Assessing the Risk of Inpatient Violence in Autism Spectrum Disorder.
Authors: Girardi A, Hancock-Johnson E, Thomas C, Wallang PM Abstract The Historical Clinical and Risk Management scale (HCR-20) is a structured clinical judgment tool used to assess risk of violence in secure settings. But the scale does not account for difficulties typical of patients with autism spectrum disorder, which are thought to contribute to their engagement in violent behaviors. The present study is a preliminary investigation of the association between risk assessment and physical and verbal violence in patients with autism spectrum disorder in a secure psychiatric hospital. Scores from the third version...
Source: Journal of the American Academy of Psychiatry and the Law - September 28, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Effectiveness of Police Crisis Intervention Training Programs.
This article describes the CIT model and reviews several recent systematic analyses of studies concerning the effects of CIT. Studies generally support that CIT has beneficial officer-level outcomes, such as officer satisfaction and self-perception of a reduction in use of force. CIT also likely leads to prebooking diversion from jails to psychiatric facilities. There is little evidence in the peer-reviewed literature, however, that shows CIT's benefits on objective measures of arrests, officer injury, citizen injury, or use of force. PMID: 31551327 [PubMed - as supplied by publisher] (Source: Journal of the American A...
Source: Journal of the American Academy of Psychiatry and the Law - September 27, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Problem-Solving Court Policies on Cannabis Use.
This article reviews implications of cannabis use for defendants' eligibility and participation in problem-solving courts, with a focus on adult drug courts and mental health courts. This article also examines a range of policies, such as abstinence-based, tolerance-based, and adaptive approaches, that problem-solving courts may consider implementing. Further research is needed to characterize existing problem-solving court policies toward cannabis use and to develop evidence-based practices that courts may follow. PMID: 31533992 [PubMed - as supplied by publisher] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - September 21, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Evaluating Intellectual Disability After the Moore v. Texas Redux.
This article reviews the history of the U.S. Supreme Court's rulings on intellectual disability in capital cases, highlighting the difficulty states have had in devising a workable definition that meets constitutional standards. The Court's decisions in Penry v. Lynaugh (1989), Atkins v. Virginia (2002), and Hall v. Florida (2014) are briefly summarized. Next, the Texas Court of Criminal Appeals' ruling in Ex parte Briseno (2004) is discussed as a prelude to the Supreme Court's decision in Moore v. Texas I (2017). On remand, the Texas Court of Criminal Appeals interpreted the Supreme Court's Moore I ruling in a manner that...
Source: Journal of the American Academy of Psychiatry and the Law - September 21, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Passive Monitoring of Mental Health Status in the Criminal Forensic Population.
This article reviews the approaches to and limitations of psychiatric assessment and contrasts this with the promise of these new technologies. It then discusses the ethics concerns associated with these technologies and explores their potential relevance to criminal forensic psychiatry and the broader implications they carry for health and criminal justice policy. PMID: 31533994 [PubMed - as supplied by publisher] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - September 21, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Long-Acting Injectable Versus Oral Antipsychotics for Restoration of Competency to Stand Trial.
Authors: Ghossoub E, Minchin S, Hayreh D, Newman WJ Abstract Treatment with antipsychotics is a mainstay of trial competency restoration, particularly given that most defendants deemed incompetent to stand trial have psychotic illnesses. We explored the association between competency restoration and antipsychotic type in a retrospective sample of defendants diagnosed with psychotic disorders and deemed incompetent to stand trial. Using regression models, we calculated the odds ratio of being competent to stand trial, adjusting for relevant confounders. We found that the use of long-acting injectable antipsychotics ...
Source: Journal of the American Academy of Psychiatry and the Law - September 21, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Effect of Delays in Civil Commitment Hearings on Outcomes Among Psychiatric Inpatients.
Authors: Kious BM, Dobias L, O'Connell PH Abstract Patients admitted involuntarily to psychiatric hospitals may face waits of varying lengths before receiving civil commitment hearings. We aimed to assess the effects of the time spent awaiting a hearing on outcomes for such patients in a university health system, hypothesizing that patients with a longer prehearing length of stay (LOS) would also have increased LOS after their hearings. We included subjects who were admitted from January 1 through December 31, 2013, and had county court records of commitment hearings. Models for each outcome were constructed using ...
Source: Journal of the American Academy of Psychiatry and the Law - September 20, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Prescribing for Women in Corrections.
