Police-reported family violence victimisation or perpetration and mental health-related emergency department presentations: an Australian data-linkage study.

BACKGROUND: Family violence is a leading social determinant of mental ill-health but its link to mental health-related emergency department presentations is poorly understood. Existing research has largely used retrospective designs with a focus on victimisation, typically among women. We examined whether police-reported family violence victimisation and perpetration were prospectively associated with mental health emergency department presentations in women and men. We also identified family violence risk and vulnerability characteristics associated with such presentations. METHODS: Demographics, prior police involvement, and individual and relationship vulnerabilities were provided by Victoria Police for 1520 affected family members (i.e., primary victims) and 1470 respondents (i.e., persons alleged to have perpetrated family violence) from family violence reports in 2016-17. Emergency mental health presentations 22-30 months post-family-violence report were determined through linkage with the Victorian Emergency Minimum Dataset and compared to statewide presentations. RESULTS: Emergency mental health presentations during follow-up were identified in 14.3% of the family violence sample, with 1.9% presenting for self-harm. Mental health presentation rates per 1,000 people were markedly higher among affected family members and respondents of both sexes and all ages than in the general population, except for male affected family members aged 45 + . Adjusting for age and sex, the mental health presentation rate was 6 and 11 times higher among affected family members and respondents, respectively, than in the general population. Individual vulnerabilities were more closely related to risk of emergency mental health presentations than relationship characteristics. CONCLUSIONS: Police-recorded family violence is associated with increased mental health-related emergency department presentations over the short-to-medium term. Strengthened cross-sector collaboration is needed to identify, address, and refer individuals with overlapping family violence and mental health needs and to improve victims' and perpetrators' access to community mental health and related services. This should help prevent individuals from reaching a crisis point in their mental health.

Sexual abuse during childhood and all-cause mortality into middle adulthood: an Australian cohort study.

OBJECTIVE: To compare mortality from all causes, internal causes (eg, cancers, circulatory and respiratory system diseases), and external causes (eg, suicide, accidents, assault) among people who were sexually abused during childhood with mortality for the general population. DESIGN: Historical cohort study. SETTING, PARTICIPANTS: 2759 people (2201 women, 79.8%) who had experienced medically assessed contact sexual abuse in Victoria while aged 16 years or younger during 1964-1995, as recorded in Victorian Institute of Forensic Medicine records. MAIN OUTCOME MEASURES: Mortality rate, based on linked National Death Index data (1980-2020), by five-year age group; sex- and age-standardised mortality ratios; comparison of rates with age- and sex-adjusted rates for the general Victorian population (incident rate ratio [IRR]). RESULTS: We included 115 deaths of people under 50 years of age in our analysis (4.2% of people sexually abused as children; 79 women, 36 men); 56 deaths were attributed to external, 56 to internal causes (cause of death information missing in three cases). In each age group from 15-19 years, the mortality rates for people sexually abused as children were higher than for the general population; age- and sex-standardised all-cause mortality ratios were highest for people aged 25-29 years (men: 16.5; 95% confidence interval [CI], 11.0-22.0; women: 19.2; 95% CI, 14.3-24.2). The age- and sex-adjusted mortality rate for people sexually abused as children was higher than in the general population for all-cause (IRR, 8.25; 95% CI, 5.92-11.5), internal cause (IRR, 5.92; 95% CI, 3.89-9.01), and external cause deaths (IRR, 12.6; 95% CI, 9.61-16.6); the differences in external cause mortality were greater for people who had experienced penetrative (IRR, 14.9; 95% CI, 10.9-20.5) than for those who had experienced non-penetrative sexual abuse as children (IRR, 8.92; 95% CI, 5.35-14.9). CONCLUSIONS: Sexual abuse during childhood is associated with higher mortality rates into mid-adulthood. Preventing child sexual abuse and intervening early to reduce the damage it inflicts is not only essential for the welfare of the child, but could also help reduce avoidable deaths later in life.

Statistical learning methods and cross-cultural fairness: Trade-offs and implications for risk assessment instruments.

