International Journal of Law and Psychiatry最新文献

The present study surveyed judges to examine how they consider and apply scientific information during sentencing determinations. Judges in criminal courts are increasingly asked to assess and make decisions based on evidence surrounding psychiatric disorders, with unclear results on sentencing outcomes. We qualitatively interviewed 34 judges who have presided over criminal cases in 16 different states and also administered vignette surveys during the interviews. We asked them to make sentencing decisions for hypothetical defendants in cases presenting evidence of either no psychiatric disorder, an organic brain disorder, or past trauma, as well as to rate the importance of different goals of sentencing for each case. Results indicated that the case presenting no evidence of a mental health condition received significantly more severe sentences as compared to either psychiatric condition. Judges' ratings of sentencing goals showed that the importance of retribution was a significant mediator of this relationship. Trauma was not deemed to be as mitigating as an organic brain disorder. These results provide unique insights into how judges assess cases and consider sentencing outcomes when presented with scientific information to explicate defendants' behavior. We propose ways forward that may help better integrate scientific understandings of behavior into criminal justice decision-making.

Child justice systems are specialized jurisdictions set up for the purpose of providing justice related services to children. In an effort to resolve many of the systemic injustices expereinced by justice involved children, Kenya recently legislated the Children Act 2022. This new law is viewed as a paradigm shift from previous children acts as it incorporates constitutional provisions, UN conventions, minimum rules and other international protocols that Kenya is a state party to. The Act seeks to transform the child justice system into a jurisdiction which is more amenable to prioritising the mental wellbeing of children. The current study sought to examine the practices applied by state child justice agencies and whether these were therapeutic or non- therapeutic. This would clarify areas where the Act may need to be amended or reviewed to further its own goals. The findings revealed that the most non-therapeutic procedures centred on the courtroom such as the formal court environment and children facing perpetrators in court as well as limited access to mental health services. Therapeutic practices included ensuring children access treatment, use of child friendly interviewing techniques and testifying in camera. These may guide justice actors as to how they apply the Children Act 2022 within their own contexts whilst developing rules and standards that embody the principles of therapeutic jurisprudence.

The number of women involved with forensic mental health systems internationally is rising, however, limited research has explored the characteristics of those assessed for criminal responsibility. We investigated the demographic, psychiatric, and criminological characteristics of women recommended as eligible or ineligible for the defence of Not Criminally Responsible (NCR) on account of mental disorder following a criminal responsibility assessment in Central Canada. Data were collected through retrospective chart reviews of court-ordered criminal responsibility assessments for 109 women referred for evaluations between 2003 and 2019. Accused were an average age of 34.55 years, predominately identified as Indigenous (37.7%) or Caucasian (20.8%), and had often been charged with assault (47.7%). Women identified in the reports as NCR-eligible were significantly more likely to be employed, experience delusions during the index offence, and have expert reports linking their mental health symptoms to NCR legal criteria. They were also significantly less likely to have a personality disorder, substance-related diagnosis, or have used substances during the index offence. Delusions during the index offence significantly predicted assessment recommendations when controlling for age at assessment order, current substance-related diagnosis, and whether the expert report linked mental health symptoms to NCR legal criteria. Findings indicate the key factors considered by forensic mental health professionals when conducting criminal responsibility assessments with women. Meaningful differences exist between women identified as NCR-eligible and ineligible, with findings illustrating who may be more likely to receive services within the Canadian forensic mental health system.

This study aimed to investigate the double mediation effect of entrapment and anger, as well as the moderated mediation effect of psychological flexibility and self-compassion on the relationship between the forensic psychiatric hospital ward climate and reactive aggression perceived by patients. A self-reporting method was used to measure ward climate, entrapment, anger, reactive aggression, psychological flexibility, and self-compassion in a sample of 246 participants being treated at the National Forensic Psychiatric Hospital. The relational model was verified according to the structural equation model analysis, and the double mediation effect of the conditional process model was verified using a Process macro. The results showed that both the simple mediation effect and the double mediation effect of entrapment and anger were statistically significant. Psychological flexibility significantly moderated the relationship between ward climate and entrapment, ward climate and anger-in, and significantly influenced the reduction of reactive aggression. When psychological flexibility was higher, ward climate did not cause entrapment, and the intensity of anger-in and reactive aggression was reduced. Self-compassion significantly reduced entrapment, and the higher the self-compassion, the lesser the entrapment. Finally, psychological flexibility and self-compassion moderated the indirect effect through entrapment and the indirect effect through anger-in on the relationship between the ward climate and reactive aggression. Hence, the moderated mediation effect by psychological flexibility and self-compassion was confirmed. To conclude our study, its limitations are outlined, and practical therapeutic intervention for preventing reactive aggression in forensic hospital patients is discussed.

Background

In 2019, the Council of Europe agreed to urge member states to take steps toward total abolition of psychiatric coercive measures.

Aims

To test if this aspiration is perceived as realistic and what the alternative would be in the event of a total abolition, we surveyed members of the European FOSTREN network of mental health practitioners and researchers, which is specifically dedicated to exchanging knowledge on reducing psychiatric coercion to its minimum.

Methods

Web-based survey. Categorical responses were analyzed using frequencies, and free text responses were analyzed through thematic analysis.

Results

In total, out of 167 invitations to FOSTREN network members, 76 responded to the survey (Response Rate 45.5%). A minority (31%) of participating experts dedicated to the reduction of psychiatric coercive measures believed a total abolition to be an achievable goal. A commonly held belief was that total abolition is not achievable because mental health disorders are difficult to treat and may cause violence, necessitating coercion, and there is a need to protect the involved persons from harm. Those responding that complete abolition is achievable argued that the consequences of coercion outweigh any gains and indicated that use of advance directives are sufficient as alternatives to coercion.

Conclusion

Of a European group of experts specifically dedicated to the reduction of psychiatric coercion who participated in this questionnaire study, a minority believed a total abolition be an achievable goal. The study adds to the empirical evidence of the feasibility of the aspiration to totally abolish involuntary measures in the mental health services from the perspective of experts.