hospitalization and medication. PAD override was more likely among psychiatrists who worked in hospital emergency departments; those who were concerned about patients' violence risk and lack of insight; and those who were legally defensive. PAD override was less likely among participants who believed that involuntary treatment is largely unnecessary in a high-quality mental health system.

[Quality characteristics of freedom-restricting coercive measures in child and adolescent psychiatry]

Putting into practice legal prescriptions of both children's rights and the personal freedom guaranteed by the German basic constitutional law requires a reflected and sensitive use of freedom-restricting coercive measures. Such measures imply uncertainties and burdens for staff and patients in child and adolescent psychiatry. Using guidelines of psychiatric associations and instructions from three institutions, basic attitudes and quality characteristics of indication, performance, and participation with regard to freedom-restricting coercive measures are described.

[Legal and practical issues on coercive measures in child and adolescent psychiatry]

Although insight, positive attitude towards therapy and compliance are key to a successful treatment, in certain situations the use of coercive measures on mentally ill or disordered minors is the only way to prevent serious harm to the patient or others. The decision to use coercive measures, such as involuntary admission or detention, seclusion, mechanical or chemical restraint or involuntary treatment, is challenging for clinicians as they have to deal, not only with the patient and his or her parents who are in a disturbed emotional state, but also with some complex legal regulations. To protect the rights of patient and parents in these difficult situations and to prevent legal consequences for clinical personnel for unlawful acts, it is essential that staff be familiar with all concerned legal rules and procedures. Interdisciplinary co-operation between the involved professionals should be encouraged to ensure a standardised procedure according to legal specifications. A growing number of mental hospitals for children and adolescents have no special locked door units but open wards that can be locked when required. A placement of voluntarily and involuntarily committed patients in the same unit can cause problems if the freedom of voluntary patients is restraint due to the placement of an interned patient. Unlawful restraint must be avoided by a sufficient number of staff and clear proceeding guidelines.

[Domestic elder abuse and neglect--conclusions from the evaluation of a model project]

The main task of a federally funded model project in the German city of Hannover was to develop approaches for prevention and intervention in the field of domestic elder abuse. Over a three year period (1998-2001), different approaches--like a telephone helpline for senior citizens, and social workers operating as counsellors for elderly people and their relatives--were tested at a local level. The paper presents results from the evaluation of the project and draws conclusions for future prevention and intervention in the field. The authors argue that the explicit use of the conceptual framework of "violence"/"abuse" creates potentials for scandalizing the issue and is therefore supportive for media appearance, whereas it can impede the approach to the main target groups (elderly people and their relatives) and reduce accessibility of counselling services for potential clients. In the light of evaluation results the focus of the project ("domestic elder abuse" or "violence against elderly people in close relationships") was too narrow for a local project. Counselling services were used in a relatively small number of cases; analyses of cases show that incidents of domestic elder abuse are often embedded in complex problem constellations. Cases brought to the attention of the model project were multifaceted and not limited to incidents of neglect and abuse of elderly care recipients caused by caregiver overload. Cases of intimate violence in partnerships and of intergenerational violence without any of the participants being dependent on care show the need to develop a broader concept of domestic elder abuse. Integration of the concepts of domestic violence, violence against women, elder abuse/neglect and abuse/neglect in caregiving relationships is necessary on a conceptual level as well as on the level of interagency cooperation of institutions dealing with cases of "elder abuse".

Professionally indicated short-term risk-taking in the treatment of borderline personality disorder

OBJECTIVE

To define and explore the rationale for professionally indicated short-term risk-taking in treating adults with borderline personality disorder, and discuss prerequisites for the approach, clinical implementation and medicolegal contexts.

CONCLUSION

When prerequisites are met and clinical and medicolegal practice is sound and thorough, taking short-term risk, as part of a comprehensive treatment, is a legitimate professional consideration in working with some adults with borderline personality disorder.