The use of statistical learning methods has recently increased within the risk assessment literature. They have primarily been used to increase accuracy and the area under the curve (AUC, i.e., discrimination). Processing approaches applied to statistical learning methods have also emerged to increase cross-cultural fairness. However, these approaches are rarely trialed in the forensic psychology discipline nor have they been trialed as an approach to increase fairness in Australia. The study included 380 Aboriginal and Torres Strait Islander and non-Aboriginal and Torres Strait Islander males assessed with the Level of Service/Risk Needs Responsivity (LS/RNR). Discrimination was assessed through the AUC, and fairness was assessed through the cross area under the curve (xAUC), error rate balance, calibration, predictive parity, and statistical parity. Logistic regression, penalized logistic regression, random forest, stochastic gradient boosting, and support vector machine algorithms using the LS/RNR risk factors were used to compare performance against the LS/RNR total risk score. The algorithms were then subjected to pre- and postprocessing approaches to see if fairness could be improved. Statistical learning methods were found to produce comparable or marginally improved AUC values. Processing approaches increased several fairness definitions (namely xAUC, error rate balance, and statistical parity) between Aboriginal and Torres Strait Islanders and non-Aboriginal and Torres Strait Islanders. The findings demonstrate that statistical learning methods may be a useful approach to increasing the discrimination and cross-cultural fairness of risk assessment instruments. However, both fairness and the use of statistical learning methods encompass significant trade-offs that need to be considered. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Clients' current presentation yields best prediction of criminal recidivism: Jointly modeling repeated assessments of risk and recidivism outcomes in a community sample of paroled New Zealanders.

OBJECTIVE: Clinicians often rely on readily observable intermediate outcomes (e.g., symptoms) to assess the likelihood of events that occur outside of treatment (e.g., relapse). Similarly, those monitoring clients with histories of criminal involvement attempt to prevent adverse outcomes considered likely and intervene when symptoms/risk factors fluctuate. Our aim was to develop a stronger understanding of associations between evolving symptoms/risk factors and case outcomes, yielding clearer practice implications. METHOD: We used longitudinal, multiple reassessment risk data from 3,421 individuals paroled in New Zealand. We used joint modeling to test the association between individual trajectories of psychosocial risk factor scores, assessed using Dynamic Risk Assessment for Offender Re-entry, and recidivism (official records of parole violations or criminal charges resulting in reconviction). We examined whether recent clinically relevant features of risk presentation (e.g., current levels, recent rate of change) predicted recidivism better than the entirety of the risk assessment trajectory. RESULTS: Although each model demonstrated similar predictive validity, measures of model fit indicated that models using current trajectory features outperformed those using the entire assessment history to predict recidivism. CONCLUSIONS: Change in dynamic risk factors is consistently associated with recidivism outcomes. When using changeable factors to monitor clients' current risk for recidivism, practitioners should focus on current presentation rather than the entire assessment history, although differences in predictive discrimination are small. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The effects of judicial supervision on recidivism of offenders in Australia and New Zealand: a systematic review and meta-analysis.

This meta-analysis compares recidivism reduction in problem-solving courts employing judicial supervision in Australia and New Zealand to traditional processes. Using a four-phased search strategy, 16 studies totalling a treatment sample of 6588 individuals and 32,147 comparison participants were identified from 7161 unique records. Meta-analyses indicate that the problem-solving courts significantly reduced both the odds and incidences of recidivism compared with standard justice processes but that the heterogeneity observed within the latter analysis plus reliance on weak methodologies limits the strength of these conclusions. Studies at risk of bias may have had an undue influence on the odds of recidivism analysis. Additionally, the benefits of treatment on the incidence of recidivism are closely linked to the overlap of measurement and treatment periods. The findings suggest a positive impact from judicial supervision but further rigorous research is needed that closely matches experimental samples, strictly measures participants post-intervention and meticulously reports pertinent information.

The cross-cultural fairness of the LS/RNR: An Australian analysis.

