Sex Differences in Violent Death During Incarceration and Legal Intervention

INTRODUCTION

This study clarifies the differences in death during incarceration and legal intervention between males and females, delineating the differences in demographic features and the circumstances of the violent death including location, injury pattern, and perpetrator.

METHODS

The data used are from the National Violent Death Reporting System database from 2003 to 2019. All victims were either in custody, in the process of custody, or in prison. Sex was coded as female or male and as assigned at birth. All analyses were conducted using SAS 9.4 software using chi-square tests, with an alpha of 0.05 to test significant differences in the circumstances of mortality and demographic characteristics for each group.

RESULTS

Our findings show that suicide was the most common cause of death during incarceration for both females and males (89.8% versus 77.4%; P < 0.001). Homicide was less common in females (1.6% versus 14.8%; P < 0.001) and legal intervention only occurred in males (2.2%; P < 0.001). Male victims were more likely to be of non-White race/ethnicity compared to females, while females were more likely to be experiencing homelessness, have documented mental illness, and comorbid substance abuse.

CONCLUSIONS

Victim sex is significantly associated with circumstances of violent death among the incarcerated and highlights the need for appropriate mental health and substance abuse treatment.

The Supreme Court Expands Second Amendment Rights as the Nation Experiences Historic Levels of Firearms Violence

This Viewpoint discusses the recent Supreme Court decision declaring a broad right to carry firearms in public and offers a public health strategy for firearms safety laws.

Analysis of "Stand Your Ground" Self-defense Laws and Statewide Rates of Homicides and Firearm Homicides

IMPORTANCE

Most US states have amended self-defense laws to enhance legal immunities for individuals using deadly force in public. Despite concerns that "stand your ground" (SYG) laws unnecessarily encourage the use of deadly violence, their impact on violent deaths and how this varies across states and demographic groups remains unclear.

OBJECTIVE

To evaluate the association of SYG laws with homicide and firearm homicide, nationally and by state, while considering variation by the race, age, and sex of individuals who died by homicide.

DESIGN, SETTING, AND PARTICIPANTS

This cohort study used a controlled, multiple-baseline and -location interrupted time series design, using natural variation in the timings and locations of SYG laws to assess associations. Changes in homicide and firearm homicide were modeled using Poisson regression analyses within a generalized additive model framework. Analyses included all US states that enacted SYG laws between 2000 and 2016 and states that did not have SYG laws enacted during the full study period, 1999 to 2017. Data were analyzed from November 2019 to December 2020.

EXPOSURES

SYG self-defense laws enacted by statute between January 1, 2000, to December 31, 2016.

MAIN OUTCOMES AND MEASURES

The main outcomes were statewide monthly rates of homicide and firearm-related homicide (per 100 000 persons) from January 1, 1999, to December 31, 2017, grouped by characteristics (ie, race, age, sex) of individuals who died by homicide.

RESULTS

Forty-one states were analyzed, including 23 states that enacted SYG laws during the study period and 18 states that did not have SYG laws, with 248 358 homicides (43.7% individuals aged 20-34 years; 77.9% men and 22.1% women), including 170 659 firearm homicides. SYG laws were associated with a mean national increase of 7.8% in monthly homicide rates (incidence rate ratio [IRR],1.08; 95% CI, 1.04-1.12; P < .001) and 8.0% in monthly firearm homicide rates (IRR, 1.08; 95% CI, 1.03-1.13; P = .002). SYG laws were not associated with changes in the negative controls of suicide (IRR, 0.99; 95% CI, 0.98-1.01) or firearm suicide (IRR, 1.00; 95% CI, 0.98-1.02). Increases in violent deaths varied across states, with the largest increases (16.2% to 33.5%) clustering in the South (eg, Alabama, Florida, Georgia, Louisiana). There were no differential associations of SYG laws by demographic group.

CONCLUSIONS AND RELEVANCE

These findings suggest that adoption of SYG laws across the US was associated with increases in violent deaths, deaths that could potentially have been avoided.

Why we dehumanize illegal immigrants: A US mixed-methods study

Dehumanization is a topic of significant interest for academia and society at large. Empirical studies often have people rate the evolved nature of outgroups and prior work suggests immigrants are common victims of less-than-human treatment. Despite existing work that suggests who dehumanizes particular outgroups and who is often dehumanized, the extant literature knows less about why people dehumanize outgroups such as immigrants. The current work takes up this opportunity by examining why people dehumanize immigrants said to be illegal and how measurement format affects dehumanization ratings. Participants (N = 672) dehumanized such immigrants more if their ratings were made on a slider versus clicking images of hominids, an effect most pronounced for Republicans. Dehumanization was negatively associated with warmth toward illegal immigrants and the perceived unhappiness felt by illegal immigrants from U.S. immigration policies. Finally, most dehumanization is not entirely blatant but instead, captured by virtuous violence and affect as well, suggesting the many ways that dehumanization can manifest as predicted by theory. This work offers a mechanistic account for why people dehumanize immigrants and addresses how survey measurement artifacts (e.g., clicking on images of hominids vs. using a slider) affect dehumanization rates. We discuss how these data extend dehumanization theory and inform empirical research.

Erasing violence: lesbian women asylum applicants in the United States

Despite growing recognition of sexual orientation- and gender identity-based violence, scholars continue to identify barriers for lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals seeking asylum protection. Lesbian women asylum applicants, in particular, encounter a system that is unsure how to classify their cases and that generally questions the credibility of women's experiences. In this way, lesbian women applicants are among the most vulnerable populations of asylum claimants, particularly in the U.S. context. In this research note, I examine U.S. appellate level Circuit Court cases initiated by lesbian women asylum applicants. I expand existing literature to include an examination of how the violence faced by lesbian women is interpreted and ultimately erased as Circuit Courts grapple with legal interpretations of persecution. Specifically, I find three mechanisms of erasure: ruling that the violence experienced was unextreme, finding that the applicants' accounts of violence were unsubstantiated, or arguing that the violence experienced was unrelated to the applicants' sexual orientation. When placed in historical context, these patterns are troubling. Unlike previous decades that have witnessed overt homophobia, racism, and ethnocentrism in the immigration system, these cases indicate a more subtle form of exclusion-finding technicalities in case law and formal legal definitions as grounds for denial.

