Policy Determinants of Inequitable Exposure to the Criminal Legal System and Their Health Consequences Among Young People.

Criminalizing young people, particularly Black- and Brown-identified young people, has increasingly been a feature of US rhetoric, policies, and practices. Thus, the domains in which young people are exposed to the legal system have continued to expand, encompassing their communities, schools, and homes. Importantly, public health researchers have begun exploring links between legal system exposure and health, although this literature is primarily focused at the interpersonal level and assesses associations within a single domain or in adulthood.Using critical race theory and ecosocial theory of disease distribution, we identified potential policy-level determinants of criminalization and briefly summarized the literature on downstream health outcomes among young people. Our analysis suggests that policy decisions may facilitate the targeting of structurally marginalized young people across domains.Future research should (1) position these legislative decisions as primary exposures of interest to understand their association with health among young people and inform institutional-level intervention, (2) measure the totality of exposure to the criminal legal system across domains, and (3) use theory to examine the complex ways racism operates institutionally to shape inequitable distributions of associated health outcomes.

Decriminalizing severe mental illness by reducing risk of contact with the criminal justice system, including for forensic patients.

Risk of contact with the criminal justice system (CJS) is greater among those with mental illness, including severe mental illness-an observation that many argue reflects a process of "criminalizing" mental illness. Forensic patients represent a subgroup at one end of a spectrum of such criminalization, typically with histories of serious violence and psychotic illness. Strategies for decriminalizing mental illness in this context should consider a range of approaches, including intervening to prevent CJS contact in those with severe mental illness, particularly in the early or emerging stages of psychosis. However, it may be that even gold standard mental healthcare applied universally is insufficient to address CJS contact risks. While there is now an extensive literature documenting the relatively low rates of repeat CJS contact for forensic patients released from secure care, appropriate comparison groups are lacking and the key ingredients of any benefits of treatment are unknown. The CJS may well have something to learn from forensic mental health systems and services given the abject failure to stem rates of prison-release reoffending internationally. Understanding how to best identify risk and effectively intervene to prevent CJS contact in those with mental illness, whether early in the course of psychosis or following release from secure care, remains a priority for those seeking to address the criminalization of mentally illness in our communities.

From trauma-blind to trauma-informed: re-thinking criminalization and the role of trauma in persons with serious mental illness.

Trauma-informed approaches offer a new perspective for understanding how and why individuals with serious mental illness (SMI) become entangled in the criminal justice system. There is growing awareness that many individuals with SMI have experienced significant life trauma, and factors beyond SMI that contribute to criminalization are being identified; however, the role of trauma continues to be overlooked in many formulations. In trauma-blind systems, trauma-related behaviors are often misunderstood and met with responses that exacerbate psychiatric and behavioral problems. Trauma-informed approaches provide a richer understanding of underlying drivers of behavior, and view trauma as an integral component of risk management, case formulation, relationship-based care, and referral. Embedding trauma-informed principles across organizations promotes continuity of care, safety, and more compassionate cultures that help reduce the flow of individuals with SMI into the criminal justice system. An expanded view of the criminalization hypothesis is offered, which incorporates all factors addressed in current research.

Decriminalization in action: lessons from the Los Angeles model.

Los Angeles County's Office of Diversion and Reentry (ODR) has removed over 3800 people from the largest jail system in the country. Across various diversion programs, ODR's fundamental goal is to provide permanent, lifetime care for each diverted person. This article describes ODR's various diversion programs, and elucidates the types of elaborate clinical and court-related interventions that are necessary to remove persons with serious mental disorders from jail custody. As Los Angeles continues to build the necessary community-based continuum of mental health care, ODR's model proves that thoughtfully removing persons with serious mental disorders from jail is possible and necessary for the health of both patients and community.

Impact of risk assessment on judges' fairness in sentencing relatively poor defendants.

