Youth adjustment to parental illness or disability: the role of illness characteristics, caregiving, and attachment

This study aimed to (1) examine relations between youth adjustment and three sets of predictors: parental illness/disability characteristics, caregiving, and parent-child attachment, and (2) explore differences on these variables between youths of parental physical illness/disability and youths of parental mental illness. Eighty-one youths between 10 and 25 years of a parent with a physical illness/disability (35%) or a mental illness (43%) completed a series of self-report measures assessing perceived characteristics of the parent's illness/disability, caregiving experiences, and adjustment outcomes. Results revealed a set of predictors of poorer youth adjustment: gradual illness/disability onset, being male, isolation, lower perceived maturity, and less choice in caregiving. Youths of parental mental illness differed from youths of parental physical illness/disability on emotional distress (worry and discomfort) dimensions of caregiving. Youth-parent attachment security was associated with youth caregiving and there was a trend for attachment to vary according to parental illness/disability type. Findings highlight young caregiving as an important target for service and policy planning.     

Survivor mission: Do those who survive have a drive to thrive at work?

Are helping professionals who have experienced the same types of struggles as their clients more engaged at work? In the current investigation, we examine this question in samples of police detectives (with and without a history of violent victimization) and mental health workers (with and without a history of mental illness). Our results indicate that police detectives who have experienced violent victimization and mental health professionals who have experienced the same mental illness as their clients do indeed exhibit greater work engagement than their colleagues who lack these parallel life experiences. The link between a professional’s firsthand experience of his/her client’s hardships and work engagement appears to be partially explained by higher levels of grit among police detectives and by a greater sense of life-narrative continuity among mental health professionals.     

Using Force: Australian Newspaper Depictions of Contacts Between the Police and Persons Experiencing Mental Illness

The media creates and sustains knowledge about socially relevant issues such as crime, mental illness, and policing. Past research suggests that while the media portrayal of the police is undoubtedly complex, their portrayal of people experiencing mental illness remains mainly negative. The depiction of their encounters in the mass media is of considerable interest because of the influential role the media has on public opinion and debate; however, there is a lack of current research in this area. This study aimed to examine media items in the major newspapers across Australia between January 2006 and December 2007 (n = 77) to investigate their portrayal of this interface. The dominant themes encountered in the initial analysis depicted people experiencing mental illness as dangerous and a threat to the public, where the mental health system has failed to manage them adequately. Further analyses found that people experiencing mental illness were stigmatised in a third of the media items reviewed and were represented significantly more negatively in these encounters than the police. Implications of these findings and some suggestions regarding possible strategies that could improve socially responsible media reporting and public discourse on mental illness are proposed.     

A randomized controlled trial of community-oriented and hospital-oriented care for discharged psychiatric patients: influence of personality disorder on police contacts

An important forensic psychiatric measure, contacts with police, was compared in a randomized, controlled trial of 155 patients with severe mental illness with a previous admission within the past two years. The patients, who also had their personality status addressed formally before randomization, were allocated to community multidisciplinary teams or to hospital-based care programs after discharge from in-patient care and were followed up for one year. A total of 138 patients (89%) had at least one post-baseline assessment and of these patients, 16 (12%) had at least one police contact in the year of the study, most of which were emergency assessments. The data showed significantly greater numbers of police contacts in patients with increasing severity of personality disturbance. Patients with such disturbance were six times more likely to have police contacts than those with no personality disorder. There were significantly more contacts in patients with borderline and antisocial (dissocial) personality disorder allocated to community-oriented care compared with hospital-oriented care. These findings have important implications for risk assessment in severe mental illness.     

The Lawyer in the Dutch Interrogation Room: Influence on Police and Suspect

In many European countries, providing a suspect in custody with legal aid before the first police interrogation is a heavily debated issue. In this paper, we report on an exploratory study on the use of coercion by the police and the use of the right to silence by suspects in 70 Dutch homicide cases and their relation to prior consultation and presence of a lawyer. Analysis of the data indicates that there is a relation between the presence of a lawyer in the interrogation room and the way in which police interrogators use coercion. To gain insight into whether the police use coercion and how this is achieved, we looked at the extent to which the interrogators make use of certain interrogation techniques and how the interrogation techniques are used to exert coercion. We found that legal advice from a lawyer before and during the interrogation corresponds with suspects more often using their right to silence. It also appears that the police are inclined to use ‘hard coercion’ when confronted with a silent suspect. The research thus raises the question as to whether the presence of a lawyer is an adequate way to prevent false confessions. Copyright © 2012 John Wiley & Sons, Ltd.     

