A welfare analysis of Medicaid and recidivism.

We present conservative estimates for the marginal value of public funds (MVPF) associated with providing Medicaid to inmates exiting prison. The MVPF measures the ratio between a policy's social benefits and its governmental costs. Our MVPF estimates suggest that every additional $1 the government spends on providing inmates exiting prison with Medicaid coverage can result in social benefits ranging between $3.45 and $10.62. A large proportion of the benefits we consider stems from the reduced future criminal involvement among former inmates who receive Medicaid. Employing a difference-in-differences approach, we find that Medicaid expansions reduce the average number of times a released inmate is reimprisoned within 1 year by approximately 11.5%. By combining this estimate with key values reported elsewhere (e.g., victimization costs, data on victimization and incarceration), we quantify specific benefits arising from the policy. These encompass diminished criminal harm due to lower reoffense rates, direct benefits to former inmates through Medicaid coverage, increased employment opportunities, and reduced loss of liberty resulting from fewer future reimprisonments. Net-costs consist of the cost of providing Medicaid net of changes in the governmental cost of imprisonment, changes in the tax revenue due to increased employment, and changes in spending on other public assistance programs. We interpret our estimates as conservative since we deliberately err on the side of under-estimating benefits and over-estimating costs when data on specific items are imprecise or incomplete. Our findings align closely with others in the sparse literature investigating the crime-related welfare impacts of Medicaid access, underscoring the substantial indirect benefits public health insurance programs can offer through crime reduction, in addition to their direct health-related advantages.

A scalable empathic supervision intervention to mitigate recidivism from probation and parole.

Incarceration is a pervasive issue in the United States that is enormously costly to families, communities, and society at large. The path from prison back to prison may depend on the relationship a person has with their probation or parole officer (PPO). If the relationship lacks appropriate care and trust, violations and recidivism (return to jail or prison) may be more likely to occur. Here, we test whether an "empathic supervision" intervention with PPOs-that aims to reduce collective blame against and promote empathy for the perspectives of adults on probation or parole (APPs)-can reduce rates of violations and recidivism. The intervention highlights the unreasonable expectation that all APPs will reoffend (collective blame) and the benefits of empathy-valuing APPs' perspectives. Using both within-subject (monthly official records for 10 mo) and between-subject (treatment versus control) comparisons in a longitudinal study with PPOs in a large US city (NPPOs = 216; NAPPs =∼20,478), we find that the empathic supervision intervention reduced collective blame against APPs 10 mo postintervention and reduced between-subject violations and recidivism, a 13% reduction that would translate to less taxpayer costs if scaled. Together, these findings illustrate that very low-cost psychological interventions that target empathy in relationships can be cost effective and combat important societal outcomes in a lasting manner.

Association between socioeconomic and motherhood characteristics with receiving community-based treatment services among justice-involved young female drug users: a retrospective cohort study in Taiwan.

BACKGROUND: Drug-involved individuals who contact treatment services in Taiwan are mostly driven by criminal justice systems either as an alternative or adjunct to criminal sanctions for a drug offence. With a focus on justice-involved young female drug users, the present study examines the extent to which socioeconomic and motherhood characteristics are associated with receiving deferred prosecution, a scheme diverting drug offenders to community-based addiction treatment. METHODS: We identified a cohort of 5869 women under the age of 30 arrested for using Schedule II drugs (primarily amphetamine-like stimulants) from the 2011-2017 National Police Criminal Records in Taiwan. Information concerning socioeconomic characteristics, pregnancy and live birth history, and deferred prosecution was obtained through linkage with the 2006-2019 National Health Insurance, birth registration, and deferred prosecution datasets. Multinomial logistic regression was used to evaluate the association with stratification by recidivism status. RESULTS: Within six months of arrest, 21% of first-time offenders (n = 2645) received deferred prosecution and 23% received correction-based rehabilitation; the corresponding estimates for recidivists (n = 3224) were 6% and 15%, respectively. Among first-time offenders, low/unstable income was associated with lower odds of deferred prosecution (adjusted odds ratio [aOR] = 0.71; 95% CI: 0.58, 0.88). For recidivists, those with low/unstable income (aOR = 1.58) or unemployment (aOR = 1.58) had higher odds of correction-based rehabilitation; being pregnant at arrest was linked with reduced odds of deferred prosecution (aOR = 0.31, 95% CI: 0.13, 0.71) and correction-based rehabilitation (aOR = 0.50, 95% CI: 0.32, 0.77). CONCLUSIONS: For the young women arrested for drug offences, disadvantaged socioeconomic conditions were generally unfavored by the diversion to treatment in the community. Childbearing upon arrest may lower not only the odds of receiving medical treatment but also correctional intervention. The criminal prosecution policy and process should be informed by female drug offenders' need for treatment and recovery.