OBJECTIVE: Use of risk assessment instruments in the criminal justice system is controversial. Advocates emphasize that risk assessments are more transparent, consistent, and accurate in predicting re-offending than judicial intuition. Skeptics worry that risk assessments will increase socioeconomic disparities in incarceration. Ultimately, judges make decisions-not risk assessments. This study tests whether providing risk assessment information interacts with a defendant's socioeconomic class to influence judges' sentencing decisions. HYPOTHESES: Tentatively, socioeconomic status was expected to have a main effect; without an interaction with risk assessment information. METHOD: Judges (N = 340) with sentencing experience were randomly assigned to review 1 of 4 case vignettes and sentence the defendant to probation, jail, or prison. Information in the vignettes was held constant, except the defendant's socioeconomic status and whether risk assessment information was provided. RESULTS: Risk assessment information reduced the likelihood of incarceration for relatively affluent defendants, but the same information increased the likelihood of incarceration for relatively poor defendants. This finding held after controlling for the sex, race, political orientation, and jurisdiction of the judge. CONCLUSIONS: Cuing judges to focus on risk may re-frame how they process socioeconomic status-a variable with opposite effects on perceptions of blameworthiness for past crime versus perceptions of risk for future crime. Providing risk assessment information may have transformed low socioeconomic status from a circumstance that reduced the likelihood of incarceration (by mitigating perceived blameworthiness) to a factor that increased the likelihood of incarceration (by increasing perceived risk). Under some circumstances, risk assessment information may increase sentencing disparities. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Impacts of Medical Marijuana Laws on Young Americans Across the Developmental Spectrum.

Introduction State legalization of marijuana for medical purposes could increase illicit marijuana use among young people. Medical marijuana laws may boost the availability of marijuana and reduce perceptions of its harmfulness, leading more young people to try it. Prior studies report little evidence that these laws are impacting marijuana consumption by young Americans, and none have systematically compared developmentally distinct age groups. Methods We performed multilevel, serial cross-sectional analyses on ten annual waves of U.S. National Survey on Drug Use and Health, from 2004 to 2013, comparing young people in states with and without medical marijuana laws. Disaggregated analyses compared multiple measures of marijuana use across approximately 450,300 individuals in early adolescence (12-14 years), late adolescence (15-17 years) and young adulthood (18-25 years). Results Dwelling in a state that had legalized medical marijuana was not associated with marijuana consumption in the past month among early adolescents, late adolescents or young adults. However, young adults living in medical marijuana states were significantly more likely to have initiated first use in the past year. Conclusions Medical marijuana laws increase the likelihood that young adults will start using marijuana but do not affect more vulnerable developmental groups in early and late adolescence. Delaying the age of first use into young adulthood can reduce the risk of a drug use disorder later in life. Young adults are in the peak years of engagement with illicit drugs and state medical marijuana laws appear to be leading larger numbers to try the drug.

Incarcerating Pregnant and Parenting Women, the New Witch Hunt: A Policy Analysis.

The mass incarceration of pregnant and parenting women is a serious problem in U.S. A policy focus is needed that takes a public health approach. This paper outlines the problems with health care delivery in correctional facilities. It is argued that correctional facilities are not the place for pregnant and parenting women. Alternative policies and programs are recommended that align with a public health approach and directly targets the pathways for imprisonment.

Meth Mouth, White Trash, and the Pseudo-Racialization of Methamphetamine Use in the U.S.

Drug scares have historically been created for a range of purposes and with a variety of effects in the United States. Moral panics evoked by these drug scares either support or challenge dominant American ideas about race, economics, and society. In the present study, we examined newspaper accounts of methamphetamine use in the Inland Pacific Northwest of the United States in an effort to understand how the "reality" of the "meth epidemic" is socially constructed in a "meth hotspot," and reflect upon the ways that the discourse of Whiteness intersects with this construction. For our analysis, we are cognizant of the "slipperiness" of the logic of Whiteness as a concept, and the ways that an alternative logic is articulated - one that strategically embraces or distances White drug users to support notions of White dominance. We focus on the possibility that individual meth users could then be portrayed pseudo-racially as "White trash," and thus rendered outside the logic of White racial order. Our findings center on two main themes: (1) the use of fear in the construction of the meth drug scare through the sensationalization of meth, its anthropomorphization, and the depiction of the threat of the White drug user; and (2) how the logic of Whiteness is discursively reconciled within this construction. Given current mediated discourses about drug use and health in the United States that center on the emergence of the White drug user as the face of the opioid crisis, we are well served to carefully consider the recent historical precedence of the "meth epidemic" in which the public was faced with reconciling their views about drug use and the intersection of race, class, and mainstream American identity.

