Psychometric Examination of Treatment Change Among Mentally Disordered Offenders: A Risk–Needs Analysis

2017 ◽  
Vol 45 (2) ◽  
pp. 153-172 ◽  
Author(s):  
Drew A. Kingston ◽  
Mark E. Olver
Keyword(s):  
Cox Regression ◽  
Readiness For Change ◽  
Baseline Risk ◽  
Mentally Disordered Offenders ◽  
Treatment Change ◽  
Psychiatric Symptomatology ◽  
Mentally Disordered ◽  
Psychometric Measures ◽  
Mentally Disordered Offender ◽  
General Recidivism

The present study examined the association of psychiatric symptomatology, criminal attitudes, and treatment changes within these domains to violent and general recidivism in a sample of 614 mentally disordered offenders. Significant pre–post changes were found on multiple measures of criminal attitudes, symptomatology, and readiness for change. Antisocial Intentions and Attitudes Toward Associates (from the Measure of Criminal Attitudes and Associates [MCAA]) predicted general recidivism and covaried with the Big Four criminogenic need domains on the Level of Service Inventory–Ontario Revision; none of the remaining psychometric measures significantly predicted violent or general recidivism. Although pre–post changes were seldom linked to changes in recidivism, positive changes in Antisocial Intentions (MCAA) significantly predicted reductions in general recidivism via Cox regression survival analysis, controlling for baseline risk and pretreatment attitudes score. Risk and need implications of psychometric assessments of treatment change in mentally disordered offender populations are discussed.

Sexual offender treatment outcomes among psychopathy subtypes

2018 ◽  
Vol 4 (3) ◽  
pp. 161-173 ◽  
Author(s):  
Lindsay A. Sewall ◽  
Mark E. Olver
Keyword(s):  
Sexual Offenders ◽  
Cox Regression ◽  
Sexual Offender ◽  
Offender Treatment ◽  
Cognitive Disability ◽  
Sexual Offender Treatment ◽  
Treatment Change ◽  
Content Type ◽  
Psychopathy Checklist Revised ◽  
General Recidivism

Purpose The purpose of this paper is to examine sexual offender treatment responses as a function of psychopathy subtype. Design/methodology/approach Measures of sexual violence risk, treatment change and outcome variables were coded retrospectively on a sample of 86 high Psychopathy Checklist-Revised (PCL-R) scoring sexual offenders. Psychopathy subtypes were identified through cluster analysis of PCL-R facet scores. Findings Two subtypes were identified labeled classic and aggressive. They were comparable in their level of risk and need and did not differ in rates of treatment completion or change. The aggressive subtype had higher rates of violent and general recidivism and higher frequencies of major mental disorder and cognitive disability. Results of Cox regression survival analysis demonstrated that treatment-related changes in risk were associated with reductions in violent recidivism for the aggressive, but not classic, psychopathy variant. Practical implications Psychopathy is a heterogeneous syndrome. Moreover, psychopathic offenders can demonstrate risk relevant treatment changes. PCL-R facet profiles have important responsivity implications. However, not all psychopathic offenders fare poorly in treatment. Originality/value This is one of very few studies to examine treatment response and links to outcome among psychopathic offenders, particularly as this relates to subtype.

Mentally disordered offenders in Zimbabwe and in England and Wales: a socio-demographic study

2007 ◽  
Vol 47 (3) ◽  
pp. 253-261 ◽  
Author(s):  
S.B. Menezes ◽  
F. Oyebode ◽  
M.S. Haque
Keyword(s):  
Standard Deviation ◽  
Patient Survey ◽  
Mentally Disordered Offenders ◽  
Developed Country ◽  
Case Register ◽  
England And Wales ◽  
Mentally Disordered ◽  
Significant Difference ◽  
Hospital Patients ◽  
Mentally Disordered Offender

Our aim was to compare socio-demographic, clinical and criminal characteristics of mentally disordered offender patients in a special institution in a developing and a developed country. Zimbabwe data from 1980-1990 was obtained from a hospital patient survey, in a written semi-structured format. The English special (high security) hospital patients' data for the same period was obtained from the case register. The sample size for Zimbabwe was 367 patients (337 males, 30 females) and for England and Wales it was 1,966 patients (1,643 males, 323 females). The average age for Zimbabwean patients was 36 years, with standard deviation of 9.7; for England and Wales the average age was 29.7 with standard deviation of 9.6. There was significant difference in marital status in the two countries. Seventy-eight per cent of patients were single in England and Wales, compared with 49% in Zimbabwe. There were 20% illiterate patients in Zimbabwe, compared with 4% in England and Wales. Thirty-seven per cent of the patients in England and Wales had a diagnosis of personality disorder, compared with 6% in Zimbabwe. There were 53% of homicides in Zimbabwe, compared with 20% in England and Wales. Employment in the two countries was similar: 34% in Zimbabwe and 33% in England and Wales. There were differences in the socio-demographic characteristics in the two countries, except for employment status. Differences were also noticed in the diagnoses of the patients, types of crime and the methods of assault.