Mental Illness: Fact or Myth? Revisiting the Debate Between Albert Ellis and Thomas Szasz

Although it is widely accepted that mental illnesses affect millions of people worldwide, there is still disagreement among scholars about the facts of mental illness. The orthodox position is that mental illness is a fact; critics argue that it is a myth. Thomas Szasz was perhaps the most influential critic of mental illness while Albert Ellis was one of the most influential psychotherapists of the twentieth century. Yet, they disagreed about the facts of mental illness. Ellis argued that mental illness is a fact; Szasz argued that mental illness is a metaphor that we have mistaken for a fact. Both men were practicing psychotherapists: Ellis developed Rational Emotive Behavior Therapy and treated mentally ill clients as irrational thinkers; Szasz developed Autonomous Psychotherapy and treated clients as existential game-players who choose, or have been coerced into, the role of sick patient. Szasz vehemently disagreed with Ellis’s view that some people with serious mental illnesses should be institutionalized and treated against their will. While Ellis argued that mental illness is a convenient label for people who are a danger to themselves and others, Szasz argued that mental illness is a metaphor for moral problems in living and involuntary institutionalization and treatment are crimes against humanity. This paper, then, revisits the debate between Ellis and Szasz on the vexed topic of mental illness.     

Police practices and perceptions regarding juvenile interrogation and interrogative suggestibility

Recent media coverage has highlighted cases in which young suspects were wrongly convicted because they provided interrogation-induced false confessions. Although youth may be more highly suggestible and easily influenced by authority than adults, police are trained to use the same psychologically coercive and deceptive tactics with youth as with adults. This investigation is the first standard documentation of the reported interrogation practices of law enforcement and police beliefs about the reliability of these techniques and their knowledge of child development. Participants were 332 law enforcement officers who completed surveys about interrogation procedures and developmental issues pertaining to youth. Results indicated that, while police acknowledge some developmental differences between youth and adults, there were indications that (1) how police perceive youth in general and how they perceive and treat them in the interrogation context may be contradictory and (2) their general view is that youth can be dealt with in the same manner as adults.     

Perspectives of people with mental health problems at hot spots: Attitudes and perceptions of safety,crime, and the police

People who live in places with high levels of crime and disorder are more likely to experience mental illness compared with those who do not live in these types of place (Weisburd et al., 2018; Weisburd & White, 2019). The increased police presence on high crime streets may also increase the likelihood that these individuals will encounter law enforcement. There is a strong body of literature focused on the relationship between neighborhoods and the physical and mental health of residents (e.g. Arcaya et al., 2016; Duncan & Kawachi, 2018; Leventhal & Brooks‐Gunn, 2003), but there are very few studies that look at the perceptions of people with mental illness directly, particularly as they relate to the environment of the street on which they live and attitudes toward the police. In turn, existing studies generally look at the most serious mental health problems (e.g. schizophrenia), ignoring more common mental health concerns such as post‐traumatic stress disorder (PTSD) and depression. This paper uses self‐report data from a large in‐person survey of people who live on crime hot spot and non‐hot spot streets in order to assess attitudes among a broader group of persons with mental health problems. Furthermore, we examine the interaction between living in crime hot spots and non‐hot spots and perceptions of these residents. Our findings in this broader sample confirm earlier studies that identify greater fear and less trust of the police among persons with mental illnesses. At the same time, our findings suggest that fear of crime and perceptions of police are moderated by living in a crime hot spot.     

CIT in small municipalities: Officer‐level outcomes

Research on the Crisis Intervention Team (CIT) as a method to deal with mental illness in policing encounters has primarily focused on officers from large urban areas. The current study examined officer‐level outcomes in a non‐urban geographical setting using a pre/post‐CIT training design. The sample included 46 police officers from seven departments that would be considered rural and 13 that would be classified as suburban. Officers completed scales to gauge change in mental illness attitudes at the beginning and end of their one‐week CIT training. CIT training resulted in reductions in stigmatic attitudes with seven large effect sizes (ranging from η² = .24 to .59) across the two measures. The findings from this research are a direct response to the call for greater diversity in the size of police settings in the CIT literature and serve to expand the empirical base for CIT in relation to officer‐level outcomes.     