The burden for clinical services of persons with an intellectual disability or mental disorder convicted of criminal offences: A birth cohort study of 14,605 persons followed to age 64.

BACKGROUND: Intellectual disability (ID), schizophrenia spectrum disorder (SSD), bipolar disorder (BD), substance use disorder (SUD), and other mental disorders (OMDs) are associated with increased risks of criminality relative to sex-matched individuals without these conditions (NOIDMD). To resource psychiatric, addiction, and social services so as to provide effective treatments, further information is needed about the size of sub-groups convicted of crimes, recidivism, timing of offending, antecedents, and correlates. Stigma of persons with mental disorders could potentially be dramatically reduced if violence was prevented. METHODS: A birth cohort of 14,605 persons was followed to age 64 using data from Swedish national health, criminal, and social registers. RESULTS: Percentages of group members convicted of violence differed significantly: males NOIDMD, 7.3%, ID 29.2%, SSD 38.6%, BD 30.7%; SUD 44.0%, and OMD 19.3%; females NOIDMD 0.8%, ID 7.7%, SSD 11.2%, BD 2.4%, SD 17.0%, and OMD 2.1%. Violent recidivism was high. Most violent offenders in the diagnostic groups were also convicted of non-violent crimes. Prior to first diagnosis, convictions (violent or non-violent) had been acquired by over 90% of the male offenders and two-thirds of the female offenders. Physical victimization, adult comorbid SUD, childhood conduct problems, and adolescent substance misuse were each associated with increased risks of offending. CONCLUSION: Sub-groups of cohort members with ID or mental disorders were convicted of violent and non-violent crimes to age 64 suggesting the need for treatment of primary disorders and for antisocial/aggressive behavior. Many patients engaging in violence could be identified at first contact with clinical services.

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Objective: To construct a model for predicting recidivism in violence in community-based schizophrenia spectrum disorder patients (SSDP) by adopting a joint modeling method. Methods: Based on the basic data on severe mental illness in Southwest China between January 2017 and June 2018, 4565 community-based SSDP with baseline violent behaviors were selected as the research subjects. We used a growth mixture model (GMM) to identify patterns of medication adherence and social functioning. We then fitted the joint model using a zero-inflated negative binomial regression model and compared it with traditional static models. Finally, we used a 10-fold training-test cross validation framework to evaluate the models' fitting and predictive performance. Results: A total of 157 patients (3.44%) experienced recidivism in violence. Medication compliance and social functioning were fitted into four patterns. In the counting model, age, marital status, educational attainment, economic status, historical types of violence, and medication compliance patterns were predictive factors for the frequency of recidivism of violence (P<0.05). In the zero-inflated model, age, adverse drug reactions, historical types of violence, medication compliance patterns, and social functioning patterns were predictive factors for the recidivism in violence (P<0.05). For the joint model, the average value of Akaike information criterion (AIC) for the train set was 776.5±9.4, the average value of root mean squared error (RMSE) for the testing set was 0.168±0.013, and the average value of mean absolute error (MAE) for the testing set was 0.131±0.018, which were all lower than those of the traditional static models. Conclusion: Joint modeling is an effective statistical strategy for identifying and processing dynamic variables, exhibiting better predictive performance than that of the traditional static models. It can provide new ideas for promoting the construction of comprehensive intervention systems.

Pharmacological interventions for alcohol misuse in correctional settings: A systematic review.