The Community Mental Health Team and the mentally disordered offender

2017 ◽  
Author(s):  
Frank Holloway ◽  
Tony Davies
Keyword(s):  
Mental Health ◽  
Criminal Justice ◽  
Criminal Justice System ◽  
Justice System ◽  
Clear Understanding ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
Mentally Disordered Offender ◽  
Offending Behaviour ◽  
The Mind

There is a long-standing policy of diversion of mentally disordered offenders (MDOs) from the criminal justice system to care by mental health services. Care of the MDO presents specific challenges to the non-forensic practitioner. These include the need to understand the workings of the criminal justice system and the specific legal issues presented by an offender, the salience of risk, and its management in the mind of the courts and novel additional ethical dilemmas that arise. The importance of substance misuse as a factor in offending behaviour is emphasized, and its implications are explored. In addition, the MDO may present with clinical problems that are unfamiliar. Key principles of management are set out. These include developing a clear understanding of the patient and their world, excellent communication between all those involved, and rapid intervention when there is cause for concern. Staff working with an MDO require adequate supervision and support.

Care of the Mentally Disordered Offender in the Community

2017 ◽  
Keyword(s):  
Mental Health ◽  
Sex Offenders ◽  
The United States ◽  
Pharmacological Therapy ◽  
Community Treatment ◽  
Clinical Aspects ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
Recent Developments ◽  
Mentally Disordered Offender

This book examines the care of the mentally disordered offender in the community from a number of perspectives: the social, administrative, and clinical context; clinical aspects of care; and the relationships between psychiatric services for mentally disordered offenders and other agencies. It incorporates recent developments in treatment and policy, including an international analysis of the use of community treatment orders, which remain controversial and divide opinion. In the United States, efforts to improve treatment have focussed on improving continuity of care between prison and the community, and the book examines US jail and prison policy. Current UK health policy as applied to the mentally disordered offender is explained. Risk and risk thinking is a theme that runs through the book and is considered in terms of its effect on society, its influence on policy, and in terms of how risk assessment is applied in everyday clinical practice. Developments in psychodynamic psychotherapy and cognitive treatments for mentally disordered offenders are discussed, including consideration of the risk-need-responsivity model, which has become increasingly influential. The treatment of sex offenders and personality disorder offenders is considered specifically, as is pharmacological therapy. Most mentally disordered offenders are managed in the community by the Community Mental Health Team (CMHT). The role of the CMHT and its interface with specialist community forensic teams is considered, as is the interaction between mental health services and other agencies and the legal context within which they operate.

Lowering legal barriers to transitioning mentally disordered offenders into general mental health care

2017 ◽  
Author(s):  
John Dawson ◽  
Tom Burns
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Mentally Disordered Offenders ◽  
Mentally Disordered ◽  
General Mental Health ◽  
Commitment Scheme ◽  
Key Factor ◽  
Mentally Disordered Offender ◽  
Legal Barriers

This chapter considers legal mechanisms for directing that the treatment of a mentally disordered offender should take place under the civil commitment scheme. Mentally disordered offenders should be dealt with in the least restrictive manner and receive timely transfer of their care to general mental health teams. We discuss factors likely to influence the responsible authorities when deciding whether to direct offenders to treatment under the civil scheme. The scope of the powers that would continue to be available over the person’s treatment is a key factor. With insufficient powers, authorities might be reluctant to direct an offender to the civil scheme. Yet, if strong powers were available, that would pose a threat to the rights of ordinary civil patients under that scheme. Some way must therefore be found to finesse the differing interests of offenders and ordinary civil patients in the design of the civil scheme. .

scholarly journals Working with psychiatric problems in probation

1992 ◽  
Vol 16 (7) ◽  
pp. 427-430
Author(s):  
Keith J. B. Rix
Keyword(s):  
Staff Development ◽  
Social Services ◽  
Northern Region ◽  
Probation Officers ◽  
Mentally Disordered Offenders ◽  
Home Office ◽  
Mentally Disordered ◽  
Experimental Scheme ◽  
Mentally Disordered Offender ◽  
Psychiatric Problems

Recent public concern about prisoners with psychiatric disorder, the deliberations of the Department of Health and Home Office Review of Health and Social Services for Mentally Disordered Offenders (the Reed Review) and the allocation by HM Government of funds for magistrates' courts to pay for duty psychiatrist schemes like the experimental scheme at Clerkenwell Magistrates' Court (James & Hamilton, 1991) are raising the profile of the mentally disordered offender and focusing attention on a group of people not only handicapped by mental disorder but also caught up in the criminal process. Probation officers have a key role in the care of many mentally disordered offenders and in the recent Home Office circular (1990) Provision for Mentally Disordered Offenders a reference is made to two courses for probation officers run by the Regional Staff Development Organisation for the Northern Region of the Probation Service. These courses are ‘Working with High Risk Offenders’ and ‘Working with Psychiatric Problems in Probation’. The former is run by Professor Herschel Prins and the latter by me. Judged by the number of applications, these are the two most popular courses run by RSD, but, as part of the process of evolving training to local probation areas, RSD closed in November 1991 and it has now organised its last course ‘Working with Psychiatric Problems in Probation’. This therefore seems an opportune time to describe the aims, format and evolution of the course and promote discussion concerning its implications for psychiatrists.

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