Mentally disordered offenders and the European Court of Human Rights

This article presents the findings from a study of cases taken to the European Court of Human Rights by mentally disordered offenders. The issues raised include the problems raised by indeterminate sentences, the use of detention for preventive purposes, and debates about treatment. The countries represented are Belgium, Norway, Poland, the Netherlands, Russia and the United Kingdom.

Factor structure and validity of the Alcohol Use Disorders Identification Test (AUDIT) in a sample of mentally disordered offenders

Investigations of the factor structure of the Alcohol Use Disorders Identification Test (AUDIT) have produced conflicting results. The current study assessed the factor structure of the AUDIT for a group of Mentally Disordered Offenders (MDOs) and examined the pattern of scoring in specific subgroups. The sample comprised 2005 MDOs who completed a battery of tests including the AUDIT. Confirmatory factor analyses revealed that a two-factor solution – alcohol consumption and alcohol-related consequences – provided the best data fit for AUDIT scores. A three-factor solution provided an equally good fit, but the second and third factors were highly correlated and a measure of parsimony also favoured the two-factor solution. This study provides useful information on the factor structure of the AUDIT amongst a large MDO population, while also highlighting the difficulties associated with the presence of people with mental health problems in the criminal justice system.

Good lives sexual offender treatment for mentally disordered offenders

Purpose – The main aim of this paper is to describe the content, structure and preliminary evaluation of a new Good Lives sexual offender treatment group (SOTG) for male mentally disordered offenders.

Design/methodology/approach – As evaluation and work on the SOTG is necessarily ongoing, case study descriptions of each patient who attended the SOTG and of their progress throughout SOTG are described.

Findings – Overall, the case study progress reports suggest that mentally disordered male patients made some notable progress on SOTG despite their differential and complex needs. In particular, attention to each patient's life goals and motivators appeared to play a key role in promoting treatment engagement. Furthermore, patients with lower intelligence quotient and/or indirect pathways required additional support to understand the links between the Good Lives Model (GLM) and their own risk for sexual offending.

Research limitations/implications – Further evaluations of SOTG groups, that incorporate higher numbers of participants and adequate control groups, are required before solid conclusions and generalisations can be made.

Practical implications – Practitioners should consider providing additional support to clients when implementing any future SOTGs for mentally disordered patients.

Originality/value – This is the first paper to outline and describe implementation of the GLM in the sexual offender treatment of mentally disordered male patients group format. As such, it will be of interest to any professionals involved in the facilitation of sexual offender treatment within this population.

Thinner cortex in the frontal lobes in mentally disordered offenders

Antisocial and violent behaviour have been associated with both structural and functional brain abnormalities in the frontal and the temporal lobes. The aim of the present study was to assess cortical thickness in offenders undergoing forensic psychiatric assessments, one group with psychopathy (PSY, n=7) and one group with autism spectrum disorder (ASD, n=7) compared to each other as well as to a reference group consisting of healthy non-criminal subjects (RG, n=12). A second aim was to assess correlation between scores on a psychopathy checklist (PCL-SV) and cortical thickness. Magnetic resonance imaging (MRI) and surface-based cortical segmentation were used to calculate cortical thickness. Analyses used both regions of interest and statistical maps. When the two groups of offenders were compared, there were no differences in cortical thickness, but the PSY group had thinner cortex in the temporal lobes and in the whole right hemisphere compared to RG. There were no differences in cortical thickness between the ASD group and RG. Across subjects there was a negative correlation between PCL-SV scores and cortical thickness in the temporal lobes and the whole right hemisphere. The findings indicate that thinner cortex in the temporal lobes is present in psychopathic offenders and that these regions are important for the expression of psychopathy. However, whether thinner temporal cortex is a cause or a consequence of the antisocial behaviour is still unknown.

A nationwide survey of mental health and correctional institutions for adult mentally disordered offenders

Mode of access: Internet.

Readiness for treatment in high risk offenders with personality disorders

Low engagement and non-completion of therapeutic interventions are important issues in the treatment and rehabilitation of offenders and mentally disordered offenders. Such factors influence a range of outcomes, including the reduction of clinical and criminogenic needs. In this paper it is proposed that low engagement and non-completion are usefully viewed as a consequence of low readiness for treatment. The dimensions of readiness are summarized (from the Multifactor Offender Readiness Model) and applied to high risk offenders with severe personality disorders. A readiness analysis has implications for the assessment and treatment of this patient/offender population and is useful in identifying future research and clinical priorities.

Characteristics of Mentally Disordered Youth Referred to a Forensic Satellite Clinic for Violence Risk Assessment: A Case Control Study

There is a lack of appropriate services to manage youth with comorbid mental health problems and violence risks. To address this gap, we implemented a forensic satellite clinic in a youth mental health service. This paper characterises offending histories among 45 young patients referred to the clinic, and compares them with matched clinical controls (n = 45). Levels of prior risk taking and aggression were prominent among referred patients. Forensic cases and controls did not differ on demographic and clinical variables, with the exception of psychiatric inpatient admissions, which were higher among referred patients. Group differences were observed for prior offending variables (e.g., physical aggression), which were significantly higher among referred patients than controls. Findings suggest that referrals were made to the clinic based on challenging and aggressive behaviour rather than specific clinical characteristics. The role of specialist assessment, treatment and management of violence risks in youth mental health services are discussed.

The abolition of defensive homicide : a step towards populist punitivism at the expense of mentally impaired offenders

The offence of defensive homicide was abolished in Victoria in November 2014, following a widely held perception that it was being abused by violent men. While primarily associated with battered women who killed in response to prolonged family violence — but who were unable to establish their offending as self-defence — a less publicised rationale underpinning the introduction of defensive homicide was to provide an alternative offence for offenders with cognitive impairments not covered by the mental impairment (formerly the insanity) defence. Cognitive impairments are complex and varied in their nature and symptomatology. Offenders presenting with cognitive impairments therefore require an appropriate range of legal responses to capture the nuances and appropriate moral culpability of their conduct. Drawing from an analysis of the cases of defensive homicide heard over its 10–year lifespan, this article contends that the abolition of defensive homicide did not adequately take into consideration the potential impacts on individuals whose mental conditions are not typically covered by the restrictive mental impairment defence. We further argue that the decision to abolish defensive homicide was driven by dominant, populist voices, without sufficient attention given to the offence’s potential to achieve the aims underpinning its enactment, including providing an alternative offence for women who kill in response to prolonged family violence.

A prospective comparative evaluation of a Criminal Justice Liaison and Diversion Service in Belfast

There is continued interest in the planning, development and implementation of services designed to identify, detainees with mental illness and connect them to health and social services. However, currently little is known about how best to configure, organise and deliver these services. The study employed a prospective follow-up design with a comparator group to describe and evaluate a police mental health liaison service based in Belfast. Participants were recruited from two neighbouring police stations, only one of which provided a mental health liaison service. Outcomes including mental health status, drug and alcohol misuse, risk-related behaviour and ‘administrative’ outcomes were assessed at the time of arrest and six months later. The service was successful in identifying and assessing detainees though there appeared to be similar between-group levels of mental health problems over time. Results highlight a need to develop firmer linkages and pathways between criminal justice liaison / diversion services and routine health and social services.