BACKGROUND: The prevalence of alcohol use disorder (AUD) is estimated to be 10 times higher amongst individuals in the criminal justice system than the general population. Alcohol use is also one of the strongest modifiable risk factors for recidivism. One intervention that has been shown to be effective in reducing alcohol consumption in the general population is medication-assisted treatment (MAT), and this systematic review synthesized the existing evidence on MAT for AUD in correctional settings. METHODS: Empirical, peer-reviewed studies on approved medications for AUD in correctional populations were searched in major databases. One hundred sixty-two articles were initially screened and 14 eligible articles were included in the final review. Four articles examined disulfiram, and 10 articles examined naltrexone. RESULTS: The studies on disulfiram were considerably older than those on naltrexone, predating contemporary scientific standards. Disulfiram in combination with substantial contingencies in a supervised setting significantly reduced alcohol-related measures of consumption and recidivism and had acceptable safety and tolerability. All naltrexone studies showed significant reductions in alcohol-related measures, but effects on recidivism were mixed. The naltrexone studies indicated that it was highly acceptable and well tolerated. In addition, offenders receiving naltrexone had significantly greater medication adherence, treatment attendance, and treatment duration than with placebo. CONCLUSIONS: A small number of studies on pharmacological interventions for AUD in the correctional population suggest that MAT is effective in reducing alcohol consumption, although results on recidivism are mixed. On balance, the evidence was more supportive of naltrexone in reducing alcohol-related outcomes than disulfiram and it may also be a more feasible intervention in correctional settings. Further research on MAT to address AUD in correctional populations with larger sample sizes, longer duration, and in combination with behavioral interventions is warranted.

Updated 5-year and new 10-year sexual recidivism rate norms for Static-99R with routine/complete samples.

Objective: The purpose of this study was to develop new 10-year recidivism rate norms as well as to update 5-year norms for the Static-99R risk tool for routine/complete samples. We also present the extrapolated sexual recidivism rates from these new 10-year norms for follow-up periods of 11 to 20 years. Hypotheses: We hypothesized that absolute-recidivism base rates (B02; i.e., the intercept centered on the median score of 2) would vary; however, the relative predictive accuracy (i.e., discrimination; B1) would be stable across samples. In addition, compared with the estimated sexual recidivism rates with a fixed 5-year follow-up time, the estimated rates with a fixed 10-year follow-up time would be expected to be consistently higher across the Static-99R scores. Method: The current study included 12 independent samples (N = 7,224 for the 5-year recidivism rate norms; N = 1,599 [k = 6] for the 10-year norms) classified as routine/complete samples, that is, relatively random samples from a correctional system. Logistic regression parameters (B02 and B1) across the studies were aggregated using fixed-effect meta-analyses. Results: There was statistically significant variability in the base rates (B02), whereas the between-sample variability in the relative-risk parameters (B1) was no more than would be expected by chance. As expected, the 10-year base rates were approximately 1.5 times higher than the 5-year base rates (7.20% vs. 4.58%), and the extrapolated 20-year sexual recidivism rates were approximately double the observed 5-year sexual recidivism rates. Conclusions: The current study provides empirical evidence to estimate 5- and 10-year sexual recidivism rates based on Static-99R total scores. Evaluators who are especially concerned about long-term sexual recidivism risk (e.g., civil commitment) can report the expected sexual recidivism risk based on the new 10-year norms and the extrapolated sexual recidivism rates for follow-up periods of 11 to 20 years. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Preventing school-based arrest and recidivism through prearrest diversion: Outcomes of the Philadelphia police school diversion program.

