The Cal-DSH diversion guidelines.

The Cal-DSH Diversion Guidelines provide 10 general guidelines that jurisdictions should consider when developing diversion programs for individuals with a serious mental illness (SMI) who become involved in the criminal justice system. Screening for SMI in a jail setting is reviewed. In addition, important treatment interventions for SMI and substance use disorders are highlighted with the need to address criminogenic risk factors highlighted.

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.

Principles and practices of risk assessment in mental health jail diversion programs.

Eligibility criteria for participation in mental health jail diversion programs often specify that, to be diverted, a candidate must not pose a level of threat to public safety that cannot be managed in the community. Risk assessment tools were developed to increase consistency and accuracy in estimates of threat to public safety. Consequently, risk assessment tools are being used in many jurisdictions to inform decisions regarding an individual's appropriateness and eligibility for mental health jail diversion and the strategies that may be successful in mitigating risk in this context. However, their use is not without controversy. Questions have been raised regarding the validity and equity of their estimates, as well as the impact of their use on criminal justice outcomes. The purpose of this review is to provide an overview of the science and practice of risk assessment to inform decisions and case planning in the context of mental health jail diversion programs. Our specific aims include: (1) to describe the process and components of risk assessment, including differentiating between different approaches to risk assessment, and (2) to consider the use of risk assessment tools in mental health jail diversion programs. We anchor this review in relevant theory and extant research, noting current controversies or debates and areas for future research. Overall, there is strong theoretical justification and empirical evidence from other criminal justice contexts; however, the body of research on the use of risk assessment tools in mental health jail diversion programs, although promising, is relatively nascent.

Multisubstance-Using Probationers and the Odds of Arrest While in the Community.

Failed drug tests commonly lead to technical violations and revocation hearings for probationers. The current study extends these observations by examining whether multisubstance-using probationers also have increased odds of arrest in the community. This is important as multisubstance-using probationers may present unique public safety challenges to community corrections agencies and require intensive treatment resources and additional monitoring. Using data from a county-level probation cohort (N = 2,257) from 2009 to 2010, a series of logistic regression analyses estimated the effects of multisubstance use on the odds of being arrested for a new offense while in the community. The findings revealed that multisubstance use and the frequency of multisubstance use increased the odds of arrest while on probation when compared with single-substance users. We discuss how agencies may best supervise multisubstance-using probationers and suggest directions for further examination.

Predictors of Change of Working Alliance Over the Course of Probation Supervision: A Prospective Cohort Study.

The body of evidence that the working alliance is associated with positive outcomes for mandated clients is growing. The aim of this research was to investigate the influence of several characteristics of probation officers (POs) and offenders on the course of the working alliance during probation supervision. This study examined the patterns on the four alliance subscales: Trust, Bond, Goals-Restrictions, and Reactance of the Working Alliance With Mandated Clients Inventory (WAMCI) in 201 offenders and their 137 POs. Three patterns on each alliance subscale were found: deteriorating, improving, and stable. Multinomial logistic analysis revealed that change of POs and the preference of the PO to maintain rules were associated with a deteriorating Trust pattern. From the perspective of the offenders, being motivated to take part in supervision was associated with a stable pattern on every alliance subscale, but having problems with substance use increased the likelihood of a deteriorating pattern on every alliance subscale.

The Collateral Consequences of Sex Offender Management Policies: Views From Professionals.

In this study, the perceptions of community corrections professionals and clinical specialists toward the collateral consequences of current sex offender management policies were explored and contrasted. In addition, potential influencing factors of these perceptions were examined. Results indicate high levels of belief that sex offenders experience a variety of collateral consequences upon reentry; however, community corrections professionals are significantly less likely to believe that sex offenders experience collateral consequences than clinical specialists. Furthermore, few demographic variables were found to significantly influence the perceptions of the sample. Implications for the management of sex offenders are discussed.

Impacto del daño cerebral adquirido en la integración comunitaria: reinserción laboral, discapacidad y dependencia dos años después de la lesión / Impact of acquired brain injury towards the community integration: employment outcome, disability and dependence two years after injury

Objetivos. Analizar el impacto del daño cerebral adquirido en la integración comunitaria (trayectoria laboral, discapacidad y dependencia) en una muestra de sujetos con daño cerebral adquirido de etiología vascular, traumática y tumoral, durante un período de dos años tras la lesión original, y examinar qué variables sociodemográficas, datos clínicos premórbidos y relacionados con la lesión predicen la integración en la comunidad. Pacientes y métodos. Muestra de 106 sujetos adultos con daño cerebral adquirido, atendidos en el Área de Neuropsicología y Neuropsiquiatría del Complejo Hospitalario de Navarra, con déficit de memoria como secuela principal. Las diferencias entre grupos se analizan con los tests t de Student, chi al cuadrado y U de Mann-Whitney. Resultados. De los participantes que antes de la lesión se encontraban activos laboralmente, el 19% y 29% recuperaron su estatus previo al año y a los dos años, respectivamente; a un 45% de la muestra total se le reconoció la discapacidad, y a un 17%, la dependencia. No se halló relación entre las variables sociodemográficas y clínicas y los parámetros funcionales contemplados. Conclusiones. La lesión cerebral adquirida impacta con intensidad en la trayectoria vital de los afectados, aunque no se han estudiado antes en España sus consecuencias en el ajuste sociolaboral en los dos años siguientes al daño a través de parámetros funcionales valorados con instrumentos oficiales estatales en una muestra de etiología vascular, traumática y tumoral (AU)