Seeking Justice: How VAWA Reduced the Stronghold Over American Indian and Alaska Native Women

The Violence Against Women Act (VAWA), originally passed in 1994, was successfully reauthorized in 2000, 2005, and 2013. Over time, VAWA altered the environment for many victims who had previously suffered in silence. This article focuses on how VAWA impacted American Indian (AI) and Alaska Native (AN) victims of dating and domestic violence. AI and AN women experience these crimes at a rate higher than the national average, yet they are often denied justice due to the interplay of federal and state laws and tribal sovereignty. VAWA affirmed tribes' sovereign authority to exercise criminal jurisdiction over non-Indians who commit crimes against AI and AN victims on tribal lands. This article also discusses future steps to enhance justice reforms.

Risk of COVID-19-related bullying, harassment and stigma among healthcare workers: an analytical cross-sectional global study

OBJECTIVES

Essential healthcare workers (HCW) uniquely serve as both COVID-19 healers and, potentially, as carriers of SARS-CoV-2. We assessed COVID-19-related stigma and bullying against HCW controlling for social, psychological, medical and community variables.

DESIGN

We nested an analytical cross-sectional study of COVID-19-related stigma and bullying among HCW within a larger mixed-methods effort assessing COVID-19-related lived experience and impact. Adjusted OR (aOR) and 95% CIs evaluated the association between working in healthcare settings and experience of COVID-19-related bullying and stigma, controlling for confounders. Thematic qualitative analysis provided insight into lived experience of COVID-19-related bullying.

SETTING

We recruited potential participants in four languages (English, Spanish, French, Italian) through Amazon Mechanical Turk's online workforce and Facebook.

PARTICIPANTS

Our sample included 7411 people from 173 countries who were aged 18 years or over.

FINDINGS

HCW significantly experienced more COVID-19-related bullying after controlling for the confounding effects of job-related, personal, geographic and sociocultural variables (aOR: 1.5; 95% CI 1.2 to 2.0). HCW more frequently believed that people gossip about others with COVID-19 (OR: 2.2; 95% CI 1.9 to 2.6) and that people with COVID-19 lose respect in the community (OR: 2.3; 95% CI 2.0 to 2.7), both which elevate bullying risk (OR: 2.7; 95% CI 2.3 to 3.2, and OR: 3.5; 95% CI 2.9 to 4.2, respectively). The lived experience of COVID-19-related bullying relates frequently to public identities as HCW traverse through the community, intersecting with other domains (eg, police, racism, violence).

INTERPRETATION

After controlling for a range of confounding factors, HCW are significantly more likely to experience COVID-19-related stigma and bullying, often in the intersectional context of racism, violence and police involvement in community settings.

Effectiveness of the Convention on the Rights of the Child in realization of the right to a remedy for Child victims of violence in Africa

BACKGROUND

In spite of the progress achieved over the years since the adoption of the CRC, violence against children (VAC) is still widespread in the African continent. Although some progress has been made in addressing violence through the implementation of the CRC and its use in the courts, there are still gaps particularly in ensuring access to remedies for child victims of violence.

PARTICIPANTS AND SETTING

The strongest factors that impede measures to eliminate VAC in Africa are its broad societal acceptance and weak remedial tools to deal with the issue, including access to justice and assistance to child victims. The article analyses the CRC's implementation and influence on national courts' jurisprudence on VAC in South Africa, Nigeria and Kenya.

OBJECTIVE

The objective of the article' is to provide evidence of the positive impact of the CRC on the right to a remedy for child victims of violence in selected African states, while highlighting existing gaps.

METHODS

Evidence is provided through the CRC reporting process, and the impact of the CRC on national courts in Kenya, Nigeria and South Africa.

RESULTS

Facts and cases of redress for child victims of violence in the three states, as well as roles and paths that the stakeholders undertake, reflect the strength, value, role and influence of the CRC on the recent progress in these states. The law and legal advocacy in the selected African states have proved to be a powerful tool for children.

CONCLUSIONS

There is a need for more evidence and more research on the topic in each African state, so that real impact of the CRC on national remedial activities, as well as its relatedness to the level and types of violence against children is properly evaluated.

Gender differences in the prosecution of police assault: Evidence from a natural experiment in Sweden

States often seek to regulate the use of police force though citizen complaint systems. This paper examines these systems, specifically, whether patterns of bias found in other juridical contexts are mirrored in the adjudication of police assault. The analysis focuses on prosecutors as the first instance of adjudication who determine whether to move forward with investigation, effectively deciding the majority of cases. We ask whether prosecutor sex is associated with the probability that a police assault claim will be investigated. We leverage a natural experiment in Sweden where prosecutors are assigned through a modified lottery system, effectively randomizing appointment. Our findings suggest that prosecutor gender plays a role in judicial outcomes: women prosecutors are 16 percentage points more likely to investigate claims of police assault than their male counterparts. These findings have implications for scholars interested in state human rights abuses, democratic institutions, and judicial inequality.

Judicial perspectives on mental health courts: The role of psychiatric disorder and violence risk

OBJECTIVE

The extent to which psychiatric diagnosis, treatment compliance, and violence risk influenced judges perceived benefits of Mental Health Court ("MHC") for defendants with psychiatric disorders was examined.