OBJECTIVES: Created to combat the school-to-prison pipeline, the Philadelphia Police School Diversion Program offers voluntary community-based services to eligible youth accused of minor school-based offeses in lieu of arrest. This study evaluated program effectiveness in accomplishing goals related to reductions in school-based arrests, serious behavioral incidents, and recidivism. HYPOTHESES: We expected the annual number of school-based arrests in Philadelphia schools to decrease over the program's first 5 years and predicted that the annual number of serious behavioral incidents would not increase. Further, we expected that diverted youth-compared to youth arrested in schools the year before Diversion Program implementation-would have significantly lower rates of recidivism arrests in the 2 years following their school-based incidents. METHOD: Using a quasi-experimental design, we examined data from 2,302 public school students (67.0% male; 76.1% Black; age range: 10-22 years) who were either diverted from arrest through the Diversion Program or arrested in Philadelphia schools in the year prior to Diversion Program implementation. We compared rate of recidivism arrest, number of arrests, and time to arrest between diverted and arrested youth. We also used district-wide descriptive statistics to examine 5-year trends in school-based arrests and serious behavioral incidents. RESULTS: Since program implementation, the annual number of school-based arrests in Philadelphia has declined by 84% and the number of serious behavioral incidents has declined by 34%. Diverted youth demonstrated less recidivism than arrested youth in the 2 years following their initial incident; however, after propensity score matching, we no longer observed significant differences. CONCLUSIONS: Findings indicate that a prearrest diversion program can safely reduce school-based arrests and suggest a need for future research regarding the role of demographic and incident-related characteristics in recidivism outcomes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

STABLE-2007 Demonstrates Predictive and Incremental Validity in Assessing Risk-Relevant Propensities for Sexual Offending: A Meta-Analysis.

STABLE-2007 is a measure of risk-relevant propensities for adult males convicted of a sexual offense. This meta-analysis evaluated the ability of STABLE-2007 and its items to discriminate between recidivists and nonrecidivists, and the extent to which STABLE-2007 improves prediction over and above Static-99R. Based on 21 studies (12 unique samples, N = 6,955), we found that STABLE-2007 was significantly and incrementally related to sexual recidivism, violent (nonsexual) recidivism, violent (including sexual) recidivism, and any crime. Scores on STABLE-2007 items and the three STABLE-2000 attitude items also discriminated between individuals who sexually reoffended and those who did not sexually reoffend. These findings support the use of STABLE-2007 in applied risk assessment practice and the interpretation of STABLE-2007 items as indicators of treatment and supervision targets.

Cross-Validation of the Revised Version of the Violence Risk Appraisal Guide (VRAG-R) in a Sample of Individuals Convicted of Sexual Offenses.

The aim of the present study was to examine the psychometric properties of the German version of the revised Violence Risk Appraisal Guide (VRAG), the VRAG-R. Therefore, VRAG-R ratings were made retrospectively in an Austrian sample of 534 individuals convicted of a sexual offense who were followed up with an average of 7.62 years. The VRAG-R showed large effect sizes for the predictive accuracy of violent (AUC = .75) and general recidivism (AUC = .78) and significant but rather small effect sizes (AUC = .63 and .61, respectively) in predicting any sexual and sexual contact recidivism. Furthermore, for the prediction of violent recidivism but not for sexual recidivism the VRAG-R was incrementally predictive beyond the Sex Offender Risk Appraisal Guide (SORAG) and the Static-99. Finally, the VRAG-R absolute recidivism rates for the risk bins showed satisfactory calibration properties. Taken together, the results of the present study support the cross-national utility of the VRAG-R and its use in applied risk assessment settings also in German-speaking countries.

Estimating Lifetime and Residual Risk for Individuals Who Remain Sexual Offense Free in the Community: Practical Applications.

Although individuals with a history of sexual crime are often viewed as a lifelong risk, recent research has drawn attention to consistent declines in recidivism risk for those who remain offense free in the community. Because these declines are predictable, this article demonstrates how evaluators can use the amount of time individuals have remained offense free to (a) extrapolate to lifetime recidivism rates from rates observed for shorter time periods, (b) estimate the risk of sexual recidivism for individuals whose current offense is nonsexual but who have a history of sexual offending, and (c) calculate yearly reductions in risk for individuals who remain offense free in the community. In addition to their practical utility for case-specific decision making, these estimates also provide researchers an objective, empirical method of quantifying the extent to which individuals have desisted from sexual crime.

Risk factors for recidivism in individuals receiving community sentences: a systematic review and meta-analysis.

