A Trigger Warning: Red Flag Laws are Still Constitutionally Permissible and Could Reduce the Suicide Rates in the Country's Most Vulnerable States.

Montana, Alaska, and Wyoming lead the United States in a category coveted by no one: the suicide rate. Firearm ownership drives the rate to the disproportionate level it reaches year after year and the states are left with little recourse. This article argues the usefulness and constitutionality of narrowly tailored red-flag laws aimed exclusively at reducing the rate of suicide in these mountain states. The article follows Supreme Court jurisprudence leading up to New York Rifle and Pistol Association v. Bruen and offers an analysis that complies with the hyper textualist history and tradition test laid out by Scalia in District of Columbia v. Heller and McDonald v. City of Chicago. The analysis demonstrates that narrowly tailored red flag laws are a constitutional means of reducing the suicide rate in these at-risk states and references statutory and cultural avenues for the implementation of the legislation.

Children's vulnerabilities and pathways to conflict with the law: Insights from Swatantra Clinic, a specialised mental health service at a tertiary care centre in India.

'Swatantra-Clinic' at NIMHANS, India, provides mental healthcare to vulnerable children. This study describes the clinical profile, vulnerability and protective factors of 77 adolescents in conflict with the law (CICL). 90.9 % (n=70) reported Adverse Childhood Experiences (ACEs), 58.4 % (n=45) had school-related difficulties, 68.9 % (n=53) reported child labour experiences, 64.9 % (n=50) had deviant peer associations, and 40 % (n=31) experimented with substance use. Despite vulnerabilities, 72.7 %(n=56) had a positive future orientation, 45.5 % (n=35) had supportive caregivers and exhibited prosocial skills. only 12 % (n=9) followed up on recommendations, highlighting the need for collaborative and transdisciplinary care to promote CICL rehabilitation and community integration.

Adult safeguarding legislation: Navigating the borderlands between mental capacity, mental health and social care law and practice.

Adult safeguarding legislation is contentious because it seeks to protect 'vulnerable' adults who fall between the borderlands of social care, mental health and mental capacity law. As a new and complex area of law and practice, further research on adult safeguarding legislation is required, in particular to consider it efficacy and human rights implications. Utilising a narrative literature review approach this article explores current research evidence on the Adult Support and Protection (Scotland) Act 2007 to consider whether safeguarding powers and duties can achieve a proportionate balance between individual autonomy and the state's duties to protect adults at risk of harm and, if so, how. The findings demonstrate there is a wide range of people who can fall into these borderland areas. For a majority, the use of the Act has made significant positive differences to their lives. However, while supported decision-making was identified it was not found to be consistently applied. In addition, concerns emerged around the adequacy of some professionals' legal knowledge, the consistent upholding of adults' will and preferences, and the commitment to and resourcing of supported decision-making. Notwithstanding these drawbacks, it is concluded that this Act provides vital functions but amendments would enhance alignment with the CRPD.

US Medical-Legal Partnerships to Address Health-Harming Legal Needs: Closing the Health Injustice Gap.

The medical-legal partnership (MLP) model is emerging across the USA as a powerful tool to address the adverse social conditions underlying health injustice. MLPs embed legal experts into healthcare teams to address health-harming legal needs with civil legal remedies. We conducted a narrative review of peer-reviewed articles published between 2007 and 2022 to characterize the structure and impacts of US MLPs on patients, providers, and healthcare systems. We found that MLPs largely serve vulnerable patient populations by integrating legal experts into community-based clinical settings or children's hospitals, although patient populations and settings varied widely. In most models, healthcare providers were trained to screen patients for legal needs and refer them to legal experts. MLPs provided a wide range of services, such as assistance accessing public benefits (e.g., Social Security, Medicaid, cash assistance) and legal representation for immigration and family law matters. Patients and their families also benefited from increased knowledge about legal rights and systems. Though the evidence base remains nascent, available studies show MLPs to be associated with greater access to care, fewer hospitalizations, and improved physical and mental health outcomes. Medical and legal providers who were engaged in MLPs reported interdisciplinary learning, and healthcare systems often experienced high returns on investment through cost savings and increased Medicaid reimbursement. Many MLPs also conducted advocacy and education to effect broader policy changes related to population health and social needs. To optimize the MLP model, more rigorous research, systematic implementation practices, evaluation metrics, and sustainable funding mechanisms are recommended. Broader integration of MLPs into healthcare systems could help address root causes of health inequity among historically marginalized populations in the USA.

Are autistic people disadvantaged by the criminal justice system? A case comparison.