OBJECTIVE: Cross-cultural research into risk assessment instruments has often identified comparable levels of discrimination. However, cross-cultural fairness is rarely addressed. Therefore, this study explored the discrimination and fairness of the Level of Service/Risk, Need, Responsivity (LS/RNR) within a sample of Aboriginal and Torres Strait Islander and non-Aboriginal and Torres Strait Islander males. HYPOTHESES: We hypothesized that discrimination would not be significantly different for Aboriginal and Torres Strait Islander individuals and non-Aboriginal and Torres Strait Islander individuals. We further hypothesized that some fairness definitions would be unsatisfied. METHOD: The study included 380 males (Aboriginal and Torres Strait Islander, n = 180) from Australia. Discrimination was assessed with the area under the curve (AUC) and cross AUC (xAUC). To determine fairness, error rate balance, calibration, predictive parity, and statistical parity were used. RESULTS: The discrimination of the LS/RNR was not statistically different (p = .61) between groups. The xAUC identified disparities (p < .001), with the LS/RNR being unable to discriminate between Aboriginal and Torres Strait Islander nonreoffenders and non-Aboriginal and Torres Strait Islander reoffenders (xAUC = .46, 95% CI [.35, .57]). Disparities among certain fairness definitions were identified, with Aboriginal and Torres Strait Islander individuals scoring higher on the LS/RNR (d = 0.52) and nonreoffenders being classified as high risk more often. CONCLUSIONS: The findings suggest that the LS/RNR may not be a cross-culturally fair risk assessment instrument for Australian individuals, and standard discrimination indices with comparable levels do not imply that a risk assessment instrument is cross-culturally fair. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The temporal relationship between mental health service use and stalking perpetration.

OBJECTIVE: Mental disorder is common among people who stalk. However, the nature of this association is unclear and it is not known whether the commencement of stalking is associated with symptoms of disorder. This study used a longitudinal design to examine the association between the onset and cessation of stalking behavior and indicators of mental disorder in the form of mental health service use. METHOD: Data linkage was used to explore public mental health service use among 157 people who engaged in stalking in Melbourne, Australia. Mental health service use across the lifetime, 5 months prior to stalking onset, between the onset and cessation of stalking (during stalking) and 5 months post-stalking was identified. Mixed regression models tested temporal associations between types of mental health service use (acute vs continuing care) and onset and cessation of stalking in a subsample of 130 participants where dates of the stalking episode were available. RESULTS: A total of 105 (67%) participants had lifetime use of public mental health services, while 15% accessed mental health services in the 5 months prior to (N = 19) or during the stalking (N = 20) and 22% (N = 29) used services in the 5 months after the stalking ceased. Odds of using acute mental health services and average monthly rate of use were highest during the stalking. Odds and average monthly rate of using continuing care were highest after the episode ceased. CONCLUSIONS: Most people who stalk have used public mental health services, but a minority access services immediately prior to or during the stalking episode. Acute service use was more common during the stalking, while use of continuing care services was more common after the stalking ceased. These findings provide preliminary support for a temporal relationship between acute mental disorder and stalking behavior.

Exploring Differences in the Experiences, Perceptions and Reporting of Violent Incidents in Australia by Country of Birth.

Australia's fast-growing migrant population encompasses many groups from culturally and linguistically diverse backgrounds. It is well documented that these groups experience varying pre- and post-migratory challenges. Despite this knowledge, little is known about the extent to which these groups experience and perceive violence and how or whether they seek assistance after such incidents. It is important to identify any potential discrepancies to ensure that services can provide the most targeted supports to victims. Data were collected from the 2016 Australian Bureau of Statistics Public Safety Survey. Using chi-square tests, prevalence, experiences, and perceptions of violence occurring after the age of 15, postincident support, reporting behaviors, and health variables related to violent incidents were compared across three cultural groups arranged by region of birth: born in Australia (BIA), born overseas in main English-speaking countries (BNMESC), and born overseas in non-English-speaking countries (BOC). BOC individuals reported much lower rates of violent victimization compared to BIA and BMSEC individuals. More than two-thirds of each cultural group did not report their most recent experience of violence to police. Violence was most commonly experienced at home, although a higher proportion of BIA individuals experienced violence at an entertainment venue, and a higher proportion of BOC individuals experienced violence outside (i.e., in the street). The contribution of Alcohol/Substances was much higher for BIA and BMESC compared to BOC individuals. BOC individuals experienced more anxiety post-incident, while more BIA individuals sustained physical injuries. A similar proportion of each group sought assistance post-incident, however, more BOC individuals had never told anyone about the incident. Perceptions of the violent incident were generally similar across groups, though fewer BOC individuals perceived the incident to be a crime. Some differences were apparent across cultural groups regarding the prevalence, experiences and reporting of violent incidents. Implications and future research directions are discussed within.

Ethics, Artificial Intelligence, and Risk Assessment.

