Problem 1 Flashcards
There are high levels of psychiatric morbidity in prisoners. Researchers tried to find out where this stems from.
What were their main findings?
- Rates of psychosis were significantly higher in low- and middle income countries than in high-income ones
- No gender differences in rates of psychosis + depression
- No increase in rates of psychosis + depression over time
What is the difference between a prison and a jail ?
Prison
- an institution under state jurisdiction for confinement of people convicted of serious crimes
Jail
- a place under the jurisdiction of a local government, (e.g. county) for the confinement of people awaiting trial or those convicted of minor crimes
Why is it so important to reinforce appropriate screening and referral for treatment at intake to jail or prison ?
Because in not doing so a lot of prisoners often have undetected mental illnesses when going to jail
–> this way these inmates are at increased risk of
- clinical deterioration
- disciplinary concerns
- suicide attempts
Are there gender differences in undetected mental health disorders of prison inmates ?
Yes,
Women are more likely to have an undetected mental health illness
–> as a result they also have a higher morbidity rate
Are there racial differences in undetected mental health disorders of prison inmates ?
Yes,
White inmates are more likely than black/hispanic ones to have an
- affective disorder
- Anxiety disorder
Do severe mental illnesses necessarily lead to violent behavior ?
No,
Because severe mental illnesses do not independently predict future violent behavior mental illnesses can not be seen as the leading cause of violence in the general population
THUS: understanding the link between violent acts + mental disorder requires taking into account their association with other variables
e.g.: Substance abuse, environmental stressors, history of violence etc.
Why did people previously assume that the cause of violence by mentally disordered people is linked fundamentally to the mental disorder itself ?
Because, these disorders usually involve paranoid psychotic symptoms
e.g. schizophenia, depression
Social stress model
Suggests that stressful life events increase psychological disorder, whereas social support decreases it
Theory of general strain
(Agnew)
- Suggests that individuals who are stressed are more likely to experience negative affective states
- these states in turn create an internal pressure called corrective action
- this pressure is most likely to lead to violent behavior when violence is viewed as
a) an alternative means to goal achievement
b) as form of retribution aimed at punishing those believed responsible for the strained situation
Social bond theory
(Cullen)
The more social support in a persons social network - the less crime will occur
–> because, social support is an important precondition to effectively exert social controls
THUS: individuals in supportive relationships are likely to experience a greater degree of social control over their behavior than those who are not
Do stressful life events + impaired social support contribute to the association between mental disorder and violence?
Yes,
When stressful life events occure but you have strong social support, the association between mental disorder + violence is substantially reduced
Psychopathological theory of criminal behavior
Suggests that untreated mental illnesses such as schizophrenia and other psychotic disorders are considered a direct cause of criminal behavior
Is psychopathology a predictor for recidivism ?
No,
But age of onset of criminal activity is a significant moderating factor on the relationship between mental illness and recidivism
–> early age of onset is before 18
How is the forensic psychiatric system different in England and Wales vs Germany and Netherlands ?
- In EW psychiatric hospitals are divided into separate security levels whereas in GN all levels of security are put into one institution
- In EW almost all responsibility is put unto the responsible clinician whereas in GN patients retain autonomy where possible
- In EW hospitalization time is added unto the prison time if you don’t have diminished responsibility whereas in GN hospitalization time is deducted from prison sentence
Why is it suggested in EW to reform the current diminished responsibility plea ?
To bring it more in line with the varying levels of responsibility available in GN
–> this can be applied to any offense, this way many more people w/ mental health issues can be recognized and treated more appropriately