OBJECTIVE: We aimed to systematically review risk factors for criminal recidivism in individuals given community sentences. METHODS: We searched seven bibliographic databases and additionally conducted targeted searches for studies that investigated risk factors for any repeat offending in individuals who had received community (non-custodial) sentences. We included investigations that reported data on at least one risk factor and allowed calculations of odds ratios (ORs). If a similar risk factor was reported in three or more primary studies, they were grouped into domains, and pooled ORs were calculated. RESULTS: We identified 15 studies from 5 countries, which reported data on 14 independent samples and 246,608 individuals. We found that several dynamic (modifiable) risk factors were associated with criminal recidivism in community-sentenced populations, including mental health needs (OR = 1.4, 95% confidence interval (CI): 1.2-1.6), substance misuse (OR = 2.3, 95% CI: 1.1-4.9), association with antisocial peers (OR = 2.2, 95% CI: 1.3-3.7), employment problems (OR = 1.8, 95% CI: 1.3-2.5), marital status (OR = 1.6, 95%: 1.4-1.8), and low income (OR = 2.0, 95% CI: 1.1-3.4). The strength of these associations was comparable to that of static (non-modifiable) risk factors, such as age, gender, and criminal history. CONCLUSION: Assessing dynamic (modifiable) risk factors should be considered in all individuals given community sentences. The further integration of mental health, substance misuse, and criminal justice services may reduce reoffending risk in community-sentenced populations.

Psychological interventions for antisocial personality disorder.