METHOD

81 judges completed one vignette in which psychiatric diagnosis (Schizophrenia, Major Depressive Disorder, Posttraumatic Stress Disorder), treatment compliance (yes/no), and violence risk (high/low) were randomized. The online survey was distributed via email and following the vignette, judges answered a question about the appropriateness of MHC.

RESULTS

Judges assessed defendants with severe psychiatric disorders (Schizophrenia and Major Depressive Disorder) - compared to defendants with PTSD - as more likely to benefit from MHCs. If deemed at low treatment compliance and/or high violence risk, judges were unlikely to appraise MHCs as beneficial, regardless of psychiatric diagnosis.

IMPLICATIONS

Judges appear to consider relevant factors when determining whether MHC will benefit defendants with psychiatric disorders; however, future research should include more variables (e.g., addictions, history of violence) to examine the combined influence on judges' perception of MHC suitability.

Incipient offending among schizophrenia patients after first contact to the psychiatric hospital system

The study examines how age, sex and substance use disorder are associated with the risk of committing a criminal offence. The study explicitly examines the risk after the first contact to the psychiatric hospital system and after the diagnosis of schizophrenia for those with no previous criminal record; the association between previous non-violent criminality and later violent criminality is also analysed. The study sample comprised 4619 individuals ever diagnosed with schizophrenia. All solved offences were accessible. Data were analysed using Cox's regression. Schizophrenic men had twice the risk of schizophrenic women of committing both violent and non-violent offences. A registered substance use disorder increased the risk 1.9- to 3.7-fold, depending on the starting point for the analyses, while increasing age on first contact or when diagnosed with schizophrenia diminished the risk. Previous non-violent criminality increased the risk for later violent criminality 2.5- to 2.7-fold, depending on the starting point for the analyses. The results suggest that the psychiatric treatment system can play an active role in preventing criminality among individuals with schizophrenia. The preventive measures should be based on a thorough assessment including criminal history at intake and alertness toward young psychotic men with substance use disorders and especially if they also have a criminal history.

Marshaling administrative data to study the prevalence of mental illness in assault on law enforcement cases

A substantial body of literature has investigated many issues surrounding police encounters with persons with mental illness. This paper focuses on a specific type of encounter - individuals with mental illness charged with assaulting officers because of their behavior during a psychiatric crisis - and uses administrative data to examine its prevalence in one state. Results suggest that individuals with mental health histories comprise a small but meaningful percentage (c. 9%) of assault on law enforcement charges, and c. 10% of these charges have an offense date within 14 days of an emergency mental health custody order, increasing the likelihood that psychiatric symptoms influenced their behavior at the time of the offense. Further results describe different categories of relevant charges, charge classifications, final dispositions, and sentences. Results are discussed in the context of outcomes for persons with mental illness and law enforcement as well as the role and limitations of forensic mental health assessment in these cases. The paper concludes with a call for similar data collection across jurisdictions.

The liability of the doctor and the health authority when the mental health patient is discharged or released on leave or escapes and something goes amiss

This study describes the legal liabilities when the discharged or released on leave patient harms himself or a third party. The nature of the duty of the doctor and the hospital are explained.

Factors Related to Rape Reporting Behavior in Brazil: Examining the Role of Spatio-Temporal Factors

The reporting of rape to police is an important component of this crime to have the criminal justice system involved and, potentially, punish offenders. However, for a number of reasons (fear of retribution, self-blame, etc.), most rapes are not reported to police. Most often, the research investigating this phenomenon considers incident and victim factors with little attention to the spatio-temporal factors of the rape. In this study, we consider incident, victim, and spatio-temporal factors relating to rape reporting in Campinas, Brazil. Our primary research question is whether or not the spatio-temporal factors play a significant role in the reporting of rape, over and above incident and victim factors. The subjects under study are women who were admitted to the Women's Integrated Healthcare Center at the State University of Campinas, Brazil, and surveyed by a psychologist or a social worker. Rape reporting to police was measured using a dichotomous variable. Logistic regression was used to predict the probability of rape reporting based on incident, victim, and spatio-temporal factors. Although we find that incident and victim factors matter for rape reporting, spatio-temporal factors (rape/home location and whether the rape was in a private or public place) play an important role in rape reporting, similar to the literature that considers these factors. This result has significant implications for sexual violence education. Only when we know why women decide not to report a rape may we begin to work on strategies to overcome these hurdles.

A non-discriminatory response to disability related problem behaviour at Australian universities

When students with a psychological disorder study at university, there are competing goals and challenges faced by administrators, teaching staff and students. Positive goals such as inclusion, self-determination and respect for diversity are sometimes counterbalanced by problem behaviour associated with mental illness. The challenge for tertiary institutions is to accommodate the educational needs of students with a psychological disorder, without undermining the inherent requirements of a course of academic study, or the duties that a university owes to staff and students with respect to safe and healthy learning environments. This article considers how the Australian legal system has attempted to find balance between these competing needs and duties, in a way that is respectful to those who study with a psychological disorder.

Call the police immediately: Factors influencing perpetrator arrest time in child abduction cases in South Korea

BACKGROUND

Considering the devastating long-term effects on victims caused by child abduction, a thorough examination of child abduction cases as well as the identification of specific factors determining offender arrest times are required.

OBJECTIVE

The current study aims to better understand the characteristics of child abduction and contribute to improving efficient investigation and rapid offender apprehension.

PARTICIPANTS AND SETTING

The study uses data from investigation and trial records of abduction cases in South Korea from 1997 to 2008. A total of 144 cases of child abductions were analyzed. We investigated the characteristics of victims and offenders and incident characteristics including crime planning, the use of violence, and the time taken to realize that a child was missing, reporting it to the police, and arresting perpetrators.

METHODS

We examined the data by using logistic regression analysis and the gamma generalized linear model.

