Forensic-Psychiatric Risk Evaluations: Perspectives of Forensic Psychiatric Experts and Older Incarcerated Persons From Switzerland

Expert opinions on criminal law cases in Switzerland - an empirical pilot study

BACKGROUND

Criminal courts of law rely on forensic psychiatric/psychological reports when clarifying legal questions of culpability, dangerousness, and the need for therapeutic measures for offenders. Incorrect decisions owing to a lack of expert report quality and comprehensibility can have serious consequences for potential victims, offenders themselves, or societal use of resources. In this pilot study, we started from the hypothesis that forensic psychiatric/psychological reports meet the minimum requirements for legally admissible expert opinions.

METHODS

Within the framework of assessment by the Concordat Expert Commission of Northwestern and Central Switzerland, 58 adult criminal law reports were randomly selected. Two researchers extracted and analyzed standardized data descriptively. For quality assurance, they followed the extended codebook of the Research and Development Department of the Zürich Office of Corrections and Reintegration.

RESULTS

Psychopathological findings accounted for only 1% of the reports, which seemed problematic considering that these findings reflect the personality traits of offenders. Furthermore, only 7% of offenders underwent physical examinations, and the reasons for not performing physical examinations were noted in fewer than half of these offenders. Of 26 sexual offenders, only one was physically assessed. Additional imaging or neurophysiological examinations (e.g. electroencephalogram) were conducted in only one offender. Furthermore, published baseline recidivism rates were used in only 37.9% of the reports.

CONCLUSIONS

The results of this study suggest that current forensic psychiatric assessment is deficient. The infrequent use of published recidivism rates for risk communication denies prosecutors and judges solid reference values for the actual recidivism probability. Moving away from somatic medicine contradicts the federal court judgment, which disqualifies psychologists from providing a forensic report owing to their lack of expertise in physical examination. The authors recommend the multidisciplinary involvement of forensic psychiatrists and psychologists and, in certain cases, of specialists in somatic medicine to produce accurate and well-founded reports.

Dignity, Social Reintegration of Prisoners, and the New Penal Power: European Human Rights, Experiences of Belgian Prisoners, and Professional Practices

Over the last 30 years, prisoners' dignity and fundamental rights have increasingly been protected by European human rights bodies such as the European Court of Human Rights and the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment. This protection is aimed particularly at the traditional power relations between prisoners and uniformed staff. More recently, social reintegration of prisoners has also been recognized by these European human rights standards as a fundamental element of human dignity and an equally important aim of imprisonment as retribution and deterrence. However, it is also accepted that some offenders may be too dangerous to be returned back to society. Psychiatric/psychological assessments are a major element in this decision-making. This "new penal power" receives much less attention in human rights protection. This article compares three intertwining perspectives on this issue: the European human rights perspective on dignity and social reintegration; the experiences and mental suffering of Belgian prisoners who find themselves being stuck in prison as a result of structural problems in the risk assessment and risk management practices; and the professional perspective on how professional standards and good practices based on scientific insights might alleviate some of these threats to human dignity.

Perceptions of collective and other unjust punishment in Swiss prisons: a qualitative exploration

PURPOSE

This paper aims to describe and analyse Swiss prisoners' and experts' views on collective punishment, the practice where a group is punished for one person's transgression.

DESIGN/METHODOLOGY/APPROACH

A series of qualitative interviews with prisoners and stakeholders are reported following thematic analysis.

FINDINGS

Despite being forbidden by the Geneva Convention and other international instruments, participants from this study expressed the view that collective punishment continues to be practiced in some form in prisons in Switzerland, violating the rights of prisoners via unjust and arbitrary decision-making, unjust rules, inequalities in prison structures and continuation of incarceration based on the behaviour of others. Families can also be both victims and vectors of collective punishment, and prolonging the detention of prisoners who would otherwise have been released because of rare high-profile cases of reoffending can also be considered a form of collective punishment.

ORIGINALITY/VALUE

These significant findings suggest that collective punishment in various forms continues to be used in Swiss prisons.

Challenges in providing ethically competent health care to incarcerated older adults with mental illness: a qualitative study exploring mental health professionals' perspectives in Canada

BACKGROUND

The population of incarcerated older adults is the fastest growing demographic in prisons. Older persons in custody have poorer health as compared with those in the community. The unmet and complex health care needs of incarcerated older adults with mental illness raise justice, safety, dignity and fairness in care as ethical concerns. As there exists research gap to better understand these concerns, the current study aimed at exploring the perspectives of mental health professionals on challenges in delivering ethically competent care to mentally ill incarcerated older adults in Canada.

METHODS

Thirty-four semi-structured interviews were conducted between August 2017 and November 2018 with prison mental health professionals in Canada who were selected using purposive and convenience sampling techniques. The audio recorded interviews were transcribed verbatim and analysed inductively to generate themes.

RESULTS

The results were distilled into three main categories and seven subcategories that related to ethical issues in the provision of health care for mentally ill incarcerated older adults. The main categories included imprisoned older persons with special care needs, lack of resources, and the peer-support program.

CONCLUSIONS

Results of this study showed that existing practices of care of mentally ill incarcerated older adults are characterised by challenges that increase their vulnerability to worse health conditions. It is imperative for local authorities, policy makers and representatives to prepare for and respond to the challenges that compromise ethically competent health care for, and healthy ageing of, mentally ill incarcerated older adults.