BACKGROUND: Antisocial personality disorder (AsPD) is associated with poor mental health, criminality, substance use and relationship difficulties. This review updates Gibbon 2010 (previous version of the review). OBJECTIVES: To evaluate the potential benefits and adverse effects of psychological interventions for adults with AsPD. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, 13 other databases and two trials registers up to 5 September 2019. We also searched reference lists and contacted study authors to identify studies. SELECTION CRITERIA: Randomised controlled trials of adults, where participants with an AsPD or dissocial personality disorder diagnosis comprised at least 75% of the sample randomly allocated to receive a psychological intervention, treatment-as-usual (TAU), waiting list or no treatment. The primary outcomes were aggression, reconviction, global state/functioning, social functioning and adverse events. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane. MAIN RESULTS: This review includes 19 studies (eight new to this update), comparing a psychological intervention against TAU (also called 'standard Maintenance'(SM) in some studies). Eight of the 18 psychological interventions reported data on our primary outcomes. Four studies focussed exclusively on participants with AsPD, and 15 on subgroups of participants with AsPD. Data were available from only 10 studies involving 605 participants. Eight studies were conducted in the UK and North America, and one each in Iran, Denmark and the Netherlands. Study duration ranged from 4 to 156 weeks (median = 26 weeks). Most participants (75%) were male; the mean age was 35.5 years. Eleven studies (58%) were funded by research councils. Risk of bias was high for 13% of criteria, unclear for 54% and low for 33%. Cognitive behaviour therapy (CBT) + TAU versus TAU One study (52 participants) found no evidence of a difference between CBT + TAU and TAU for physical aggression (odds ratio (OR) 0.92, 95% CI 0.28 to 3.07; low-certainty evidence) for outpatients at 12 months post-intervention. One study (39 participants) found no evidence of a difference between CBT + TAU and TAU for social functioning (mean difference (MD) -1.60 points, 95% CI -5.21 to 2.01; very low-certainty evidence), measured by the Social Functioning Questionnaire (SFQ; range = 0-24), for outpatients at 12 months post-intervention. Impulsive lifestyle counselling (ILC) + TAU versus TAU One study (118 participants) found no evidence of a difference between ILC + TAU and TAU for trait aggression (assessed with Buss-Perry Aggression Questionnaire-Short Form) for outpatients at nine months (MD 0.07, CI -0.35 to 0.49; very low-certainty evidence). One study (142 participants) found no evidence of a difference between ILC + TAU and TAU alone for the adverse event of death (OR 0.40, 95% CI 0.04 to 4.54; very low-certainty evidence) or incarceration (OR 0.70, 95% CI 0.27 to 1.86; very low-certainty evidence) for outpatients between three and nine months follow-up. Contingency management (CM) + SM versus SM One study (83 participants) found evidence that, compared to SM alone, CM + SM may improve social functioning measured by family/social scores on the Addiction Severity Index (ASI; range = 0 (no problems) to 1 (severe problems); MD -0.08, 95% CI -0.14 to -0.02; low-certainty evidence) for outpatients at six months. 'Driving whilst intoxicated' programme (DWI) + incarceration versus incarceration One study (52 participants) found no evidence of a difference between DWI + incarceration and incarceration alone on reconviction rates (hazard ratio 0.56, CI -0.19 to 1.31; very low-certainty evidence) for prisoner participants at 24 months. Schema therapy (ST) versus TAU One study (30 participants in a secure psychiatric hospital, 87% had AsPD diagnosis) found no evidence of a difference between ST and TAU for the number of participants who were reconvicted (OR 2.81, 95% CI 0.11 to 74.56, P = 0.54) at three years. The same study found that ST may be more likely to improve social functioning (assessed by the mean number of days until patients gain unsupervised leave (MD -137.33, 95% CI -271.31 to -3.35) compared to TAU, and no evidence of a difference between the groups for overall adverse events, classified as the number of people experiencing a global negative outcome over a three-year period (OR 0.42, 95% CI 0.08 to 2.19). The certainty of the evidence for all outcomes was very low. Social problem-solving (SPS) + psychoeducation (PE) versus TAU One study (17 participants) found no evidence of a difference between SPS + PE and TAU for participants' level of social functioning (MD -1.60 points, 95% CI -5.43 to 2.23; very low-certainty evidence) assessed with the SFQ at six months post-intervention. Dialectical behaviour therapy versus TAU One study (skewed data, 14 participants) provided very low-certainty, narrative evidence that DBT may reduce the number of self-harm days for outpatients at two months post-intervention compared to TAU. Psychosocial risk management (PSRM; 'Resettle') versus TAU One study (skewed data, 35 participants) found no evidence of a difference between PSRM and TAU for a number of officially recorded offences at one year after release from prison. It also found no evidence of difference between the PSRM and TAU for the adverse event of death during the study period (OR 0.89, 95% CI 0.05 to 14.83, P = 0.94, 72 participants (90% had AsPD), 1 study, very low-certainty evidence). AUTHORS' CONCLUSIONS: There is very limited evidence available on psychological interventions for adults with AsPD. Few interventions addressed the primary outcomes of this review and, of the eight that did, only three (CM + SM, ST and DBT) showed evidence that the intervention may be more effective than the control condition. No intervention reported compelling evidence of change in antisocial behaviour. Overall, the certainty of the evidence was low or very low, meaning that we have little confidence in the effect estimates reported. The conclusions of this update have not changed from those of the original review, despite the addition of eight new studies. This highlights the ongoing need for further methodologically rigorous studies to yield further data to guide the development and application of psychological interventions for AsPD and may suggest that a new approach is required.

Short- and long-term effects of imprisonment on future felony convictions and prison admissions.

A substantial contributor to prison admissions is the return of individuals recently released from prison, which has come to be known as prison's "revolving door." However, it is unclear whether being sentenced to prison itself has a causal effect on the probability of a subsequent return to prison or on criminal behavior. To examine the causal effect of being sentenced to prison on subsequent offending and reimprisonment, we leverage a natural experiment using the random assignment of judges with different propensities for sentencing offenders to prison. Drawing on data on all individuals sentenced for a felony in Michigan between 2003 and 2006, we compare individuals sentenced to prison to those sentenced to probation, taking into account sentence lengths and stratifying our analysis by race. Results show that being sentenced to prison rather than probation increases the probability of imprisonment in the first 3 years after release from prison by 18 percentage points among nonwhites and 19 percentage points among whites. Further results show that such effects are driven primarily by imprisonment for technical violations of community supervision rather than new felony convictions. This suggests that more stringent postprison parole supervision (relative to probation supervision) increases imprisonment through the detection and punishment of low-level offending or violation behavior. Such behavior would not otherwise result in imprisonment for someone who had not already been to prison or who was not on parole. These results demonstrate that the revolving door of prison is in part an effect of the nature of postprison supervision.