Aims. To analyze the impact of acquired brain injury towards the community integration (professional career, disability, and dependence) in a sample of people affected by vascular, traumatic and tumor etiology acquired brain damage, over a two year time period after the original injury, and also to examine what sociodemographic variables, premorbid and injury related clinical data can predict the level of the person’s integration into the community. Patients and methods. 106 adults sample suffering from acquired brain injury who were attended by the Neuropsychology and Neuropsychiatry Department at Hospital of Navarra (Spain) affected by memory deficit as their main sequel. Differences among groups have been analyzed by using t by Student, chi squared and U by Mann-Whitney tests. Results. 19% and 29% of the participants who were actively working before the injury got back their previous status within one and two years time respectively. 45% of the total sample were recognized disabled and 17% dependant. No relationship between sociodemographic and clinical variables and functional parameters observed were found. Conclusions. Acquired brain damage presents a high intensity impact on affected person’s life trajectory. Nevertheless, in Spain, its consequences at sociolaboral adjustment over the the two years following the damage through functional parameters analyzed with official governmental means over a vascular, traumatic and tumor etiology sample had never been studied before (AU)

Re: Mental health rehabilitation in therapeutic jurisprudence: Theoretical improvements.

Legal scholarship relevant to criminal court mental health initiatives that divert people with mental illness from prosecution to treatment has created the concept of therapeutic jurisprudence (TJ), an approach that seeks to maximize the law's potential for therapeutic outcomes. Despite recognition that TJ includes a rehabilitative response as a key animating principle and that it advocates for interdisciplinary synthesis, TJ has developed mainly from within the practice and discipline of law and without reference to the discipline of rehabilitation science, in which approaches to mental health rehabilitation (MHR) have witnessed significant developments in recent decades. In particular, concepts of MHR have shifted from a biomedical focus to a psychosocial approach, such as the recovery model, that incorporates values of self-determination, independence, and empowerment. It is argued that greater consideration of MHR will improve the theoretical validity of TJ by 1) helping define what 'therapeutic' means; 2) constructing a normative framework; and 3) broadening the scope of TJ as an interdisciplinary approach. More research is needed to ensure concepts from MHR rehabilitation science are considered in TJ legal scholarship and criminal court mental health initiatives.

Public support of community corrections in China.

There are a variety of factors that have been associated with support for the use of community corrections in the West. However, little research has been completed to examine if these same factors are also associated with support for the use of community corrections in China. This exploratory study examined the degree of agreement and support of 764 Chinese citizens on the use of community corrections methods. Results indicated that most respondents supported the use of community corrections methods rather than traditional incarceration methods. In addition, five attitudes (the punishment perspective, the rehabilitation perspective, the humanitarian perception, cost-effectiveness, and risk) toward the use of community corrections methods were examined and all were found to be significantly associated with the support of community corrections in present-day China.

[Is "mental health" part of the common good? The sociopolitical framework of psychiatric ethics and the responsibility of health-care elites]. / "Psychische Gesundheit" als Gemeinwohlgut und der soziopolitische Rahmen einer Ethik der Psychiatrie--die Verantwortung der Eliten im Gesundheitswesen.

Psychiatric work can only be that ethical as the framework of a health-care system allows. Thus, the responsibility of the health-care elites to establish a sociopolitical framework that suits psychiatric ethics is discussed on the basis of a theory of the common good and of a philosophical and normative elite theory. "Mental health" is demonstrated to be part of a basic sphere of the common good which cannot be denied to any member of a society. The final section discusses which specific duties can be derived for health-care elites on the ground of the aforementioned conception of "mental health" as a part of the common good.

[Handling of patients with dementia--scenario 2050]. / Umgang mit Demenz--Szenario 2050.

The relationship between social attitudes, normative ethics, health care elite's and individual failure has been highlighted in a scenario for patients with dementia. Inhuman abuse may be protected by sense of responsibility, duty to social being, inclusion of psychiatric patients, and the foundation of human dignity.

Spirituality and desistance from substance use among reentering offenders.

Prior research has indicated an inverse relationship between religion and criminal behavior; however, few studies have specifically examined the effect of spirituality on the desistance process among a contemporary and diverse sample of reentering drug-involved offenders. A comprehensive understanding of how spirituality is related to desistance from substance use can lead to more effective and evidence-based preventive and rehabilitative interventions. Using data from a longitudinal study of 920 diverse offenders returning to the community after a period of incarceration, the current study examines three distinct forms of substance use (alcohol, marijuana, and cocaine) to gauge the effect that spirituality plays in the desistance process. The findings suggest a relatively high importance of spirituality in terms of preventing substance use during reentry, particularly concerning the use of both alcohol and cocaine.