LAY ABSTRACT: Most autistic people will never experience being arrested or charged with a crime, however for those who do tend to be less satisfied with the way they were treated. The purpose of this study was to find out if autistic people are being disadvantaged by the criminal justice system if they are arrested. Previous research has shown that autistic people may have difficulties communicating with the police. This study builds on this knowledge by uncovering why autistic people may not feel able to communicate with the police and whether the police made any adjustments to help them. This study also measures the impact of being involved with the criminal justice system on autistic people's mental health, such as stress, meltdowns and shutdowns. The results show that autistic people were not always given the support they felt they needed. For example, not all autistic people had an appropriate adult with them at the police station who could help to make sure they understood what was happening around them. Autistic people were also more likely to feel less able to cope with the stress and more likely to suffer meltdowns and shutdowns because of their involvement with the criminal justice system. We hope this study will help police officers and lawyers to better support autistic people if they become involved with the criminal justice system.

International migrants' right to sexual and reproductive health care.

International migration puts people's sexual and reproductive health (SRH), particularly those of women and children, at increased risk. However, many international migrants are denied access to timely and adequate SRH information, goods, and services by governments and/or service providers. This article reviews relevant international human rights treaties to argue that the barriers faced by migrants in accessing SRH care constitute violations of international law. It is well established that migrants are guaranteed access to SRH care as a part of their right to health, as well as the rights enjoyed by vulnerable populations. Increasingly, hindrance of migrants' access to SRH care is also recognized as a threat to their rights to life and equality with non-migrants. The case of Toussaint v Canada illustrates how governments may be held accountable by human rights treaty monitoring bodies when they fail to respect and fulfill migrants' right to SRH care.

Perceived structural vulnerabilities among detained noncitizen immigrants in Minnesota.

Across several decades there has been an unprecedented increase in immigration enforcement including detention and deportation. Immigration detention profoundly impacts those experiencing detention and their family members. An emerging area of research has found that immigrants experience a number of challenges which constrain and limit their decisions, choices, and options for security and integration in the United States due to social, political and structural determinants. These determinants lead to greater structural vulnerabilities among immigrants. The purpose of the current study was to illuminate the perceived vulnerabilities of detained noncitizen immigrants as they are raised and described while attending case hearings at the Bloomington, Minnesota immigration court. Through conducting a thematic analysis of notes derived from third party immigration court observers, three areas of perceived vulnerability were identified. These perceived vulnerabilities include 1) migration and motivations to migrate, 2) structural vulnerabilities (e.g., discrimination, financial insecurity, social ties and family support, stable or fixed residence, English language proficiency, health and mental health) in the US, and 3) challenges in navigating immigration detention. These findings demonstrate that noncitizen immigrants who are undergoing immigration detention are experiencing multiple intersecting vulnerabilities which profoundly impact their lives. Collaborative efforts across sectors are needed to work towards comprehensive immigration reforms including both short-term and long-term solutions to address pressing issues for noncitizens undergoing immigration detention.

Las personas con discapacidad intelectual como víctimas de delitos contra la libertad sexual: una realidad invisible / People with Intellectual Disability as Victims of Sexual Offences: An Invisible Reality

El presente trabajo tiene por objeto conocer los ajustes de procedimiento que se desarrollan durante los procesos judiciales ante hechos constitutivos de abuso o agresión sexual cuando la víctima presenta una discapacidad intelectual o del desarrollo (DID). Además, analiza las características de víctimas con DID y agresores, aportando información adicional sobre el proceso de denuncia. Para ello, se analizaron un total de 56 sentencias resueltas en un periodo de cuatro años (2014-2018), extrayendo informa­ción objetiva de las mismas con respecto a los aspectos más relevantes referidos a la víc­tima, el delito, el agresor y al proceso judicial. Del análisis realizado podemos concluir la existencia de multitud de obstáculos que aún siguen presentes en la práctica judicial española, siendo necesaria una formación exhaustiva de las personas vinculadas a los sistemas procesales en aspectos referidos a esta discapacidad: la víctima declara en reite­radas ocasiones, especialmente cuando se juzga un delito de agresión sexual, sin ningún tipo de adaptación o apoyo profesional. Señalamos asimismo la necesidad de evaluar la huella psicológica que pudiera presentar la víctima, así como desterrar mitos con respec­to a las discapacidades del desarrollo que dificultan el derecho a acceder y participar en los procedimientos judiciales en condiciones de igualdad

The following paper aims to analyze the provision of procedural accom­modations during the legal process to victims of sexual abuse or sexual assault with an intellectual or developmental disability (IDD). It also examines the characteristics of victims with IDD and their aggressors, providing additional information on the re­porting process. To this end, a total of 56 sentences resolved over a period of four years (2014-2018) were analyzed, extracting objective information regarding the most relevant aspects of the crime committed, the victim, the aggressor, and the legal process. The obtained results showed the existence of different obstacles that are still present in the Spanish jurisprudence, requiring an appropriate training for those working in the field of administration of justice: the victim declares repeatedly, especially when a crime of sexual assault is being judged, and without any type of accommodation or professional support. We also point out the need to evaluate the psychological consequences that the victim may experience, and to dispel myths regarding developmental disabilities that hinder access and participation in legal proceedings under equal conditions

Exploring equity and inclusion in Malawi's National Disability Mainstreaming Strategy and Implementation Plan.