Authors: Friedman SH, Tamburello AC, Kaempf A, Hall RCW Abstract Prescribing for women in jails and prisons requires special consideration and should be informed by extant evidence. Incarcerated women have higher rates of mental illness than both females in the community and incarcerated men. Medication administration concerns that may disproportionately affect female prisoners include drug-drug interactions with contraceptives, intermittent dosing schedules, and concerns about metabolic side effects. Further, pregnancy, lactation, and menopause may all affect medication choices. Incarcerated women frequently have ...
Source: Journal of the American Academy of Psychiatry and the Law - September 15, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Assessing Malingered Auditory Verbal Hallucinations in Forensic and Clinical Settings.
Authors: Pierre JM Abstract The gold standard for the detection of malingered psychosis involves expert clinical assessment augmented by standardized psychometric testing. The evaluation of malingered auditory verbal hallucinations is complicated, however, by increasing evidence that voice-hearing is a broadly heterogeneous experience that does not always reflect psychopathology, with atypical features nearly as common as typical characteristics. The detection of malingered auditory verbal hallucinations in clinical settings may be particularly vulnerable to false positives and false negatives due to low suspicion ...
Source: Journal of the American Academy of Psychiatry and the Law - September 15, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Diversity and Inclusion Within AAPL.
Authors: Wall BW, Aoun EG PMID: 31467072 [PubMed - in process] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - September 1, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Reflections Prompted by the Maintenance of Certification.
Authors: Gold L PMID: 31467073 [PubMed - in process] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - September 1, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Erratum.
Authors: PMID: 31467074 [PubMed - in process] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - September 1, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Letters.
Authors: Roskes E PMID: 31467075 [PubMed - in process] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - September 1, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Graphic History.
Authors: PMID: 31467076 [PubMed - in process] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - September 1, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Adjudicative Competence and the Criminalization of Intellectual Disability.
Authors: Wall BW, Lee R Abstract Wood and colleagues effectively argue that Title II of the Americans with Disabilities Act applies to securing accommodations for persons with intellectual/disability disorder so that such persons can meaningfully participate in the criminal adjudicative process. This invited commentary further discusses the challenges in identifying, assisting, and fully accommodating persons with intellectual/disability disorder in the criminal justice system. It also highlights ongoing problems with stereotypes within this population, which may affect the outcome of criminal proceedings. This com...
Source: Journal of the American Academy of Psychiatry and the Law - August 15, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Understanding the Needs of Female Veterans.
Authors: Ritchie EC Abstract This commentary attempts to frame the article, "Safer Housing for Homeless Women Veterans," in a wider context. It defines female veterans, homelessness, and military sexual trauma. This commentary also tackles a question that often confuses civilian providers regarding who has access to care at the Veterans Health Administration. It does not repeat in detail all of the recommendations in the article, but it advocates their broader use in shelters and transitional housing. Finally, I close with some thoughts about a new generation of young, homeless, female veterans who may ha...
Source: Journal of the American Academy of Psychiatry and the Law - August 11, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

A Systematic Approach to the Detection of False PTSD.
This article presents a systematic approach to help clinicians and forensic evaluators distinguish genuine PTSD from false variants of the disorder. It describes the types of false PTSD to be considered as alternative diagnoses, including malingered PTSD (for external gain, such as receiving a disability pension or evading criminal consequences), factitious PTSD (for internal gain, such as assuming the victim or hero/veteran role), and misattributed PTSD (legitimate psychopathology misdiagnosed as PTSD). The authors describe clinical features and psychological testing that may be leveraged to aid in reaching a more valid d...
Source: Journal of the American Academy of Psychiatry and the Law - June 13, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Media and Mental Illness in a Post-Truth Era.
Authors: Cohen SN, Kolla NJ PMID: 31182650 [PubMed - in process] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - June 13, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

AAPL Advocacy Through Education.
Authors: Wills CD PMID: 31182651 [PubMed - in process] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - June 13, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Practice Resource for Forensic Training in General Psychiatry Residency Programs.
Authors: Cerny-Suelzer CA, Ferranti J, Wasser T, Janofsky JS, Michaelsen K, Alonso-Katzowitz JS, Cardasis W, Noffsinger S, Martinez R, Spanggaard M Abstract Full Document: Alonso-Katzowitz JS, Cardasis W, Cerny-Suelzer CA, et al: Practice Resource for Forensic Training in General Psychiatry Residency Programs. Journal of the American Academy of Psychiatry and the Law Online Supplement 2019, 47 (1). Available at: http://www.jaapl.org/content/47/1_Supplement. PMID: 31182652 [PubMed - in process] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - June 13, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Safer Housing for Homeless Women Veterans.