Risk and resources: A qualitative perspective on low-level sentencing in Virginia.

Virginia's sentencing guidelines include alternative sanctions based on the use of a quantitative instrument called the Nonviolent Risk Assessment (NVRA) that identifies individuals convicted of drug and property crimes that are considered to be at lower risk of recidivism. Although nondispositive, the NVRA affords judges the discretion to grant alternative sentences to eligible low-risk defendants. In this study, we explore how judges make use of the NVRA instrument when sentencing individuals convicted of low-level drug and property crimes. Through semistructured interviews (N = 24) and inductive thematic analysis, the research team identified contextual factors that influence the use of the NVRA results, including: the availability of alternative programs in a community, the role of court actors, particularly prosecutors, in shaping the sentencing outcomes, as well as an individual judge's willingness to defer to or reject negotiated plea agreements offered by the prosecutor. Our research shows that while some judges are aware of and embrace the benefits of the instrument, others lack knowledge altogether of its function and empirical basis. We identified seven themes that account for variation in how actuarial risk is utilized in the sentencing process. Our findings provide insight into the practical challenges of using risk-based assessment as a tool for the sentencing of low-level convictions. As more states adopt risk-based approaches to sentencing, studying Virginia, which has gone farther than other states in legislating this strategy, becomes increasingly important.

Ethical, Legal and Forensic Issues in Geriatric Psychiatry.

PURPOSE OF THE REVIEW: To evaluate the ethical, legal and forensic issues that is faced by the older adult population. RECENT FINDINGS: Many older individuals will face a host of ethical, medical and legal issues associated with their care. Most prominent among these issues are the maintenance of autonomy while ensuring their safety and the safety of individuals who care for them. Decisions regarding end of life including the formulation of advance directives add to the complexity of care for these older adults. A significant portion of individuals in the criminal justice system are aging and many of these individuals have psychiatric disorders. Their care is compromised due to the lack of appropriate services within criminal justice system for providing care for these individuals. CONCLUSIONS: Ethical, legal and forensic issues among older are not uncommon and complicate the care of these vulnerable individuals.

A systematic review of co-responder models of police mental health 'street' triage.

BACKGROUND: Police mental health street triage is an increasingly common intervention when dealing with police incidents in which there is a suspected mental health component. We conducted a systematic review of street triage interventions with three aims. First, to identify papers reporting on models of co-response police mental health street triage. Second, to identify the characteristics of service users who come in to contact with these triage services. Third, to evaluate the effectiveness of co-response triage services. METHODS: We conducted a systematic review. We searched the following databases: Ovid MEDLINE, Embase, PsycINFO, EBSCO CINAHL, Scopus, Thompson Reuters Web of Science Core Collection, The Cochrane Library, ProQuest National Criminal Justice Reference Service Abstracts, ProQuest Dissertations & Theses, EThoS, and OpenGrey. We searched reference and citation lists. We also searched for other grey literature through Google, screening the first 100 PDFs of each of our search terms. We performed a narrative synthesis of our results. RESULTS: Our search identified 11,553 studies. After screening, 26 were eligible. Over two-thirds (69%) had been published within the last 3 years. We did not identify any randomised control trials. Results indicated that street triage might reduce the number of people taken to a place of safety under S136 of the Mental Health Act where that power exists, or reduce the use of police custody in other jurisdictions. CONCLUSIONS: There remains a lack of evidence to evaluate the effectiveness of street triage and the characteristics, experience, and outcomes of service users. There is also wide variation in the implementation of the co-response model, with differences in hours of operation, staffing, and incident response.

Criminal responsibility: Meta-analysis and study space.

While some correlates of criminal responsibility (CR) outcomes are consistent, others are not. Study-level characteristics, such as sample selection, variability in the operational definition of insanity, or other unknown influences may explain discrepant findings. It is critical to systematically consolidate and assess the literature in order to guide future work. We conducted the first meta-analysis and study space analysis (see Malpass et al., ) in this area. 15 studies met inclusion criteria for the meta-analysis, which encompassed 19,500 cases. Summary effects for psycholegal cases indicated that older age, female sex, educational attainment, and unemployment were associated with insanity. Those classified insane more often had psychiatric histories and psychotic disorders. Finally, individuals opined or found insane were less likely to have criminal histories but more likely to have been opined incompetent to stand trial in the past. Importantly, virtually all summary effects were impacted by study design. Study space analyses (N = 7) revealed a dearth of literature that thoroughly addressed theoretically important variables. Taken together, the project provides a comprehensive, empirical analysis of CR correlates and a systematic call for future research.