RESULTS

It took significantly less time to arrest offenders if they had criminal records. The higher the age of the victim, the longer it took for the offender to be arrested. It took longer for the offender to be arrested in parental abduction cases than in non-parental abduction cases, and it took longer to arrest the perpetrator with delayed recognition that a child was missing and delayed police reporting.

CONCLUSIONS

The current findings emphasize the importance of rapid responses following abductions. The study provides strategies to assist with accurate decision making by investigators and fast case resolution through the early arrest of child abductors.

Social Security Administration Violence Evaluation and Reporting System. Final rule

We are issuing a final rule to exempt a system of records entitled Social Security Administration Violence Evaluation and Reporting System (SSAvers) from certain provisions of the Privacy Act because this system will contain investigatory material compiled for law enforcement purposes.

Measuring Attitudes About Hate: Development of the Hate Crime Beliefs Scale

Employing the federal Hate Crimes Prevention Act (HCPA) of 2009 and other such legislation as a backdrop, the present study evaluated the nature of beliefs about hate-crime legislation, offenders, and victims. In addition, it investigated construct validity (i.e., political beliefs and prejudice) and predictive validity (i.e., blame attribution and sentencing recommendations). A total of 403 U.S. adults completed measures of prejudice and an initial pool of 50 items forming the proposed Hate Crime Beliefs Scale (HCBS). Participants were randomly assigned to read one of four hate-crime vignettes, which varied in regard to type of prejudice (racial-, sexual orientation-, transgender-, and religion-based prejudices) and then responded to blame and sentencing questions. Factor analyses of the HCBS resulted in four sub-scales: Negative Views (i.e., higher scores reflect negative views of legislation and minority group protection), Offender Punishment (i.e., higher scores suggest endorsement of greater punishment), Deterrence (i.e., greater scores denote support for hate-crime legislation as a deterrent of more violence), and Victim Harm (i.e., higher scores reflect pro-victim attitudes). Greater pro-legislation and pro-victim beliefs were related to liberal political beliefs and less prejudicial attitudes, with some exceptions. Controlling for a number of demographic, situational, and attitudinal covariates, the Negative Views sub-scale displayed predictive utility, such that more negative views of legislation/minority group protection were associated with elevated victim blame, as well as lower perpetrator blame and sentencing recommendations. Results are discussed in the context of hate-crime research and policy, with additional implications considered for trial strategy, modern prejudice, and blame attribution theory.

Corporal punishment bans and physical fighting in adolescents: an ecological study of 88 countries

OBJECTIVE

To examine the association between corporal punishment bans and youth violence at an international level.

DESIGN

Ecological study of low-income to high-income 88 countries.

SETTING

School-based health surveys of students.

PARTICIPANTS

403 604 adolescents.

INTERVENTIONS

National corporal punishment bans.

PRIMARY OUTCOME MEASURE

Age-standardised prevalence of frequent physical fighting (ie, 4+ episodes in the previous year) for male and female adolescents in each country.

RESULTS

Frequent fighting was more common in males (9.9%, 95% CI 9.1% to 10.7%) than females (2.8%, 95% CI 2.5% to 3.1%) and varied widely between countries, from 0.9% (95% CI 0.8% to 0.9%) in Costa Rican females to 34.8% (95% CI 34.7 to 35.0) in Samoan males. Compared with 20 countries with no ban, the group of 30 countries with full bans (in schools and in the home) experienced 69% the rate of fighting in males and 42% in females. Thirty-eight countries with partial bans (in schools but not in the home) experienced less fighting in females only (56% the rate found in countries without bans).

CONCLUSIONS

Country prohibition of corporal punishment is associated with less youth violence. Whether bans precipitated changes in child discipline or reflected a social milieu that inhibits youth violence remains unclear due to the study design and data limitations. However, these results support the hypothesis that societies that prohibit the use of corporal punishment are less violent for youth to grow up in than societies that have not.

A retrospective cohort study describing the characteristics of patients under 18 years old in one section 136 suite

Section 136 of the Mental Health Act 1983 is an authority allowing police officers to remove a person 'who appears to him to be suffering from mental disorder' from a public area. There has been much media coverage regarding the inappropriate detention of minors under section 136 and the suggestion that many were taken to police cells, as there were no suitable places of safety. Although previous studies describe characteristics of a typical individual detained under section 136, few distinguish the differences between adults and adolescents. Profiling these adolescents can help to identify adolescents at risk, allowing for earlier intervention and prevent the inappropriate detention of individuals. Data were collected retrospectively for all patients under 18 years of age who were brought to a section 136 suite in south-west London over a five-year period. The typical profile of an adolescent presenting to this suite was a 16-year-old female of white ethnicity who was sectioned in a public area due to attempted suicide or deliberate self-harm. The individual is more likely to have mental or behavioural difficulties, a history of abuse, be under the care of local authorities and have had previous convictions compared to adolescents in the general population.

More legislation, more violence? The impact of Dodd-Frank in the DRC

The Dodd Frank Act was passed by the US Congress in July 2010 and included a provision—Section 1502—that aimed to break the link between conflict and minerals in the Eastern Democratic Republic of Congo. To date there is only one rigorous quantitative analysis that investigates the impact of Dodd-Frank on local conflict events. Looking at the short-term impact (2011–2012), it finds that the policy backfired. This study builds on a larger, more representative, dataset of mining sites and extends the time horizon by three years (2013–2015). The results indicate that the policy also backfired in the longer run, especially in areas home to gold mines. For territories with the average number of gold mines, the introduction of Dodd-Frank increased the incidence of battles with 44%; looting with 51% and violence against civilians with 28%, compared to pre-Dodd Frank averages. Delving deeper into the impact of the conflict minerals legislation is important, as President Trump suspended the legislation in February 2017 for a two-year period, ordering his administration to replace it with another policy.