Authors: Kim JC, Matto M, Kristen E Abstract Homeless women veterans face unique vulnerability and significant mental health needs; it is important for their housing to include gender-specific safety measures. Providers of supportive housing for veterans can take important steps to accommodate the women they serve, including providing separate housing facilities or areas for women. More than half of all homeless women veterans were sexually assaulted during their military service, and many exhibit mental health disabilities as a result, which provides a strong legal basis for requiring gender-based accommodations. ...
Source: Journal of the American Academy of Psychiatry and the Law - June 13, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

The Impact of Gliomas on Cognition and Capacity.
This article discusses some of the unique cognitive concerns that arise from gliomas and their impact on patient care and personal decision-making, both contemporaneously and in a postmortem context. PMID: 31186364 [PubMed - as supplied by publisher] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - June 13, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Reasonable Accommodations for Meeting the Unique Needs of Defendants with Intellectual Disability.
Authors: Wood ME, Lawson KM, Anderson JL, Kinney DI, Nitch S, Glassmire DM Abstract The Americans with Disabilities Act has allowed for greater participation of individuals with disabilities across a variety of contexts, most notably in employment settings. Individuals with intellectual disability (ID) are still precluded, however, from full participation in other contexts, and they are often relegated to the forensic arena without sufficient support, including after being adjudicated incompetent to stand trial (IST). Frequently, individuals who are adjudicated IST due to ID are committed to inpatient psychiatric h...
Source: Journal of the American Academy of Psychiatry and the Law - June 13, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Practice Resource for Forensic Training in General Psychiatry Residency Programs.
Authors: Cerny-Suelzer CA, Ferranti J, Wasser T, Janofsky JS, Michaelsen K, Alonso-Katzowitz JS, Cardasis W, Noffsinger S, Martinez R, Spanggaard M PMID: 31113834 [PubMed - in process] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - May 24, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Distractions in Forensic Evaluations.
Authors: Brodsky SL, Johnson LN Abstract Although test manuals and professional guidelines universally specify that forensic assessments should take place in quiet, private, and distraction-free environments, such absences of distractions are rare in jail and prison settings. In this article, four aspects of this problem are examined. First, compelling examples of noise and distractions are described to give a sense of the nature of the problem. Second, the portions of guidelines from the American Academy of Psychiatry and the Law and the American Psychological Association regarding distractions are presented, alon...
Source: Journal of the American Academy of Psychiatry and the Law - May 18, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Lessons from Canadian Courts for All Expert Witnesses.
Authors: Booth BD, Watts J, Dufour M Abstract Expert witnesses have a special place in court, bringing their knowledge and skills in the form of opinion evidence to educate the court. This allows the fact-finder to make legal decisions more effectively. Although experts are often allowed a role in civil and criminal matters, this brings certain risks to the court process. Admissibility of expert witness testimony in Canada has generally paralleled American law, including the standards enunciated in Daubert v Merrell Dow Pharmaceutical, Inc. (1993). Recently, there has been a series of decisions in Canadian law that...
Source: Journal of the American Academy of Psychiatry and the Law - May 18, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Arrest and Prosecution of Animal Sex Abuse (Bestiality) Offenders in the United States, 1975-2015.
Authors: Edwards MJ Abstract Bestiality is an uncomfortable topic about which there is limited scientific literature. Prevalence research has focused on self-reported acts, and no research has established the actual frequency and nature of deliberate sex acts with animals. This quantitative, descriptive study examined 456 arrests for bestiality-related incidents in the United States from 1975 to 2015 to explore patterns of offending, offender characteristics, and how cases were adjudicated. The results suggest that animal sex offending may be linked to other criminal behavior, and involves a spectrum of sexual acts...
Source: Journal of the American Academy of Psychiatry and the Law - May 18, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Assessing Inpatient Victimization Risk Among Insanity Acquittees Using the HCR-20V3.