Juvenile probation officers' evaluation of traumatic event exposures and traumatic stress symptoms as responsivity factors in risk assessment and case planning.

Juvenile probation officers (JPOs) are increasingly using risk/needs assessments to evaluate delinquency risk, identify criminogenic needs and specific responsivity factors, and use this information in case planning. Justice-involved youth are exposed to traumatic events and experience traumatic stress symptoms at a high rate; such information warrants attention during the case planning process. The extent to which JPOs identify specific responsivity factors, in general, and trauma history, specifically, when scoring risk/need assessments is understudied. In the current study, 147 JPOs reviewed case vignettes that varied by the adolescents' gender (male vs. female), traumatic event exposure (present vs. absent), and traumatic stress symptoms (present vs. absent), and then scored the YLS/CMI and developed case plans based on that information. JPOs who received a vignette that included trauma information identified a higher number of trauma-specific responsivity factors on the YLS/CMI. Despite an overall high needs match ratio (57.2%), few JPOs prioritized trauma as a target on case plans. The findings underscore the importance of incorporating trauma screening into risk/needs assessment and case planning. (PsycINFO Database Record

HIV, prisoners, and human rights.

Worldwide, a disproportionate burden of HIV, tuberculosis, and hepatitis is present among current and former prisoners. This problem results from laws, policies, and policing practices that unjustly and discriminatorily detain individuals and fail to ensure continuity of prevention, care, and treatment upon detention, throughout imprisonment, and upon release. These government actions, and the failure to ensure humane prison conditions, constitute violations of human rights to be free of discrimination and cruel and inhuman treatment, to due process of law, and to health. Although interventions to prevent and treat HIV, tuberculosis, hepatitis, and drug dependence have proven successful in prisons and are required by international law, they commonly are not available. Prison health services are often not governed by ministries responsible for national public health programmes, and prison officials are often unwilling to implement effective prevention measures such as needle exchange, condom distribution, and opioid substitution therapy in custodial settings, often based on mistaken ideas about their incompatibility with prison security. In nearly all countries, prisoners face stigma and social marginalisation upon release and frequently are unable to access health and social support services. Reforms in criminal law, policing practices, and justice systems to reduce imprisonment, reforms in the organisation and management of prisons and their health services, and greater investment of resources are needed.

A Validation Study of the Need for Affect Questionnaire-Short Form in Legal Contexts.

We evaluated the psychometric properties of scores on the Need for Affect-Short Form (NAQ-S) in 3 samples: undergraduate students (Sample I), jury-eligible community members (Sample II), and forensic clinicians (Sample III). Concerning factor structure, the NAQ-S 2-factor structure displayed good fit to the data in Sample I, with mostly acceptable levels of internal consistency for both approach and avoidance scores. Construct validity patterns were observed such that approach scores were most strongly correlated with female gender and trait agreeableness scores, whereas avoidance scores were most strongly correlated to trait agreeableness scores. Criterion validity associations emerged in that approach scores displayed main effects on mock juror judgments in hate crimes, and forensic clinician judgments of violence risk estimation. Finally, avoidance scores displayed moderating effects on recommended sentencing length by hate crime victim type. Implications are discussed for emotion in legal decision making and future research.

Overcoming Challenges to Care in the Juvenile Justice System: A Case Study and Commentary.

Youth in the criminal justice system commonly suffer from multiple medical and psychological health problems. Because they likely live in lower socioeconomic environments, the medical care they receive through the justice system might be their only recent medical care and can result in the discovery of health problems or chronic illnesses that must be managed while in the system and beyond. We describe the case of an adolescent diagnosed with a serious chronic disease during his time in an urban detention center to illustrate how health workers and justice staff must use a team approach in caring for this vulnerable population of children. Barriers to appropriate care, including social and systems-level challenges, are discussed. The lessons learned in this case can be applied more broadly to other vulnerable youth populations, including those in foster care and impoverished communities where the primary care pediatrician (or other assigned pediatric specialist) is both the leader of the medical team and an advocate for quality care.