A Study of the Impact of Screening for Poly-Victimization in Juvenile Justice: The Rocky Road to a Successful Investigation in the Real World

Poly-victimization during formative developmental periods represents an important focus for screening and assessment in settings and populations in which interpersonal violence is pervasive. This article describes the multistage evolution of a research project designed to empirically test a poly-victimization enhancement of a widely used and validated behavioral health screening tool for youth using retrospective and prospective archival juvenile justice system outcome data. Several operational and methodological revisions to the project's design and procedures were necessitated by barriers that arose as a result of unforeseen shifts in the host juvenile justice system's policies and personnel. The present report describes real-world challenges that face investigators working in public sector systems, and highlights the key role of establishing long-term collaborative professional relationships with personnel at all levels in those systems based on providing services and evaluation data that meet the system's core goals, responsibilities, and mission. Also highlighted are the methodological and logistical adaptations needed to successfully accomplish a project's internal objectives while striking a balance between flexibility in operational and methodological tactics on one hand, and adherence to ethical, conceptual/clinical, and methodological principles on the other hand.

The burden of firearm violence in the United States: stricter laws result in safer states

BACKGROUND

Increasing firearm violence has resulted in a strong drive for stricter firearm legislations. Aim of this study was to determine the relationship between firearm legislations and firearm-related injuries across states in the United States.

METHODS

We performed a retrospective analysis of all patients with trauma related hospitalization using the 2011 Nationwide Inpatient Sample database. Patients with firearm-related injury were identified using E-codes. States were dichotomized into strict firearm laws [SFL] or non-strict firearm laws [Non-SFL] states based on Brady Center score. Outcome measures were the rate of firearm injury and firearm mortality. Linear Regression and correlation analysis were used to assess outcomes among states.

RESULTS

1,277,250 patients with trauma related hospitalization across 44 states were included of which, 2,583 patients had firearm-related injuries. Ten states were categorized as SFL and 34 states as Non-SFL. Mean rate of firearm related injury per 1000 trauma patients was lower in SFL states (1.3±0.5 vs. 2.1±1.4; p=0.006) and negatively correlated with Brady score (R2 linear=-0.07; p=0.04). SFL states had a 28% lower incidence of firearm related injuries compared to Non-SFL states (Beta coefficient, -0.28; 95% CI, -1.7- -0.06; p=0.04). Firearm related mortalities resulted in overall 9,722 potential life years lost and more so in the non-SFL states (p=0.001).

CONCLUSIONS

States without SFL have higher firearm related injury rates, higher firearm related mortality rate, and significant potential years of life lost compared to SFL states. Further analysis of differences in the legislation between SFL and non-SFL states may help reduce firearm related injury rate.

The State of Physical Injury and Serious Physical Injury in New York Criminal Law

The terms "physical injury" and "serious physical injury" are key elements of proof in assault cases in New York; the applicability of each element depends on the degree, or severity, of the crime. Jurisprudence in this area continues to evolve, as it is often very fact-specific, and the interpretation of what constitutes a physical injury or serious physical injury varies by the court considering individual cases. This article reviews recent New York cases in this area, and highlights, where applicable, the differences in outcome among the judicial departments in their treatment of physical injury and serious physical injury as elements of assault in New York criminal law.

A Violent Birth: Reframing Coerced Procedures During Childbirth as Obstetric Violence

In the United States, women are routinely forced to undergo cesarean sections, episiotomies, and the use of forceps, despite their desire to attempt natural vaginal delivery. Yet, the current American legal system does little to provide redress for women coerced to undergo certain medical procedures during childbirth. Courts and physicians alike are prepared to override a woman's choice of childbirth procedure if they believe this choice poses risks to the fetus, and both give little value to the woman's right to bodily autonomy. This Note proposes a solution for addressing the problem of coerced medical procedures during childbirth by importing a framework created in Venezuela and Argentina that characterizes this issue as "obstetric violence." First, this Note contains an overview of the shortcomings of the existing American legal framework to address the problem. Second, it explains the advantages of the obstetric violence framework and argues that its adoption in the United States would address many of the failures of the existing system. And third, this Note introduces a few legislative and litigation strategies that can be used to implement this framework in the United States and briefly addresses some of the challenges these strategies may pose.

Mens Rea and Methamphetamine: High Time for a Modern Doctrine Acknowledging the Neuroscience of Addiction

In American criminal law, actus non facit reum, nisi mens sit rea, "an act does not make one guilty, without a guilty mind." Both actus reus and mens rea are required to justify criminal liability. The Model Penal Code's (MPC) section on culpability has been especially influential on mens rea analysis. An issue of increasing importance in this realm arises when an offensive act is committed while the actor is under the influence of drugs. Several legal doctrines address the effect of intoxication on mental state, including the MPC, limiting or eliminating its relevance to the mens rea analysis. Yet these doctrines do not differentiate between intoxication and addiction. Neuroscience research reveals that drug addiction results in catastrophic damage to the brain resulting in cognitive and behavioral deficits. Methamphetamine addiction is of particular interest to criminal law because it causes extensive neural destruction and is associated with impulsive behavior, violent crime, and psychosis. Furthermore, research has revealed important distinctions between the effects of acute intoxication and addiction. These findings have implications for the broader doctrine of mens rea and, specifically, the intoxication doctrines. This Note argues for the adoption of an addiction doctrine that acknowledges the effect of addiction on mens rea that is distinct from doctrines of intoxication.

[The risk of reoffending, a major concern of the doctor-coordinator]

Doctor-coordinators are nominated by the judge for the enforcement of sentences as soon as socio-judicial supervision with court-ordered therapy is to be implemented. Their mission is to facilitate the contact between offenders and the general practitioner likely to be working with them on the therapeutic level. The experience of the doctor-coordinator in Bordeaux sheds light on the conditions in which this function is performed. Identifying elements which may be considered as indicators of the risk of reoffending is, in daily practice, a constant concern for this specialist.