Electronic monitoring devices during substance use treatment are associated with increased arrests among women in specialty courts.

Background: Electronic monitors (EMs) are commonly used as a sanction and to improve compliance with substance use treatment and reduce re-arrest in criminal justice settings. However, there is minimal evidence for their effectiveness, especially among women. Objectives: We examined whether the use of EMs (i.e., devices placed on one's body to encourage treatment compliance) increased rates of substance use treatment completion, and as a result, reduced re-arrest and substance use among women offenders. Methods: We sampled 114 women referred to residential substance use treatment and a subsample of 102 women charged with felonies. Logistic regression models accounting for clustering of time within person were fit. Results: Overall, EMs were associated with 3.13 greater odds of re-arrest after accounting for criminogenic risk indicators; however, no association was detected among women charged with felonies only. Women who were assigned to EMs were significantly less likely to report illicit drug use in the past 30 days, and women charged with felonies were less likely to report both alcohol and illicit drug use in the past 30 days. There was no association between EM assignment and treatment completion or positive urinalysis result. Conclusion: EM provision did not enhance the retention of women in residential treatment and the presence of an EM was associated with a more than tripling in the odds of re-arrest. Results also suggest that EM use for women in Specialty Courts may have some limited utility in reducing substance use; however, the mechanism driving this effect remains unclear.

Comparison of outcome in men and women after treatment in psychiatric security hospitals in Germany.

Previous research has shown that forensic psychiatric treatment reduces reoffending, rehospitalization and premature mortality. Treatment outcome varies with diagnosis, but little is known about the influence of sex, psychosocial adjustment and aftercare. To assess these variables, we interviewed male and female patients discharged from three psychiatric security hospitals in Germany in the years 2010-2017. Participants were interviewed at discharge (n = 609) and 1 year later (n = 366) about reoffending, readmissions, substance use and psychosocial adjustment. Among patients with substance use disorder (SUD), 14% reoffended, 20% were re-hospitalized and 60% maintained abstinence. Among patients with severe mental disorder, 5% reoffended and 13% were re-hospitalized. Significant sex differences were found in offenders with SUD. The results suggest that sociodemographic and disorder-related risk factors are associated with treatment success and that female patients with SUD might need a specific treatment approach. Sex-specific aspects, diagnosis and psychosocial adjustment should be considered in forensic psychiatric treatment and risk assessment.

Employing standardized risk assessment in pretrial release decisions: Association with criminal justice outcomes and racial equity.

OBJECTIVE: We examined efforts by a Mississippi court to base pretrial release decisions on risk assessment rather than primarily on bond. HYPOTHESES: (a) Pretrial detention will be shorter than that associated with prevailing bond practices in the same counties. (b) Rearrest rates will be lower than a similar pretrial population in a nearby southern state. (c) False positive rates for predicting rearrests will be higher for African American than Caucasian participants. (d) Pretrial detention will be longer for African American participants because of higher risk scores or assessment overrides. METHOD: Pretrial defendants (N = 521) completed the Risk and Needs Triage (RANT) within 2 weeks of arrest, and outcomes examined included the length of pretrial detention, index case dispositions, and rearrest rates. RESULTS: (a) Pretrial detention averaged approximately 60 days compared with prevailing detentions averaging approximately 90 and 180 days in the same counties. (b) Pretrial rearrest rates were 17 percentage points higher than a similar pretrial population; however, representative comparison data are unavailable to confidently measure recidivism impacts. (c) Positive predictive power did not differ by race in predicting pretrial rearrests, SE = .04, 95% CI [.11, -.06], z = .61, p = .54, d = .08. (d) Despite comparable risk scores, African American participants were detained significantly longer than Caucasian participants (M = 60.92 vs. 45.58 days), p = .038, d = .18, 95% CI [.01, .36], and were less likely to receive a diversion opportunity (11% vs. 23%), p = .009, V = .17. CONCLUSION: The observational design precludes causal conclusions; however, risk assessment was associated with shorter pretrial detention than prevailing bond practices with no racial disparities in risk prediction. Greater attention to risk assessment may reduce racial inequities in pretrial conditions. Representative comparison data are needed to measure the recidivism impacts of pretrial reform initiatives. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Predictive validity of the Structured Assessment of Violence Risk in Youth (SAVRY) among a sample of Asian Canadian youth on probation.