This study involved retrospective ratings of the HCR-20V3 for 169 hospitalized insanity acquittees and examined the utility of HCR-20V3 ratings in predicting victimization. Although the HCR-20V3 was not explicitly developed to aid in evaluations of victimization risk, other structured professional judgment tools intended to predict violence risk have demonstrated potential for predicting victimization, due to the existence of common risk factors and overlap between patients who engage in violence and those who are victimized. Results from this study suggest that evaluators may consider the Clinical scale score of the HCR-2...
Source: Journal of the American Academy of Psychiatry and the Law - May 18, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Extreme Overvalued Belief and the Legacy of Carl Wernicke.
Authors: Rahman T, Meloy JR, Bauer R Abstract Individuals with extreme overvalued beliefs often carry out abhorrent and inexplicable acts of violence. They hold odd and bizarre beliefs that are shared by others in their culture or subculture. This creates a dilemma for the forensic psychiatrist because the definition of delusion may not be adequate. We discuss the evolution of the term "overvalued idea" first described in a forensic context by neuropsychiatrist Carl Wernicke in 1892. The overvalued idea is invoked in British scholarship as a definition for beliefs seen in anorexia nervosa, morbid jealousy...
Source: Journal of the American Academy of Psychiatry and the Law - May 17, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Treatment Refusal in Arizona's Jail-Based Competency to Stand Trial Restoration Programs.
This article focuses on the topic of treatment refusal and the use of forced medications for detainees who are in these jail-based restoration programs. We describe Arizona's novel statewide jail-based programs, Arizona's statutory and case law approach to treatment refusal, and the restoration to competency programs in one large county jail that has no legal mechanism outside of civil commitment for the determination of whether forced treatment will be permitted. We conclude with a discussion of specific override procedures that might apply directly to incompetent detainees in a jail-based competency restoration program a...
Source: Journal of the American Academy of Psychiatry and the Law - May 4, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

The Migration of Arizona's Post-Insanity Defense Procedures to a Modified GBMI Model.
Authors: Kirkorsky SE, Shao W, Bloom JD Abstract Arizona's insanity defense and post-insanity procedures have evolved over the last 30 years into a unique system. Arizona moved from a typical M'Naughten-based insanity defense to an adaptation of the Oregon Psychiatric Security Review Board (PSRB) model and then to its current form, in which the PSRB is cast in a correctional framework. These changes have resulted in a correctional statute, with outcomes that may subject the guilty except insane (GEI) offender to a disposition similar to that of someone found guilty but mentally ill (GBMI). We review the literature ...
Source: Journal of the American Academy of Psychiatry and the Law - April 29, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

The Impact of the Psychiatrist on the Life Care Plan.
This article summarizes the life care planning process and emphasizes the role of the psychiatrist in establishing a strong medical foundation for the plan. The psychiatrist's expertise in determining the nature and extent of the evaluee's psychiatric illness, prognosis, need for and likely benefit from treatment, and costs of care inform the life care planning process. Advising life care planners on these matters is a natural extension of the work of psychiatrists and forensic psychiatrists, who are accustomed to providing medical opinions to the courts. There are specific challenges when the psychiatrist creates recommen...
Source: Journal of the American Academy of Psychiatry and the Law - April 21, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Medical Privacy versus Public Safety in Aviation.
Authors: Kenedi CA, Appel JM, Friedman SH Abstract Confidentiality, considered a fundamental principle of medical ethics, is potentially at odds with public safety when an airplane pilot is experiencing symptoms of mental illness. Reporting requirements for pilots vary across the world, and pilots can be subject to multiple national regulatory authorities for international flights. Stigma exists about getting treated for depression. If one's livelihood and core sense of identity is placed at risk by seeking treatment, people will naturally avoid assessments and engagement with mental health clinicians, the very tre...
Source: Journal of the American Academy of Psychiatry and the Law - April 21, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Evaluating and Reducing Risk in Online Child Pornography Cases.
Authors: Berlin FS Abstract In their article on the subject of risk assessment of online child sexual exploitation offenders, Hirschtritt and colleagues highlight an important finding derived from an analysis of group data which concludes that the vast majority of individuals convicted for accessing child pornography online (and who have had no prior conviction for a contact sexual offense) are at low risk of becoming a contact, hands-on, sexual offender. This commentary is intended to complement their observations by emphasizing the importance of performing a comprehensive psychiatric-forensic evaluation when asse...
Source: Journal of the American Academy of Psychiatry and the Law - April 17, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Risk Assessment of Online Child Sexual Exploitation Offenders.
