OBJECTIVE--To determine the efficacy of psychiatric liaison schemes to magistrates' courts in shortening the period that mentally ill accused people spend in custody between arrest, the provision of psychiatric reports, and admission to hospital under the Mental Health Act 1983 and to establish the direct costs of setting up such schemes. DESIGN--A nine month prospective study of court referrals and concurrent analysis of prison records. SETTING--An inner London magistrates' court (Clerkenwell) and a large remand prison (Brixton). PATIENTS--Consecutive series of 80 remand prisoners receiving psychiatric assessment through a liaison scheme; 50 remand prisoners placed on hospital orders by magistrates' courts after being remanded to prison for reports; 364 psychiatric prisoners undergoing second opinion assessments at a remand prison; 520 offenders in a remand prison placed on hospital orders. MAIN OUTCOME MEASURES--Comparison of lengths of time spent in custody for different stages of the assessment and disposal process. RESULTS--For the 50 remand prisoners assessed in prison the mean time from arrest to appearance in court with a psychiatric report was 33.7 days and from arrest to admission to hospital 50.8 days. For those examined in court under the liaison scheme the equivalent figures were 5.4 days (t = 12.63, p less than 0.0001) and 8.7 days (t = 13.04, p less than 0.0001). The number of hospital orders made at the court increased fourfold after the liaison scheme began. The additional direct costs of the scheme were negligible. CONCLUSION--Psychiatric liaison services to magistrates' courts can greatly reduce the length of time that offenders with mental disorders spend in custody. Such schemes may increase recognition of offenders suitable for admission to hospital. A scheme could be established in some areas within existing service provision.
To compare the prevalence of psychiatric disorders in youths processed in adult criminal court with youths processed in the juvenile court.
Participants were a stratified random sample of 1829 youths (10–18 years of age) arrested and detained in Chicago, IL. Data on 1715 youths (13–18 years of age) from version 2.3 of the Diagnostic Interview Schedule for Children are presented, including 1440 youths processed in juvenile court and 275 youths processed in adult criminal court.
Among youths processed in the adult criminal court, 66% had at least one psychiatric disorder and 43% had two or more types of disorders. Prevalence rates and the number of comorbid types of disorders were not significantly different between youths processed in adult criminal court and those processed in the juvenile court. Among youths processed in adult criminal court, those sentenced to prison had significantly greater odds of having disruptive behavior, substance use, or comorbid affective and anxiety disorders than those receiving a less severe sentence. Males, African Americans, Hispanics, and older youths had greater odds of being processed in adult criminal court than females, non-Hispanic whites, and younger youths, even after controlling for felony-level violent crime.
Community and correctional systems must be prepared to provide psychiatric services to youths transferred to adult criminal court, and especially to youths sentenced to prison. Psychiatric service providers must also consider the disproportionate representation of racial/ethnic minorities in the transfer process when developing and implementing services.
The 12-month cost effectiveness of juvenile drug court and evidence-based treatments within Court were compared with traditional Family Court for 128 substance abusing/dependent juvenile offenders participating in a four-condition randomized trial. Intervention conditions included Family Court with community services (FC), Drug Court with community services (DC), Drug Court with Multisystemic Therapy (DC/MST), and Drug Court with MST enhanced with a contingency management program (DC/MST/CM). Average cost effectiveness ratios for substance use and criminal behavior outcomes revealed that economic efficiency in achieving outcomes generally improved from FC to DC, with the addition of evidence-based treatments improving efficiency in obtaining substance use outcomes.
juvenile drug court; cost effectiveness; substance abuse; multisystemic therapy; contingency management
Professional working at computer notebooks is associated with high requirements on the body posture in the seated position. By the high continuous static muscle stress resulting from this position at notebooks, professionals frequently working at notebooks for long hours are exposed to an increased risk of musculoskeletal complaints. Especially in subjects with back pain, new notebooks should be evaluated with a focus on rehabilitative issues.
In a field study a new notebook design with adjustable screen was analyzed and compared to standard notebook position.
There are highly significant differences in the visual axis of individuals who are seated in the novel notebook position in comparison to the standard position. Also, differences are present between further alternative notebook positions. Testing of gender and glasses did not reveal influences.
This study demonstrates that notebooks with adjustable screen may be used to improve the posture. Future studies may focus on patients with musculoskeletal diseases.
The purpose of the current study was to evaluate the impact of a July 2008 Tennessee Court of Appeals opinion that shifted financial responsibility for juvenile court ordered psychiatric evaluations from the State to the County.
We used de-identified administrative data from the Tennessee Department of Mental Health and mid-year population estimates from the U.S. Census Bureau from July 1, 2006 to June 30, 2010, and an interrupted time series design with segmented regression analysis to quantify the impact of the implementation of the Court opinion.
In the study period, there were 2,176 referrals for juvenile court ordered psychiatric evaluations in Tennessee; of these, 74.1% were inpatient evaluations. The Court opinion was associated with a decrease of 9.4 (95% C.I. = 7.9–10.8) inpatient and increase of 1.2 (95% C.I. = 0.4–2.1) outpatient evaluations per 100,000 Tennessee youth aged 12 to 19 years per month.
The Court opinion that shifted financial responsibility for juvenile court ordered psychiatric evaluations from the State to the County was associated with a sudden and significant decrease in inpatient psychiatric evaluations, and more modest increase in outpatient evaluations.