Juvenile Probation Officer Self-Assessed Mental Health Competency as a Predictor of Case Management Practices.

Justice-involved youth endorse high rates of mental health problems. Juvenile probation is the most common disposition in the justice system and juvenile probation officers (JPOs) are crucial for connecting justice-involved youth with appropriate care. We examined the role of mental health competency on the use of self-report case management strategy types (deterrence, restorative justice, and treatment) by JPOs and whether jurisdiction-level differences were relevant. Results suggest that mental health competency predicted use of restorative justice and treatment strategies and all three strategy types varied at the county level. The role of mental health competency in use of treatment strategies is relevant to connecting justice-involved youth to mental health care. Furthermore, a substantial amount of the variance predicting the use of all three strategies was accounted for at the county level.

Low-SES Preschool Children's Eyewitness Memory: The Role of Narrative Skill.

This study investigated the relation between narrative skill and eyewitness memory in young children from low-socioeconomic status (SES) communities. A total of 176 children aged 3-5 years were interviewed about a conflict event they witnessed. The quality of their narratives about the event and their ability to narrate a story from a picture book were examined in relation to memory of the event. Comprehensive measures of individual differences in vocabulary skill, adaptive language use, and behavioral characteristics were also administered. The results revealed that children who produced longer, more descriptive, and more cohesive narratives about the event recalled more accurate details and made fewer memory errors, independent of their language ability and behavioral characteristics. The quality of story narratives did not make any independent contributions to memory. Child's age was a robust predictor of memory for the event. Implications of the findings for understanding eyewitness memory in low-SES children are discussed. Copyright © 2016 John Wiley & Sons, Ltd.

Getting to Know You: Familiarity, Stereotypes, and Children's Eyewitness Memory.

The present study concerned how the acquisition of social information, specifically knowledge about personal characteristics, influences young children's memory and suggestibility. Effects of two sources of knowledge about a target person were systematically examined: familiarity and stereotypes. Children, aged 4-5 and 7-9 years (N = 145), were randomly assigned, per age group, to experimental conditions based on a familiarity (6 hours vs. no prior exposure) × stereotype (negative depiction as messy and clumsy vs. no stereotype) factorial design. Children then watched the target person engage in a target event (a series of contests) at a preschool ("Camp Ingrid"). The children's memory and suggestibility about the target person and target event were tested after a delay of 2 weeks. Results indicated that the negative stereotype resulted in an increase in children's correct responses both to free-recall stereotype-related questions (when children were unfamiliar with the target person) and to closed-ended questions overall (for younger children). However, the stereotype was associated with greater error to stereotype-related closed-ended questions. Moreover, familiarity increased children's accuracy to closed-ended questions. Implications for theory and application are discussed. Copyright © 2016 John Wiley & Sons, Ltd.

The Diagnostic Value of Children's Responses to Cross-Examination Questioning.

In response to a widespread belief within the legal system that cross-examination is instrumental in uncovering the truth, we examined the effect of cross-examination questioning on the reports of children who had-and had not-been coached to lie. A group of children, aged 6-11 years (N = 65), played three computer games with one of their parents. For half of the pairs, the parents-who acted as confederates-coached their children to make lies of commission concerning the occurrence of two target activities. For the remaining pairs, these two target activities actually occurred, and there was no coaching. Immediately afterwards, children were interviewed about the two activities. Those who-correctly or incorrectly-reported that both activities occurred were retained for the final sample (n = 56); these children were then interviewed again with both neutral questions and cross-examination-style challenges. Neither style of questioning elicited responses that discriminated between liars and truth-tellers: although the accuracy of children who were lying increased in response to cross-examination questions, the accuracy of truth-telling children saw a corresponding decrease. When asked neutral questions, children's responses tended to be consistent with their earlier responses, whether or not those responses were lies. These findings raise important questions about the function that cross-examination might serve in trials involving child witnesses. Copyright © 2016 John Wiley & Sons, Ltd.