Treating Aggression in Forensic Psychiatric Settings

Forensic psychiatric units are high-risk environments for aggressive behavior. Many elements are necessary for the successful reduction or elimination of aggression in the process of creating a safe treatment environment. Many specific interventions have been attempted over the years with various degrees of, usually limited, success. Tolisano et al. present an integrated behavioral approach with solid theoretical underpinnings and opportunities to support significant safety improvements for select patients, albeit with several caveats.

Critical incidents and judicial response during medium security treatment

This study examined inpatient incidents in three Flemish forensic medium security units and analyzed the subsequent judicial reactions to these incidents. During medium security treatment, incidents were reported for more than half of the participants. The most frequently registered incidents were non-violent in nature, such as absconding and treatment non-compliance. The base rate for physically violent incidents was low. Although crime-related incidents during medium security treatment were rarely prosecuted and adjudicated, the base rate of revocation - and hence drop-out from treatment - as a result of these incidents was high.

[Treating patients on the court-ordered therapy programme]

Psychologists and a psychiatrist testify to the clinical condition of people sentenced to socio-judicial supervision with court-ordered therapy. Despite the extension of the indication of the programme, this complex supervision often concerns the perpetrators of intra and/or extra familial sexual abuse. Preventing reoffending through the global treatment of the patient is a major concern both for the doctor-coordinators as well as the doctor and psychologists delivering the therapy.

[The interaction between the judge and doctors with court-ordered therapy]

Faced with the increase in convictions for sex offences, legislators in the 1990s studied the possibility of monitoring these criminals and offenders, considered to be among the most dangerous, following their imprisonment. This resulted in the law of 17th June 1998, establishing socio-judicial supervision. Inspired by several high-profile cases, the resulting changes to the legislation have reinforced judicial measures aimed at preventing repeat offending with regard to the most serious crimes. Socio-judicial supervision in particular is routinely ordered as part of certain safety measures while court-ordered therapy has become a cornerstone in the management of the most dangerous prisoners. An analysis of the connection between the judge and court-ordered therapy enables its role to be better understood.

Agents of the Father's law in a society of brothers: A philosophic and psychoanalytic perspective on legitimate use of violence

This paper explores subjective processes of "Agents of Law" - individuals who the state grants the authority to use violence - and the dissonance stemming from the contradictory demands posed on them as legitimate users of violence despite the societal taboo against violence. A conceptual model will be offered based on two theoretical legs, Lacanian psychoanalysis and political theories of legitimacy. Specifically, psychoanalytic ideas would serve to examine unconscious processes, subject position and various identifications related to the question of "self-legitimacy" of Agents of Law. A central link between psychoanalysis and political thought is found in the image of the father and in the triad ruler-God-Father, which calls for an oedipal analysis. A psychoanalytic reading of two philosophical schools that elaborated on the question of legitimacy will be presented, and yield two analytic poles of a model for the understanding of possible subject positions of agents of Law: identification with a "Living Father" vs. identification with a "Dead Father". The psychoanalytic reading will shed light on the limitations of the philosophical perspectives in reflecting on the various (im)possible psychological positions of agents of Law. Finally, then, it will be shown how psychoanalysis helps finding words to characterize different nuances in the coping of agents of Law with the contradictory demands posed on them in an age in which God is dead, the father was murdered and the king was beheaded.

A Positive Behavioral Approach for Aggression in Forensic Psychiatric Settings

Aggression toward self and others by complex patients admitted to forensic psychiatric settings is a relatively common yet extremely difficult behavior to treat. Traditional interventions in forensic inpatient settings have historically emphasized control and management over treatment. Research over the past several years has demonstrated the value of behavioral and psychosocial treatment interventions to reduce aggression and to increase prosocial skill development in inpatient forensic population. Positive behavioral support (PBS) offers a comprehensive approach that incorporates the science of applied behavioral analysis (ABA) in support of patients with challenging behaviors, including aggression and violence. In this article, we describe a PBS model to treat aggression in forensic settings. PBS includes a comprehensive functional assessment, along with four basic elements: ecological strategies, positive programming, focused support strategies, and reactive strategies. Other key components are described, including data collection, staff training, fidelity checks to ensure correct implementation of the plan, and ongoing monitoring and revision of PBS strategies, according to treatment outcomes. Finally, a behavioral consultation team approach within the inpatient forensic setting is recommended, led by an assigned doctoral-level psychologist with specialized knowledge and training in behavioral methods. The behavioral consultation team works directly with the unit treatment team and the identified patient to develop, implement, and track a plan that may extend over several weeks to several months including transition into the community. PBS can offer a positive systemic impact in forensic inpatient settings, such as providing a nonpharmacologic means to address aggression, reducing the incidences of restraint and seclusion, enhancing staff proficiency in managing challenging patient presentations, and reducing recidivism when used as part of the bridge to community re-entry.

["Even the best law will never replace reflection in the field"]

Implemented in 2006 by the French minister for health, the resource centres for people working with sex offenders (CRIAVS) provide support for professionals and non-professionals, concerned with transgressive sexual behaviour. They offer tools for legal, health and social professionals to facilitate the supervision of sex offenders. Florent Cochez, a psychiatrist and medical examiner, manager of the Aquitaine CRIAVS, describes in this interview the missions of these regional structures, their link with court-ordered therapy and his practice.

MPs to debate violence in NHS

Parliament is set to debate whether the law should be changed to make attacks on NHS staff a criminal offence.