BACKGROUND: Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi's National Disability Mainstreaming Strategy and Implementation Plan. METHODS: We applied an analytical methodology to review the Malawi's National Disability Mainstreaming Strategy and Implementation Plan using the EquIPP (Equity and Inclusion in Policy Processes) tool. The EquIPP tool assesses 17 Key Actions to explore the extent of equity and inclusion. RESULTS: The development of the Malawi National Disability Mainstreaming Strategy and Implementation Plan was informed by a desire to promote the rights, opportunities and wellbeing of persons with disability in Malawi. The majority (58%) of the Key Actions received a rating of three, indicating evidence of clear, but incomplete or only partial engagement of persons with disabilities in the policy process. Three (18%) of the Key Actions received a rating of four indicating that all reasonable steps to engage in the policy development process were observed. Four (23%) of the Key Actions received a score five indicating a reference to Key Action in the core documents in the policy development process. CONCLUSIONS: The development of disability policies and associated implementation strategies requires equitable and inclusive processes that consider input from all stakeholders especially those whose wellbeing depend on such policies. It is pivotal for government and organisations in the process of policy or strategy development and implementation, to involve stakeholders in a virtuous process of co-production - co-implementation - co-evaluation, which may strengthen both the sense of inclusion and the effectiveness of the policy life-cycle.

Tecer e Aprender: Programa Bolsa Família, principais orientações

Orientações sobre o Programa Bolsa Família - Sesap/RN.

When and how to include vulnerable subjects in clinical trials.

There has been a good deal of discussion in the literature regarding which subjects are vulnerable in the context of clinical trials. There has been significantly less discussion regarding when and how to include vulnerable subjects in clinical trials. This lack of guidance is a particular problem for trials covered by the US regulations, which mandate strict requirements on the inclusion of three groups: pregnant women/fetuses, prisoners, and children. For the past 30 years, funders, investigators, and institutional review boards have frequently responded to these regulations by excluding pregnant women/fetuses, prisoners, and children from clinical trials. More recent work has emphasized the extent to which a default of exclusion can undermine the value of clinical trials, especially pragmatic trials. A default of exclusion also has the potential to undermine the interests of vulnerable groups, in both the short and the long term. These concerns raise the need for guidance on how to satisfy existing US regulations, while minimizing their negative impact on the value of clinical trials and the interests of vulnerable groups. The present manuscript thus describes a six-step decision procedure that institutional review boards can use to determine when and how to include vulnerable subjects in clinical trials, including pragmatic trials, that are covered by US regulations.

Challenges Related to Safety and Independence.

Advancing age is associated with increasing risk of activities important for independence, such as driving and living alone. Cognitive impairment is more common with older age; financial resources and social support may dwindle. Risk, cognitive impairment, and decisional capacity each change over time. Transparent decision making and harm reduction help balance risk and safety. When a patient lacks decisional capacity, an option that considers the patient's preferences and shows respect for the person is favored. Vulnerable patients making choices that are high risk, and patients for whom others are making such choices, may require state intervention.

Cumulative Disadvantage: A Psychological Framework for Understanding How Innocence Can Lead to Confession, Wrongful Conviction, and Beyond.

False confessions are a contributing factor in almost 30% of DNA exonerations in the United States. Similar problems have been documented all over the world. We present a novel framework to highlight the processes through which innocent people, once misidentified as suspects, experience cumulative disadvantages that culminate in pernicious consequences. The cumulative-disadvantage framework details how the innocent suspect's naivete and the interrogator's presumption of guilt trigger a process that can lead to false confession, the aftereffects of which spread to corrupt evidence gathering, bias forensic analysis, and virtually ensure wrongful convictions at trial or through pressured false guilty pleas. The framework integrates nascent research underscoring the enduring effects of the accumulated disadvantages postconviction and even after exoneration. We synthesize findings from psychological science, corroborating naturalistic evidence, and relevant legal precedents to explain how an innocent suspect's disadvantages can accumulate through the actions of law enforcement, forensic examiners, prosecutors, defense attorneys, judges, juries, and appeals courts. We conclude with prescribed research directions that can lead to empirically driven reforms to address the gestalt of the multistage process.