Authors: Hirschtritt ME, Tucker D, Binder RL Abstract Over the past two decades in the United States, a dramatic increase in access to the Internet has facilitated an increase in the production, viewing, and distribution of child pornography. In this context, forensic mental health professionals may be called on to estimate the risk of future violence, especially of contact sexual offenses, among individuals charged with online sexual offenses. We summarize demographic and clinical characteristics that differentiate online from contact and "mixed" offenders (those who commit both online and contact offens...
Source: Journal of the American Academy of Psychiatry and the Law - April 17, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Criminal Justice and Suicide Outcomes with Indiana's Risk-Based Gun Seizure Law.
This article examines the application and effectiveness of a 2006 Indiana law designed to prevent gun violence by authorizing police officers to separate firearms from persons who present imminent or future risk of injury to self or others, or display a propensity for violent or emotionally unstable conduct. A court hearing is held to determine ongoing risk in these cases; a judge decides whether to return the seized firearms or retain them for up to five years. The study examines the frequency of criminal arrest as well as suicide outcomes for 395 gun-removal actions in Indiana. Fourteen individuals (3.5%) died from suici...
Source: Journal of the American Academy of Psychiatry and the Law - April 17, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Integrating Non-Psychiatric Models of Delusion-Like Beliefs into Forensic Psychiatric Assessment.
Authors: Pierre JM Abstract In both clinical and forensic psychiatry, it can often be difficult to distinguish delusions from normal beliefs. The categorical approach of the Diagnostic and Statistical Manual of Mental Disorders (DSM) leaves few options to describe intermediate delusion-like beliefs (DLBs). Neurocognitive models offer an alternative view of DLBs as existing on a continuum that can be quantified based on dimensions of severity as well as underlying cognitive biases. The Internet provides broadened access to putative evidence for diverse beliefs, with filter bubbles and echo chambers that can amplify ...
Source: Journal of the American Academy of Psychiatry and the Law - April 17, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

A Review of Statutes and the Role of the Forensic Psychiatrist in Cyberstalking Involving Youth.
This article focuses on the current legal landscape governing cyberstalking behavior involving adolescents, the roles a forensic psychiatrist may assume in this context, and the opportunity to bring a developmental perspective to these cases. PMID: 30914437 [PubMed - as supplied by publisher] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - March 28, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Invoking History and Structural Competency to Minimize Racial Bias.
Authors: Shadravan SM, Bath E PMID: 30852558 [PubMed - in process] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - March 11, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Graphic History.
Authors: PMID: 30852559 [PubMed - in process] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - March 11, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Sharing Violent Thoughts on the Internet.
This article discusses the case of United States v. Valle, 807 F.3d 508 (2nd Cir. 2015) and the tension between First Amendment protections and criminal activity. Forensic mental health experts may be well suited to educate the trier of fact about violent fantasies and their associated risks. PMID: 30782605 [PubMed - as supplied by publisher] (Source: Journal of the American Academy of Psychiatry and the Law)
Source: Journal of the American Academy of Psychiatry and the Law - February 22, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Clozapine Reduces Self-Injurious Behavior in a State Prison Population.
In this study, we describe the use of clozapine to treat 10 offenders with chronic, repetitive self-injury refractory to other medications and behavioral therapies. The primary diagnosis for all 10 offenders was a personality disorder. Eight of the 10 inmates allowed weekly blood draws and took medication regularly (approximately 95% adherence), whereas two inmates discontinued treatment within the first two weeks. For these eight patients, we compared the number of in-house urgent care visits and outside emergency room visits related to SIB for the six-month periods before and after treatment with clozapine. After initiat...
Source: Journal of the American Academy of Psychiatry and the Law - February 22, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Examining Racial Disparities in Juvenile Justice.
Authors: Robles-Ramamurthy B, Watson C Abstract Decades of research have focused on understanding and addressing racial disparities that occur at every stage of processing in the juvenile justice system. Leaders in the field have raised concerns about the differential treatment and selection of youth based on race. Taking into consideration Sussman and colleagues' results regarding the use of manifest injustice in Washington State, we review briefly the legislative changes that have occurred nationally to address the problem of disproportionate minority contact. We also consider data and hypotheses that have increa...
Source: Journal of the American Academy of Psychiatry and the Law - February 15, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

A Seat at the Table.