OBJECTIVE: Although past studies suggest that the Structured Assessment of Violence Risk in Youth (SAVRY; Borum et al., 2006) has moderate predictive validity, its predictive validity with Asian youth in Western countries is unknown. We therefore compared the SAVRY's predictive validity in a sample of Asian Canadian versus White Canadian youth. HYPOTHESES: Given that the SAVRY is normed on samples comprising mostly youth who are White, we expected its predictive validity for recidivism would be lower for Asian Canadians than White Canadians. METHOD: We examined youth probation officers' SAVRY assessments for 573 youth (445 White Canadians, 56 East/Southeast Asian Canadians, and 72 South Asian Canadians) on community supervision (i.e. probation) in a Canadian province. Youth were prospectively followed for an average of 1.97 years (SD = 0.56 years) to determine if they were subsequently charged with violent or nonviolent offenses. RESULTS: Asian Canadians scored significantly lower on risk total scores compared to White Canadians. Predictive validity for violent and nonviolent recidivism fell in the medium to large range for East/Southeast Asian Canadians (AUCs = .69 to .89) and South Asian Canadians (AUCs = .64 to .83). In comparison, predictive validity for White Canadians was generally lower (AUCs = .63 to .77; small to large range). Risk total scores and nonviolent risk ratings significantly predicted nonviolent recidivism better for East/Southeast Asian Canadians (AUCs = .89 and .87, respectively) than White Canadians (AUCs = .77 and .71, respectively). Despite few significant differences between Asian subgroups, predictive validity for nonviolent risk ratings was significantly higher in East/Southeast Asian Canadians (AUC = .87) than South Asian Canadians (AUC = .64). CONCLUSIONS: The SAVRY may be a useful tool for predicting recidivism with Asian Canadians. However, future research should examine the SAVRY's predictive validity for youth of Asian descent in different countries and contexts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

On the Effectiveness of Sexual Offender Treatment in Prisons: A Comparison of Two Different Evaluation Designs in Routine Practice.

Although there is less continuity of sexual offending in the life course than stereotypes suggest, treatment should lead to a further reduction of reoffending. Contrary to this aim, a recent large British study using propensity score matching (PSM) showed some negative effects of the core sex offender treatment program (SOTP) in prisons. International meta-analyses on the effects of sex offender treatment revealed that there is considerable variety in the results, and methodological aspects and the context play a significant role. Therefore, this study compared different designs in the evaluation of sex offender treatment in German prisons. PSM was compared with an exact matching (EM) by the Static-99 in a sample of 693 sex offenders from Bavarian prisons. Most results were similar for both methods and not significant due to low base rates. There was a treatment effect at p < .05 on general recidivism in the EM and at p = .06 on serious reoffending in the PSM. For sexual recidivism, EM showed a negative trend, whereas PSM suggested the opposite. Overall, the study underlines the need for more replications of evaluations of routine practice, methodological comparisons, sensitive outcome criteria, and differentiated policy information.

Comparing Recidivism of Sexual and Nonsexual Offenders: The Role of Humanist, Spiritual, and Religious Involvement.

Some research has considered whether faith-informed programs help persons with a previous incarceration navigate a life away from crime. Few studies considered whether offense category moderates this relationship. Building upon studies that found a strong association between a prior sexual conviction and participation in religion in prison, we assess whether time spent in humanist, spiritual, and religious (HSR) programs in prison is associated with reconviction, separately for persons convicted of a sex offense and any other offense. Our results revealed that a higher level of participation in HSR programs was associated with a lower likelihood and rate of reconviction; however, this effect was more pronounced for persons with a prior sexual conviction. Supplementary analyses revealed that the use of religion in an extrinsic manner was beneficial, suggesting this group may look to religion to gain social support and overcome rejection and loneliness. Extrinsic religiosity among other groups, however, was associated with an increased risk of reconviction.