El proceso de re-integración de la capacidad legal / No disponible

El presente artículo trata sobre la experiencia de una usuaria, Almudena, atendida por el Equipo de Apoyo Socio Comunitario(EASC) «Retiro» desde abril de 2008, quien recientemente, en el mes de enero de 2013, consiguió la Reintegración de su capacidad legal tras haber estado durante tres años y medio en situación de curatela económica, ejercida por una institución tutelar, la Agencia Madrileña de Tutela de Adultos (AMTA).Este hecho y la intervención psicosocial articulada para lograrlo, han promovido un proceso de reflexión y de autocrítica interna en los profesionales implicados y cercanos al caso. Esa reflexión se centró en primer lugar en un análisis de la posición más bien pasiva (en vez de proactiva) que tendemos a adoptaren un primer momento ante este tipo de propuestas, en segundo lugar sobre la desconfianza de la que partíamos con Respecto al éxito del proceso (contraria al factor de esperanza, clave en cualquier intervención terapéutica) y, en tercer lugar, sobre la función y/o funciones que desempeñamos los profesionales en general, y los recursos de rehabilitación en particular, en el desarrollo de este proceso. En este relato pasamos a exponer los pasos previos que se dieron antes y durante la tramitación de la solicitud para la RE-integración de la capacidad legal (objetivos a alcanzar dentro de su proceso de intervención, metodología de trabajo adoptada por el EASC, coordinaciones con el resto de profesionales implicados en el caso -Servicio de Salud Mental y AMTA-, preparación de la documentación y la vista judicial). En último lugar, pasamos a plasmar las reflexiones y conclusiones a las que hemos llegado tras haber pasado con Almudena por esta experiencia tan gratificante, en la que hemos experimentado que la recuperación no puede ser completa si no tenemos también presente el objetivo de que la persona recupere sus derechos civiles. Finalmente se transcribe el escrito que realizó Almudena para el día de la vista judicial y que adjuntó a su solicitud

The current article is about the experience of a patient, Almudena, who was being taken care by the «Equipo de ApoyoSocio-Comunitario (EASC) Retiro» from April 2008. Recently, in January2013, she achieved her legal capacity back after she was in a legal situation of economic partial guardianship for three years and a half. This situation was applied by a guardianship institution called «Agencia Madrileña de Tutela de Adultos (AMTA)».Both the fact and its psychosocial intervention in order to achieve it have boosted a process of reflection and inner self-criticism among the professionals involved in this case. First of all, that reflection was focused on the analysis of the position rather «passive» —instead of a proactive one— that we are keen to adopt before this kind of propositions at first glance. Secondly, it was also focused on the mistrust from which we start regarding the success of the process —that was contrary to the factor of hope, a key factor in any therapeutic intervention—.Thirdly, it was focused on the function and/or functions that we the professionals play in general and the rehabilitation resources throughout this process in particular. In this article we will expose the previous steps that took place before and during the application process for the Reintegration of the legal capacity (goals to be achieved within the intervention process, methodology adopted by EASC, coordination with other professionals involved in the case -Mental Health Services and AMTA-, document processing and hearing). Afterwards, we will show the considerations and conclusions that we have reached after having undergone this rewarding experience with Almudena, through which we have realized that recovery can not be complete if the person has not recovered his civil rights. Finally, there is a transcription of the writing drafted by Almudena for the day of the hearing and attached to her application

Final priority--National Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers. Final priority.

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation Research and Training Center (RRTC) on Disability in Rural Areas. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend this priority to improve outcomes among individuals with disabilities in rural areas.

Final priority; National Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers. Final priority.

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation Research and Training Center (RRTC) on Community Living Policy. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend this priority to improve outcomes among individuals with disabilities.

Final priorities; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priorities.

The Assistant Secretary for Special Education and Rehabilitative Services announces priorities under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce priorities for a Rehabilitation Engineering Research Center (RERC) on Rehabilitation Strategies, Techniques, and Interventions (Priority 1), Information and Communication Technologies Access (Priority 2), Individual Mobility and Manipulation (Priority 3), and Physical Access and Transportation (Priority 4). The Assistant Secretary may use one or more of these priorities for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend these priorities to improve community living and participation, health and function, and employment outcomes of individuals with disabilities.

Final priority; National Institute on Disability and Rehabilitation Research--Advanced Rehabilitation Research Training Program. Final priority.

The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for the Advanced Rehabilitation Research Training (ARRT) program under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2013 and later years. We take this action to ensure that NIDRR's resources are appropriately allocated across the three outcome domains--community living and participation, employment, and health and function. We intend this priority to (1) strengthen the capacity of the disability and rehabilitation field to train qualified individuals, including individuals with disabilities, to conduct high-quality, advanced multidisciplinary rehabilitation research; and (2) improve outcomes for individuals with disabilities across the domains of community living and participation, employment, and health and function.