Cultural considerations in forensic psychiatry: The issue of forced medication

There has been an ongoing debate regarding the forced use of antipsychotic medications and both the psychiatric and legal professions have reacted strongly to the growing debate. Within the penological context, cases such as Washington v. Harper, Riggins v. Nevada, and Sell v. United States established the framework for determining when antipsychotic medication may be forcibly administered. Medication decisions under the Sell and Riggins cases are to be approved at judicial hearings; whereas, administrative hearings are sufficient for Harper cases. Forensic psychiatrists are also given responsibility in making the legal decision of whether or not to forcibly treat a patient with psychotropic medication against his will. In making this critical decision, a significant factor that is often minimized is the cultural background of the patient. The purpose of this paper is to present cultural factors to be considered in forced medication. Focusing on the culture defense argument, a review of how the legal system has dealt with cultural implications of a case will be presented. This paper will then discuss cultural issues embedded in the assessment, diagnosis, and treatment of psychiatric patients by forensic psychiatrists who are called upon to make the decision of whether or not to force medicate a patient against his will. Lastly, recommendations and a framework for providing a culturally sensitive assessment during the decision to forcibly medicate a patient with psychotropic medication will be offered.

A 3-year follow-up study of Swedish youths committed to juvenile institutions: Frequent occurrence of criminality and health care use regardless of drug abuse

This 3-year follow-up study compares background variables, extent of criminality and criminal recidivism in the form of all court convictions, the use of inpatient care, and number of early deaths in Swedish institutionalized adolescents (N=100) with comorbid substance use disorders (SUD) and Attention-Deficit/Hyperactivity Disorder (ADHD) (n=25) versus those with SUD but no ADHD (n=30), and those without SUD (n=45). In addition it aims to identify whether potential risk factors related to these groups are associated with persistence in violent criminality. Results showed almost no significant differences between the three diagnostic groups, but the SUD plus ADHD group displayed a somewhat more negative outcome with regard to criminality, and the non-SUD group stood out with very few drug related treatment episodes. However, the rate of criminal recidivism was strikingly high in all three groups, and the use of inpatient care as well as the number of untimely deaths recorded in the study population was dramatically increased compared to a age matched general population group. Finally, age at first conviction emerged as the only significant predictor of persistence in violent criminality with an AUC of .69 (CI (95%) .54-.84, p=.02). Regardless of whether SUD, with or without ADHD, is at hand or not, institutionalized adolescents describe a negative course with extensive criminality and frequent episodes of inpatient treatment, and thus requires a more effective treatment than present youth institutions seem to offer today. However, the few differences found between the three groups, do give some support that those with comorbid SUD and ADHD have the worst prognosis with regard to criminality, health, and untimely death, and as such are in need of even more extensive treatment interventions.

Conforming STOP Violence Against Women Formula Grant Program Regulations to Statutory Change; Definitions and Confidentiality Requirements Applicable to All OVW Grant Programs. Final rule

This rule amends the regulations for the STOP (ServicesTrainingOfficersProsecutors) Violence Against Women Formula Grant Program (STOP Program) and the general provisions governing Office on Violence Against Women (OVW) programs to comply with statutory changes and reduce repetition of statutory language. Also, this rule implements statutory requirements for nondisclosure of confidential or private information relating to all OVW grant programs.

Behaviour that underpins non-pathological criminal incapacity and automatism: Toward clarity for psychiatric testimony

Psychiatric expert testimony is challenging in cases of violence when the accused person submits a defence that he or she was so overwhelmed by emotions triggered by an upsetting event that his or her violent behaviour was an uncontrollable consequence of the emotions. This defence is usually presented in terms of an automatism particularly not attributed to a mental disorder. Clouding testimony in these cases is the various definitions of both automatism and mental disorder-definitions by which the jurisprudential distinction is made between a sane and an insane automatism, or pathological and non-pathological incapacity (NPCI). To avert testimony that is tainted from the very beginning by the lack of agreed definitions, this article proposes that psychiatrists focus in their assessment and testimony on particularly the behaviour as being distinct from the jurisprudential concerns whether that behaviour constitutes an automatism and whether it is (not) attributed to a mental disorder. This focus on the behaviour affords clarity by which the properties of the behaviour may be examined theoretically and clinically in terms of behaviour therapy, specifying accordingly its antecedents, consequences, topography, intensity, latency, duration, frequency, and quality. So informed, the behaviour that underpins NPCI and automatism is described here as emotionally triggered involuntary violent behaviour about which testimony may be given distinct from whether the behaviour is (not) causally attributed to a mental disorder, and from jurisprudential concerns with accountability.

Reconviction and revocation rates in Flanders after medium security treatment

AIM

To examine the criminal outcome of Flemish forensic psychiatric patients ('internees') after medium security treatment. Also, the effect of conditional release on recidivism of two subgroups (internees under conditional release and internees who received unconditional release) was examined.

METHOD

Reconviction rates and revocation rates were collected for all participants. Kaplan-Meier survival analyses were used to investigate recidivism rates while controlling for time at risk.

RESULTS

During the 10-year period, 502 offenders were discharged from medium security treatment. Over a follow-up period averaging 3.6years, 7.4% of discharged patients were reconvicted or received a new 'not guilty by reason of insanity' (NGRI) verdict for a violent offence. One-quarter of the population had their conditional release revoked. Part of the study population was granted unconditional release. Reconviction rates were higher after unconditional release in comparison to conditional release.

CONCLUSIONS

The results of this study suggest that the court supervision of NGRI patients in Flanders is effective in protecting the community from further offending.

Older offenders deemed criminally irresponsible in Flanders (Belgium): Descriptive results from a retrospective case note study

INTRODUCTION

In Belgium, offenders who are deemed criminally irresponsible for their criminal actions because of mental illness or intellectual disability are subject to a specific safety measure with the dual objective of protecting society and providing mandated care to the offender. While Belgian law requires that offenders who are deemed criminally irresponsible should be in a hospital, clinic or other appropriate institution outside of prison, in practice, about one-third of all such offenders still reside in prison. Whether imprisoned or living in settings outside prison, there is a dearth of knowledge on the characteristics of the aging population among the criminally irresponsible offenders.