A considerable number of papers have been published on the ethics of artificial intelligence for the purposes of violence risk assessment. In this issue of The Journal, Hogan and colleagues argue that artificial intelligence introduces novel concerns for violence risk assessment that require consideration. While the concerns that have been raised are entirely valid and require consideration, we argue that artificial intelligence does not herald a more serious or unique challenge in these areas relative to other forms of violence risk assessment.

Exploring presentation differences in multi-cultural youth seeking assistance for mental health problems.

BACKGROUND: Mental ill-health can impact an individual's capacity to interact with others, make decisions, and cope with social challenges. This is of particular importance for many Culturally and linguistically diverse (CALD) individuals who may be at various stages of the acculturation process. The increasing diversity of the Australian population necessitates informed and culturally relevant services that meet the needs of a changing demographic. However the extant research on the mental health needs of CALD Australians is limited. This study aimed to further our understanding of the mental health needs of young CALD Australians by exploring the mental health concerns and social factors exhibited by CALD individuals accessing community based youth mental health services in two major cities. METHODS: We performed a series of logistic regression models to ascertain if a concert of factors (i.e., clinical, socio-economic, criminal justice system involvement, child maltreatment, social support) were associated with CALD status RESULTS: Comparisons across factors revealed no significant differences between groups. A small number of correlates differentiated between CALD and non-CALD participants (mental illness diagnosis during childhood, family history of mental illness/suicide, sensation seeking, sensitivity to punishment, maternal overprotection) however these factors were no longer meaningful after adjustment for multiple comparisons. CONCLUSIONS: In help-seeking mainstream youth populations, cultural differences across clinical and environmental factors appear to be minimal.

Finding Colour in Conformity Part II-Reflections on Structured Professional Judgement and Cross-Cultural Risk Assessment.

There has been an increasing interest in cross-cultural risk assessment over the past 5 years. Much of this has been driven by concerns that particular risk instruments may be biased against, or ill-suited to, non-White offending populations. A growing body of work has asserted that unique cultural-specific risk factors and experiences may not be adequately considered within current risk assessment frameworks which have led to calls to culturally alter/remodel risk instruments. While recognising the importance of generalizable risk instruments, this article outlines a number of realities that cross-cultural risk assessment researchers must contend with before embarking on projects to alter instruments. With specific regard to structured professional judgement risk instruments, the article notes that efforts to culturally amend instruments, could paradoxically reduce accuracy and increase bias.

Crystalline methamphetamine (ice) use prior to youth detention: A forensic concern or a public health issue?

Links between crystalline methamphetamine (CM) use and criminal offending are often drawn in the media; however, there has been little scientific research into this relationship. The aim of this study was to ascertain the prevalence and correlates of lifetime CM use among a sample of young people in detention in Australia and to examine whether an association exists between lifetime CM use and recidivism in this population.The sample included 202 young people (164 males) in youth detention in the state of Victoria, Australia. Participants were administered questionnaires related to lifetime substance use and socio-environmental experiences. Lifetime mental health data and offending data were obtained for each participant from public mental health and policing databases. More than one third (38%) of the sample reported lifetime CM use. In multivariate logistic regression analyses, older age, male gender, polysubstance use, and high levels of community disorganisation were associated with CM use. The presence of a psychiatric diagnosis over the lifetime was not significantly associated with CM use. CM use was also not significantly associated with violent recidivism. Efforts to address CM use and related harm in detained youth should include community-based strategies to reduce CM use among this vulnerable population following their release from detention. However, the findings suggest that CM use on its own is unlikely to be an important consideration for professionals concerned with determining which young people should be selected for treatment designed to reduce the risk of violent recidivism.

Asking the Right Questions: Examining the Efficacy of Question Trails as a Method of Improving Lay Comprehension and Application of Legal Concepts.

The present study examines the 'fact based' approach to jury instructions, which embeds legal concepts in a series of logically ordered written factual questions that the jury must answer to reach a verdict. The study utilised a sample of 1007 adults called for jury service in Victoria, Australia. Four instructional types (standard, plain language, checklist, fact based) were compared on paraphrase and application measures across three time points. Results indicated that paraphrase performance was significantly lower for standard instructions compared to all other instructional types at the pre-deliberation stage. Findings around application of law were mixed. At the pre-deliberation stage, participants receiving fact based instructions had significantly higher scores on true/false application questions compared with participants in other conditions, whereas there were no significant differences between conditions for multiple-choice application. However, testing following deliberation revealed that participants in the fact-based condition had significantly higher scores on multiple-choice application items.

