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This chapter offers a prospective and naturalistic study of the impact of a risk-assessment and risk-management program on mentally abnormal young offenders admitted to a medium secure adolescent psychiatric inpatient unit in the United Kingdom (U.K.) because of violent, dangerous or self-harming behaviour. As a result of the risk assessment, there was a reduction in their violent, dangerous or self-harming behaviour that was significantly associated with a reduction in the number of risk factors. About 80% were discharged directly back into the community.

Large numbers of adults with mental illness detained by police, seen in the courts, and confined in prisons and jails has been a longstanding concern of officials in the mental health and criminal justice systems. Diversion programs represent an important strategy to counteract the criminalization of persons with mental illness. The challenge is to identify and integrate resources in such a way that an organization bridging the police, courts, mental health, substance abuse, homelessness, welfare and entitlements agencies would evolve that would effectively and appropriately serve offenders with mental health issues, keeping them stable in the community and reducing recidivism.

This chapter focuses on women's descriptions of their own violence in nineteenth-century Ireland, as revealed in prisoner petitions held in the National Archives of Ireland. It uses the case files of women imprisoned or sentenced to death for violent crimes such as infanticide, manslaughter, murder, wounding and assault. This chapter takes an empirical approach and considers the ways that women explained and rationalised their violent acts. An analysis of the petitions offers an insight into women's views of their own violence, gendered attitudes at the time, and women's sense of the factors that might lead to a commutation of sentence. The accuracy or truthfulness of the petitions is not important in this study; instead, the chapter explores the self-image that women wanted to portray and the tactics that they opted to use to seek a reduction in their sentences. As shown in this chapter, most women emphasised their passivity: they typically claimed to be innocent, coerced or provoked into violence.

The original ‘plan’ for deinstitutionalization of America's population of persons with severe and persistent mental illness saw community mental health services as providing many of the functions of large mental hospitals in community settings. While substantial effort and resources have been committed to this enterprise, many persons with mental illness encounter significant problems in adjusting to life in the community. Prominent among these problems is the disproportionate involvement in the criminal justice system of persons with psychiatric disorders. This problem, popularly described as the ‘criminalization’ of mental illness, often threatens the clinical stability and safety of persons with mental disorders, and at the same taxes heavily the resources of the criminal justice system. This paper reviews data exploring the relationship between levels and availability of community-based services and the likelihood that persons with mental illness will become involved with the criminal justice system. Finding no relationship, we conjecture that community mental health services are effective with only certain individuals, and move toward a taxonomy of offenders with mental illness. This classification scheme takes into account the relationship between psychiatric disorder, lifestyle and pre-morbid criminal involvement, and is designed to inform system actors with regard to the targeting of these resources.

Traditionally evaluators of offending behaviour programmes have examined group-level mean change in treatment targets without acknowledging the potential variability of change at an individual level. Clinically significant change, although used widely in the therapy literature generally, has only recently been examined within forensic therapeutic contexts. This chapter provides an overview of key concepts, and the published literature in which clinically significant change has been examined within forensic samples is reviewed. It is concluded that although this technique has the potential to validate programme theory, it is yet to be used to its full potential within a forensic context.

Purpose – This chapter provides a roadmap for future research and evaluation on violent extremist risk analysis.

Methodology/Approach – The authors synthesize the lessons learned from process evaluations of general violence risk assessment, bias research, survey designs, linguistic analyses, and spatial analyses, and apply them to the problem of violent extremist risk assessment and management.

Findings – The next generation of violent extremist risk assessment research will necessitate a focus upon process, barriers to effective implementation and taking the human element of decision-making into account. Furthermore, the development of putative risk factors for violent extremist attitudes and behaviors necessitates a movement toward more survey-based research designs. Future risk assessment processes may additionally take language and spatial components into account for a more holistic understanding.

Originality/Value – Based on existing literature, there is a paucity of research conducting process evaluations, survey designs, linguistic analyses, and spatial analyses in this area. The authors provide several roadmaps, assessments of respective strengths and weaknesses, and highlight some initial promising results.

The aim of this article is an analysis of the links between race and psychotic illness, psychiatric diagnosis and treatment, as well as psychiatric, police and prison violence against people with mental health problems. The analysis focuses on Black men who are more frequently diagnosed with schizophrenia and other psychotic disorders and who face more brutal treatment than other people with such diagnoses. We have adopted a multidisciplinary approach which draws insights from psychiatry, psychology, and sociology and challenges the biologistic interpretation of “mental illness.” We take into account the United States and Britain – two countries with large Black minorities and an established tradition of research on these groups. Among the crucial findings of this study are the facts that racial bias and stereotypes heavily influence the way Black men with a diagnosis of psychotic illness are treated by the psychiatric system, police and prison staff, and that the dominant approach to psychosis masks the connections between racism and mental health.

We study changes in age-specific diabetes-related mortality and annual health care utilization. We find that half of the estimated 16% increase of diabetic mortality falls within employable age groups. We estimate that disease combination-specific increase in case fatality has resulted in premature diabetic mortality costing $3.2 billion annually. The estimated annual direct cost of treating high-risk diabetics reaches $36 billion, of which Medicare and Other Federal Programs compensate 54%. Respiratory conditions among diabetics comprise the same proportion of high-risk diabetics as do the disease combinations including coronary heart diseases. Treating of general diabetic conditions has become more efficient as indicated by the estimated declines in per unit health care costs.

In this chapter, an overview of the trauma-informed approach is described. The background and context to trauma, its impact on the person, and organisational responses are considered. More specifically, I distinguish between trauma specific and non-specific organisations by defining the characteristic of each. This chapter sets the tone for the remainder of the book by introducing a conceptual model for both specific and non-specific trauma organisations. In order to do this, I outline the differential components that are deemed necessary for organisations to be trauma-responsive; in doing so, I introduce the Trauma Ecology Model to the literature, outlining its various components.