OBJECTIVE

This paper aimed to explore the characteristics of older offenders categorized as criminally irresponsible in Flanders (northern Belgium) with a focus on the differences between imprisoned older offenders deemed criminally irresponsible and their peers who are residing outside prison.

METHOD

A retrospective case note study of all offenders deemed criminally irresponsible, >60years of age (n=174), was conducted in the four Commissions of Social Defense, which implement the procedure in the case of those deemed criminally irresponsible in Flanders. The files were screened for (1) demographic characteristics, (2) criminal history as well as (3) mental and physical health issues.

RESULTS

One-fourth of the population were >70years of age. A total of 30.5% were in prison. Compared to their non-imprisoned peers, the imprisoned offenders had a history of having committed more serious violent crimes towards persons, such as homicides and sexual crimes. In addition, imprisoned older offenders categorized as criminally irresponsible are characterized more explicitly by personality traits that are likely to reduce their chances of being transferred to more appropriate settings in the community.

IMPLICATIONS

A comprehensive and systematic screening of all older offenders deemed criminally irresponsible with regard to health needs and social functioning, including age-related deterioration, alcoholism, and other causes of social disadvantages, is warranted to detect potentially hidden problems.

Workplace psychological harassment: Gendered exposures and implications for policy

This article reports on the results of an empirical study of working conditions including psychological harassment (workplace bullying) in the province of Québec, Canada, the first North American jurisdiction to regulate psychological harassment in its labor legislation. All empirical data provided in this article was drawn from the Québec Survey on Working, Employment and Occupational Health and Safety Conditions, conducted through 5071 telephone interviews of a representative sample of Québec workers, including the self-employed. Here we focus on employees, and provide bivariate and multivariate analyses. All analyses were stratified by gender. We provide a portrait of exposure to psychological harassment, and exposure to other psychosocial factors in the workplace associated with exposure to psychological harassment. Results show associations between exposure to psychological harassment and negative health measures including psychological distress, symptoms of depression, traumatic work accidents, musculoskeletal disorders and negative perception of health status. We report on steps taken by employees to put an end to the harassment. Gender similarities and differences in exposure, associated risk factors, health measures and strategies are presented and discussed in light of the legal context in which the study took place. We conclude with recommendations for prevention strategies that take into consideration the gender composition of the workplace.

Victim Responses to Violence: The Effect of Alcohol Context on Crime Labeling

The labeling of an incident as a crime is an essential precursor to the use of criminal law, but the contextual factors that influence this decision are unknown. One such context that is a frequent setting for violence is the barroom. This study explored how the setting of a violent incident is related to the decision by victims to label it as a crime. It tested the hypothesis that violent incidents that took place in or around a licensed premises were less likely to be regarded as crimes than violence in other settings. The hypothesis was tested using a pooled sample of respondents from successive waves of the British Crime Survey (2002/2003-2010/2011). Logistic regression models controlled for demographic factors, victim behavioral characteristics, and incident-specific factors including the seriousness of the violence. Respondents who were in or around a licensed premises at the time of victimization were less likely to regard that violence as a crime (adjusted odds ratio = 0.48, 95% confidence intervals [CIs] = [0.34, 0.67]) than respondents who were victimized in other locations. Despite a disproportionate amount of violence taking place in barrooms, it appears that the criminal nature of violence in these spaces is discounted by victims. The findings emphasize how context affects victim interpretations of crime and suggest a victim-centered reconceptualization of the "moral holiday" hypothesis of alcohol settings.

Projecting Risk: The Importance of the HCR-20 Risk Management Scale in Predicting Outcomes with Forensic Patients

The present study evaluates data from 116 forensic inpatients who underwent violent risk assessments, which included the Historical, Clinical, Risk-20 (HCR-20), from 2006 to 2013 as part of an opportunity to be conditionally discharged from state forensic facilities. Of the 116 inpatients, 58 were never released, 39 were released and returned to a hospital, and 19 were released and never returned. Results from analyses of variance and multinomial logistic regression found the risk management (R) scale of the HCR-20 successfully predicted group membership in that higher scores were associated with a greater likelihood of not being released from a forensic facility or returning to a forensic facility after release. The results of this study indicate that clinicians should consider community-based risk variables when evaluating forensic patients for potential return to the community. This research demonstrates that clinicians failing to fully consider dynamic risk factors associated with community integration jeopardize the quality and thoroughness of their violence risk assessment with regards to readiness for release. Copyright © 2016 John Wiley & Sons, Ltd.

[Forensic assessments from the Netherlands Institute of Forensic Psychiatry and Psychology in retrospect; applications of genetics and neuroscience, in 2000 and 2009]

BACKGROUND

Developments in neurosciences and genetics are relevant for forensic psychiatry.

AIM

To find out whether and how genetic and neuroscientific applications are being used in forensic psychiatric assessments, and, if they are, to estimate to what extent new applications will fit in with these uses.

METHOD

We analysed 60 forensic psychiatric assessments from the Netherlands Institute of Forensic Psychiatry and Psychology, Pieter Baan Center, and 30 non-clinical assessments from 2000 and 2009.

RESULTS

We found that (behavioral) genetic, neurological and neuropsychological applications played only a modest role in forensic psychiatric assessment and they represent different phases of the implementation process. Neuropsychological assessment already occupied a position of some importance, but needed to be better integrated. Applications from neurology were still being developed. Clinical genetic assessment was being used occasionally in order to diagnose a genetic syndrome with behavioral consequences.

CONCLUSION

If further validated information becomes available in the future, it should be possible to integrate new research methods more fully into current clinical practice.