Identifying the prevalence and predictors of suicidal behaviours for indigenous males in custody.

BACKGROUND: High rates of suicidal behaviours among Indigenous Australians have been documented. Justice-involved individuals are also at a higher risk for engaging in suicidal behaviours. This study sought to ascertain the prevalence and correlates of suicidal behaviours for 107 Indigenous adult males in custody in Victoria, Australia. METHODS: Participants undertook a structured interview comprising a psychiatric assessment. Information on suicidal behaviours (ideation and attempts), socio-demographics, environmental stressors, negative life events and mental health was obtained. RESULTS: A high proportion of Indigenous males in custody experienced lifetime suicidal ideation (63.7%) and over one-half had attempted suicide (54.5%). A smaller, yet significant number of participants experienced ideation over the past 12 months (27.9%). Having a loved one pass away within the past 12 months predicted recent ideation; lifetime ideation and a diagnosis of Post-Traumatic Stress Disorder predicted a lifetime suicide attempt. CONCLUSIONS: The prevalence of suicidal behaviours among Indigenous people in custody is remarkably high. Correlates of suicidal behaviours for Indigenous people in custody in this study likely manifest in the community, denoting an urgent public health response. Prevention must begin in communities at-risk for suicidal behaviours. The development of low intensity mental health service infrastructure in communities to promote awareness and provide accessible, least restrictive support and treatment is necessary. Correctional institutions must also continue to improve custodial suicide prevention and management initiatives.

Measuring empathy in undergraduate law students: Examining the factorial validity of the Jefferson Scale of Empathy - Law Students (JSE-LS).

Several scholars have hypothesised a link between empathy and a range of important outcomes for law students including well-being, mental health and the development of effective client-lawyer relationships. However, few studies have examined these claims empirically. Empirical investigation of empathy among law students requires effective methods of measuring empathy. The present study sought to examine an instrument designed specifically to measure empathy among law students - the Jefferson Empathy Scale - Law Students (JSE-LS). The study involved examining the internal consistency and factor structure of the instrument using a sample of 276 Australian undergraduate law students. The study found that a four-factor solution was optimal for the dataset. Two of the factors were readily interpretable with previous literature, however the remaining two factors were unstable, suggesting the need for further revision of the instrument. Recommendations for revising the JSE-LS to better measure empathy are discussed.

Correlates of self-harm and suicide attempts in justice-involved young people.

The purpose of this study was to ascertain the prevalence and correlates of self-harm among young people in detention in Australia. The sample included 215 (177 male; 38 female) young people who were in youth detention in the state of Victoria, Australia. Participants were administered a series of questionnaires related to self-harm, mental health, socio-environmental experiences and behaviours. Overall, one-third (33%) of the sample reported previous self-harm and 12% reported at least one suicide attempt. In a multivariate logistic regression analysis, a history of childhood trauma, contact with mental health services, and low educational interest significantly increased the likelihood of self-harm. Young people who reported a suicide attempt scored significantly higher on the measure of childhood trauma than did youth who had engaged in non-suicidal self-harm. Findings demonstrate a strong connection between childhood traumatic experiences and suicidal behaviours for youth in detention. Trauma histories and mental health concerns must be considered when identifying youth at increased risk of self-harm.

Striking the Right Balance: Police Experience, Perceptions and Use of Independent Support Persons During Interviews Involving People with Intellectual Disability.

BACKGROUND: Several jurisdictions mandate the presence of an independent support person during police interviews with vulnerable people. The current study investigated police officers' experiences and perceptions of these volunteers during interviews with people with intellectual disability(ies) (ID). METHODS: The sample comprised 229 police officers who attended a mandatory firearms training course in Melbourne, Australia, in 2010. RESULTS: Participants commonly reported utilizing independent support persons and displayed a fair understanding of their role. Overall, volunteers were engaged more frequently than family/friends; police considered the volunteers to be more impartial during interviews, whereas family/friends provided a greater level of emotional support to interviewees. CONCLUSIONS: Independent support persons need to demonstrate two quite different types of support to people with intellectual disability(ies) during police interviews; these require quite different skill sets and suggest the need for more tailored training and support for these volunteers. Implications for future research and policy are discussed.