Authors: Thompson CR Abstract Organized medicine and psychiatry have a long tradition of governmental advocacy and public engagement. The American Academy of Psychiatry and the Law (AAPL), since its founding 50 years ago, has made some forays into these fields. However, its involvement has been less substantial than other similarly situated professional organizations. With its increasing membership and expertise, AAPL now possesses the capacity to dedicate some of its organizational attention, energy, and resources to educating policymakers and the public on current and future topics related to forensic mental heal...
Source: Journal of the American Academy of Psychiatry and the Law - February 15, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Involving Forensic Patients in Treatment Planning Increases Cooperation and May Reduce Violence Risk.
Authors: Papapietro DJ Abstract Risk assessment in a forensic hospital is a complex process. Decisions made about individuals and their lives cannot be made lightly and must include relevant information from as many sources as possible. The forensic hospital and the greater legal system that oversees forensic treatment have an obligation to protect the safety of the community. Thus, any decision about a forensic patient's progress from high to low security or eventual transition and discharge into the community must be thoughtful and balanced, and must include input from the patients themselves. Eliciting and provi...
Source: Journal of the American Academy of Psychiatry and the Law - February 14, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Competency Restoration for Adult Defendants in Different Treatment Environments.
Authors: Danzer GS, Wheeler EMA, Alexander AA, Wasser TD Abstract The optimization of trial competency restoration is a topic of growing interest and controversy in the fields of forensics, psychology, criminal law, and public policy. Research has established that adult defendants who have severe psychotic disorders and cognitive impairments are more likely than defendants without these conditions to be found incompetent to stand trial and are less likely to be restored to competency thereafter. Research has also identified some of the benefits of attempting restoration in hospitals, jails, or outpatient settings f...
Source: Journal of the American Academy of Psychiatry and the Law - February 11, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Use of Manifest Injustice in the Washington State Juvenile Rehabilitation Administration.
Authors: Sussman NI, Lee TG, Hallgren KA Abstract In the Washington State Juvenile Code, the Manifest Injustice (MI) provision allows judges to sentence youth outside of the standard guidelines. We compared rates of Juvenile Rehabilitation Administration (JRA) involvement and MI between racial minority youth and Caucasian youth. Although not statistically significant, there was a trend toward African American and multiracial youth having MI used to decrease their sentence less frequently than Caucasian youth. African American youth were about half as likely to have MI used to intensify their sentence compared with ...
Source: Journal of the American Academy of Psychiatry and the Law - February 11, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Prevalence Rates of Acute Stress Disorder Symptomatology and Association to Juvenile Crime Involvement.
This study examined data from the National Comorbidity Survey-Adolescent Supplement (NCS-A). Participants in this survey, which took place between February 2001 and January 2003, consisted of 10,148 youth between the ages of 13 and 18 years. Because the NCS-A was conducted prior to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), symptoms of posttraumatic stress disorder from the fourth edition of the DSM were mapped to DSM-5 criteria for ASD. Due to changes in the DSM-5 criteria for ASD, youth in this study were described as having "ASD symptomatology." Youth with ASD symptomatol...
Source: Journal of the American Academy of Psychiatry and the Law - February 11, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Professional Boundaries in Corrections.
Authors: Cooke BK, Hall RCW, Friedman SH, Jain A, Wagoner R Abstract Boundary violations occurring in corrections settings require special attention. There is a unique relationship between officers and inmates, governed by policies and procedures as well as ethics in general (e.g., the lack of ability for a person in a controlled environment to consent to a relationship due to power imbalance). Recent high-profile cases between corrections officers and inmates demonstrate the complexities inherent in these relationships. We examine several recent cases and offer analysis of the factors leading to these dangerous en...
Source: Journal of the American Academy of Psychiatry and the Law - February 9, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research

Shared Risk Formulation in Forensic Psychiatry.
Authors: Ray I, Simpson AIF Abstract Patients in forensic mental health care have a difficult journey through inpatient rehabilitation and re-integration into the community. Risk assessment guides this progress, usually with clinician-based processes that use structured risk-assessment tools. Patients' understanding of their own risk is important to inform risk assessment and the chances of successful rehabilitation. The emergence of shared decision-making approaches provides an opportunity to consider shared risk assessment and formulation. We reviewed the literature to explore models of patients' involvement in r...
Source: Journal of the American Academy of Psychiatry and the Law - January 20, 2019 Category: Medical Law Tags: J Am Acad Psychiatry Law Source Type: research