[The legal system and health: obstacles and supportive areas for intersectorial action]

Article 8 of the Act Respecting the Protection of Persons Whose Mental State Presents a Danger to Themselves or to Others (Québec, 1997) introduced a new legal framework requiring a linkage between police departments and crisis intervention services to prevent involuntary hospitalizations. Through telephone interviews, observation sessions, and documentary analysis, the authors studied the implementation of article 8 in 16 Québec administrative regions. Results pertain to organizational consequences for the health and police sectors and methods of collaboration between the two sectors. They cast light on the difficulties of implementing article 8 and suggest conditions for the success of initiatives aimed at reducing unjustified recourse to the legal system and hospitalization in cases of persons with mental health problems.

Substance abuse and relationship violence among men court-referred to batterers' intervention programs

There is extensive theoretical and empirical evidence linking substance abuse and marital violence. However in batterer populations, researchers have not compared hazardous and nonhazardous drinkers' substance use characteristics, marital aggression, extramarital violence (i.e., general violence), depressive symptomatology, marital satisfaction, and other relevant variables. In addition, much of the previous research on substance use and abuse in batterer populations employed a single, nonstandardized measure of substance use, and no previous research has examined substance use in court-mandated batterers' relationship partners. We recruited 150 men who were arrested for violence and court-referred to batterer intervention programs. We administered multiple measures of substance use and abuse and assessed the batterers' marital aggression, relationship satisfaction, depressive symptomatology, use of general violence, and their relationship partners' substance use. We also divided the sample into groups of Hazardous Drinkers (HD) and Nonhazardous Drinkers (NHD). Across the entire sample, half of the batterers had an alcohol-related diagnosis and approximately one third reported symptoms consistent with a drug-related diagnosis. Over one third of the total sample reported that their relationship partners were hazardous drinkers. Relative to the NHD group, the HD group scored significantly higher on measures of general violence, depressive symptomatology, alcohol use, alcohol problems, and drug problems. The HD group also reported significantly higher partner alcohol and drug use and abuse scores, relative to the NHD group. The results of the study suggest that substance use and abuse should routinely be assessed as part of batterer interventions and that batterer programs would be improved by offering adjunct or integrated alcohol treatment.

The mental health of crime victims: impact of legal intervention

In the aftermath of crime, victims must decide whether to seek justice. An encounter with the legal system offers major potential benefits to crime victims, but also exposes them to significant risks. Victims who file civil or criminal complaints are subject to the rules and procedures of a complex legal system, where their mental health and safety may be of marginal concern, and where the potential for retraumatization may be high. This paper reviews the social and psychological barriers that discourage victim participation in the legal system, and existing studies that document the impact of participation on victims' mental health. Prospective longitudinal research focusing on victims in the legal system is recommended.

Workplace trauma and the law

The law places increasing responsibilities on organizations to protect its workforce from psychological injury. This paper looks at the development of British law relating to traumatic stress and explores a growing concern of clinicians that the law and the legal processes themselves may increase the psychological injury of victims of traumatic stress. The statutory requirement for organizations to provide effective support for employees following a traumatic incident is enshrined in law. However organizations are confused by the conflicting statements on the effectiveness of debriefing and trauma counselling.

Psychiatric crises and emergency admissions

Emphasize safe practice to avoid legal liability when evaluating individuals in psychiatric crisis. Test your knowledge with the following questions, then check your answers at http://www.nursingmanagement.com.

A survey on use of advance directives for mental health treatment in Oregon

Oregon is one of three states that allows persons to prepare a legal document-and advance directive-to stipulate the mental health treatment they wish to receive should they lose their decision-making capacity. An informal one-page questionnaire on the use of advance directives for mental health treatment in the state was enclosed in newsletters sent to families and care providers of persons with severe and persistent mental disorders. Responses were received from 156 people; they reported that 64 advance directives had been completed by consumers, 40 surrogate decision makers had been appointed, and ten consumers had used their advance directives when in crisis. In each case, the consumer's wishes were honored. The small response to this preliminary survey suggests the need for further education about advance directives among mental health care consumers, their families, and providers.