Integrating the criminal justice system into mental health service delivery: the worcester diversion experience

The substantial number of persons with mental illness encountered in many sectors of the criminal justice system has spurred actors from various agencies within that system to take actions aimed at reducing the growth of this population. These actions have included the development of specialty police units, jail diversion programs, and other mechanisms for channeling persons with mental illness out of the criminal justice system and into mental health treatment. The courts, too, have become involved in this effort with the recent development of the "mental health court," the latest of the "specialty" or "problem solving courts." These courts have not been without their critics, however, nor are they the only feasible approach to court-based diversion. This paper identifies and explores a range of options for structuring the relationship between criminal courts and local mental health systems. Beginning with a discussion of the rationale motivating the development of mental health courts, two alternatives to this specialty court model are discussed. One involves judges dealing with defendants having mental illness and substance abuse on a case-by-case basis. The other takes advantages of linkages that may already exist between most courts and the mental health providers who conduct their forensic assessments, expanding the role of these providers to serve as boundary spanners between courts and the components of local mental health systems. Regardless of the model adopted, however, appropriate linkages must exist between the courts and relevant providers. A case study is provided that demonstrates how the status of a locale's linkages can be evaluated and how the information derived from such evaluation can be used to improve the linkages between police, courts, and health and human services agencies.     

Insurance Coverage and Mental Health Service Use by Adolescents with Serious Emotional Disturbance

This paper examines the relationships between insurance coverage, need, and mental health services in a community-based sample of 1,015 youths who were 9, 11, and 13 years old at the beginning of the study. They were followed over a two-year period. A strong measure of need based on a standardized diagnostic interview was available and repeated over three annual waves. Data on service use was collected quarterly across two years. Major findings included: (a) high need (serious emotional disturbance [SED]) was strongly related to use of any mental health services; (b) services use was much more likely to occur with public (Medicaid) insurance coverage than either private or no insurance; (c) considerable unmet need was observed even for youths with SED; (d) school-based mental health services potentially substituted for professional mental health services; and (e) there was little unnecessary use of mental health services in the low need group. The major policy implication of these findings is that the regulation of insurance benefits should be based on level of need, rather than on arbitrary limits which are likely to either reduce the probability of or appropriate amount of care for youths who most need mental health services.     

Marshaling administrative data to study the prevalence of mental illness in assault on law enforcement cases

A substantial body of literature has investigated many issues surrounding police encounters with persons with mental illness. This paper focuses on a specific type of encounter – individuals with mental illness charged with assaulting officers because of their behavior during a psychiatric crisis – and uses administrative data to examine its prevalence in one state. Results suggest that individuals with mental health histories comprise a small but meaningful percentage (c. 9%) of assault on law enforcement charges, and c. 10% of these charges have an offense date within 14 days of an emergency mental health custody order, increasing the likelihood that psychiatric symptoms influenced their behavior at the time of the offense. Further results describe different categories of relevant charges, charge classifications, final dispositions, and sentences. Results are discussed in the context of outcomes for persons with mental illness and law enforcement as well as the role and limitations of forensic mental health assessment in these cases. The paper concludes with a call for similar data collection across jurisdictions.     

“I'm a police officer not a social worker or mental health nurse”: Online discourses of exclusion and resistance regarding mental health‐related police work

Despite estimates suggesting that around 15% of UK police incidents involve people with a mental health concern, officers receive very little mental health training. The police have faced high‐profile criticisms over their handling of mental health‐related incidents, whereas the underfunding and fragmentation of UK mental health services has led to concerns that police officers are being forced to undertake a primary role in mental health care. At a time of austerity and widespread cuts to public services, it is important to explore how particular groups work to justify the parameters of their professional duties. This article therefore explores the discourses surrounding mental health problems on an online police discussion forum, highlighting two distinct ways in which mental health‐related work is represented as being incompatible with policing. First, mental health problems are delegitimised and conflated with “scrounging,” positioning individuals as undeserving of police time; second, mental health problems are reified and associated with violence and extreme behaviour, justifying the use of force by police officers and deflecting responsibility onto mental health services. Findings are consistent with previous research suggesting that mental health work is not perceived to be a valid part of the police role.     

Using elaborative interrogation to facilitate acquisition of factual information in cooperative learning settings: One good strategy deserves another

The primary purpose of this study was to determine whether providing 6th-grade students with cooperative elaborative interrogation instruction would facilitate learning relative to providing them with cooperative learning, elaborative interrogation or reading-for-under-standing instructions. All students were presented with 36 factual statements about six animals. Cooperative elaborative interrogation students were instructed to work collaboratively and use their prior knowledge to state why each fact is true. Cooperative learning students were told to work collaboratively to learn target materials, while elaborative interrogation students were instructed to generate answers to the why questions on their own. Reading-control students were also on their own and instructed to read the animal facts for understanding. For immediate free recall and immediate associative matching tests, students in the experimental conditions outperformed those in the control condition. Cooperative elaborative interrogation and elaborative interrogation students maintained this advantage on a 30-day follow-up associative matching test, with elaborative interrogation students maintaining a significant advantage relative to reading controls on a 60-day associative matching follow-up. (There was also a strong trend favouring the cooperative elaborative interrogation condition on this 60-day measure.) The quality of the ‘why’ answer affected learning: Generating and listening to scientifically correct answers that used relevant prior knowledge to clarify target information was associated with better memory for facts than were other types of study responses. Students in this study learned the most when they were explicitly directed to activate relevant prior knowledge that supports and clarifies new information–processing that occurs following either small-group or individual elaborative interrogation instruction.     

Madness or Mental Illness? Revisiting Historians of Psychiatry

Is madness medical disease, problems in living, or social labeling of deviance? Does the word merely refer to behavior peculiar enough to be disturbing? Are the mad mad because of mental, physical, or environmental vulnerabilities? No one knows the answers to these questions because there is no scientific validation for any theory or specific causes of madness. Nonetheless, a view of madness as medical/bodily disease has been receiving concrete and rhetorical support from the government mental health bureaucracy, Big Pharma, mental health lobby groups, the organized profession of psychiatry, hundreds of thousands of providers of mental health services and countless books and articles. This article explores the role that medicalized language and its use by seven noted historians of psychiatry (Norman Dain, Albert Deutsch, Gerald Grob, Roy Porter, Charles Rosenberg, Andrew Scull, and Edward Shorter) might have played in shaping the contemporary view of madness as mental illness. The evidence we uncover suggests that historical “facts” about madness, much as psychiatric “facts” supporting the disease model, are shaped by belief, bias, error or ambiguous rhetoric rather than the facts of the matter.     

Predictors of recidivism by stalkers: a nine-year follow-up of police contacts

In a subsample of a multisite stalking study (Mohandie, Meloy, McGowan, & Williams, 2006) comprising 78 offenders from one site, 77% committed new offenses within an average follow-up of 106 months (8.8 years). Over half (56%) were charged for new stalking related offenses and 33% for violent recidivism. Violent reoffending, including sexual offenses, was predicted by risk factors consistent with existing literature: younger age at first conviction, prior release failures, and criminal history. Stalking recidivism was predicted by pre-index offending scores, using the Cormier-Lang, and prior diagnosis of a mental illness. In addition, stalkers with previously diagnosed mental illness had significantly more police contacts as complainants than those without; their recidivism was also more likely to be non-violent.     

Is It Me or My Brain? Depression and Neuroscientific Facts

This article considers the roles played by brain images (e.g., from PET scans) in mass media as experienced by people suffering from mental illness, and as used by scientists and activist groups in demonstrating a biological basis for mental illness. Examining the rhetorical presentation of images in magazines and books, the article describes the persuasive power that brain images have in altering the understanding people have of their own body—their “objective self.” Analyzing first-person accounts of encounters with brain images, it argues that people come to understand themselves as having neurotransmitter imbalances that are the cause of their illnesses via received facts and images of the brain, but that this understanding is incomplete and in tension with the sense that they are their brain. The article concludes by querying the emergence of a “pharmaceutical self,” in which one experiences one's brain as if on drugs, as a new form of objective self-fashioning.     

?Psychische St?rung�� als Begr��ndung f��r staatliche Eingriffe in Grundrechte des Individuums

When dealing with ?old cases?? of preventive detention as well as retrospectively ordered preventive detention, a continuation of confinement should be possible if the offender involved suffers from a ??mental disorder?? which constitutes the danger of future serious violent or sexual crimes. In this psychiatric article it will be explained that the terms ??mental illness?? and also ??mental disorder?? must retain an empirical scientifically definable psychiatric content in order not to instigate deception. They must also be functionally defined in each judicial environment (police law, social law, civil law and criminal law) with respect to the capabilities of the individual which are impaired by the mental disorder. Such an approach could prevent a misuse of psychiatry for purely political security purposes.     

Investigating true and false confessions within a novel experimental paradigm

The primary goal of the current study was to develop a novel experimental paradigm with which to study the influence of psychologically based interrogation techniques on the likelihood of true and false confessions. The paradigm involves guilty and innocent participants being accused of intentionally breaking an experimental rule, or "cheating." In the first demonstration of this paradigm, we explored the influence of two common police interrogation tactics: minimization and an explicit offer of leniency, or a "deal." Results indicated that guilty persons were more likely to confess than innocent persons, and that the use of minimization and the offer of a deal increased the rate of both true and false confessions. Police investigators are encouraged to avoid interrogation techniques that imply or directly promise leniency, as they appear to reduce the diagnostic value of any confession that is elicited.