Interrupted time series; Juvenile court ordered psychiatric evaluation; Youth
With massive amounts of data being generated in electronic format, there is a need in basic science laboratories to adopt new methods for tracking and analyzing data. An electronic laboratory notebook (ELN) is not just a replacement for a paper lab notebook, it is a new method of storing and organizing data while maintaining the data entry flexibility and legal recording functions of paper notebooks. Paper notebooks are regarded as highly flexible since the user can configure it to store almost anything that can be written or physically pasted onto the pages. However, data retrieval and data sharing from paper notebooks are labor intensive processes and notebooks can be misplaced, a single point of failure that loses all entries in the volume. Additional features provided by electronic notebooks include searchable indices, data sharing, automatic archiving for security against loss and ease of data duplication. Furthermore, ELNs can be tasked with additional functions not commonly found in paper notebooks such as inventory control. While ELNs have been on the market for some time now, adoption of an ELN in academic basic science laboratories has been lagging. Issues that have restrained development and adoption of ELN in research laboratories are the sheer variety and frequency of changes in protocols with a need for the user to control notebook configuration outside the framework of professional IT staff support. In this commentary, we will look at some of the issues and experiences in academic laboratories that have proved challenging in implementing an electronic lab notebook.
The recent increase in the number of girls involved in the juvenile justice system has resulted in increased academic and public attention. Thus far, this attention has focused on entry into the juvenile justice system rather than longer-term consequences. This research helps fill this gap by examining a sample of 700 maltreated and/or impoverished juvenile court–involved females. Competing risks models were used to control for time from juvenile-court entry to adult outcomes: criminal justice system involvement, use of public mental health or substance use services, and income maintenance use. Results indicate that there are distinct predictors associated with the different outcomes, although learning disability and adolescent parenthood were associated with higher risk of both mental health/substance use services and income maintenance. Individualized services for juvenile court–involved girls are suggested. Prospective, longitudinal research is needed to investigate intrapsychic and behavioral dynamics associated with females’ young adult outcomes.
Juvenile justice; gender; delinquency; life course; female; offending
Historically, the juvenile court has been expected to consider each youth's distinct rehabilitative needs in the dispositional decision-making process, rather than focusing on legal factors alone. This study examines the extent to which demographic, psychological, contextual, and legal factors, independently predict dispositional outcomes (i.e., probation vs. confinement) within two juvenile court jurisdictions (Philadelphia, Phoenix). The sample consists of 1,355 14- to 18-year-old male and female juvenile offenders adjudicated of a serious criminal offense. Results suggest that legal factors have the strongest influence on disposition in both jurisdictions. For example, a higher number of prior court referrals is associated with an increased likelihood of secure confinement in both jurisdictions. Juveniles adjudicated of violent offenses are more likely to receive secure confinement in Phoenix, but are more likely to be placed on probation in Philadelphia. Race is unrelated to dispositional outcome, but, males are consistently more likely than females to be placed in secure confinement. Importantly, individual factors (e.g., developmental maturity) generally were not powerful independent predictors of disposition. Finally, an examination of the predictors of juvenile versus adult court transfer in Phoenix indicated that males, older juveniles, and those with a violent adjudicated charge were more likely to be transferred to adult court, while juveniles scoring high on responsibility as well as those juveniles with an alcohol dependence diagnosis were more likely to be retained in juvenile court.
Adolescence; Juvenile justice; Waiver to adult court; Sentencing; Maturity
Many youth in juvenile justice are in need of substance use services, yet referral to services is often inadequate. This study examines the ecological factors related to substance use service referrals made through Tennessee’s juvenile courts. A series of hierarchical binomial logistic models indicated that individual-level factors accounted for 31% of the variance among courts in referral rates. Community and court factors accounted for an additional 16% of the variance. Youth were more likely to be referred if they had a higher need, were White, were male, were adjudicated in communities that had a higher service density, and appeared in courts that had good relationship and frequent contact with mental health providers. Controlling for individual need, youth in rural areas tended to have lower referral rates; however, this relationship was mediated by the frequency of contact and the quality of relations between the court and mental health providers and county average SES.
Behavioral Health Care; Adolescence; Substance Use Services; Juvenile Justice; Rural; Disparities; Community; Racial and Ethnic Differences; Service Referral; Hierarchical Logistic Modeling
Juvenile drug courts (JDC) largely focus on marijuana and other drug use interventions. Yet, JDC offenders engage in other high-risk behaviors, such as alcohol use and sexual risk behaviors, which can compromise their health, safety and drug court success. An examination of alcohol use and sexual risk behaviors among 52 male substance abusing young offenders found that over 50% were using alcohol, 37% reported current marijuana use and one-third of all sexual intercourse episodes were unprotected. After accounting for recent marijuana use, the odds of a juvenile having vaginal or anal sex was 6 times greater if they had recently used alcohol. Juvenile drug courts may benefit from delivering alcohol and sexual risk reduction interventions to fully address the needs of these young offenders.
Alcohol use; marijuana; juvenile drug courts; HIV; sexual risk; juvenile offenders
Juvenile mental health courts for adjudicated youth.
To describe the role of psychiatric nurses in reducing mental health disparities for adjudicated youth via juvenile mental health courts.
ISI Web of Knowledge; Sage Journals Online; HighWire; PubMed; Google Scholar and Wiley Online Library and websites for psychiatric nursing organizations. Years included: 2000–2010.
Juvenile mental health courts may provide a positive and effective alternative to incarceration for youth with mental health problems with psychiatric nurses playing a key role in program implementation.
Adjudicated youth; adolescent mental health; child and adolescent psychiatric nursing; juvenile delinquency; juvenile justice system; juvenile mental health courts; psychiatric nurse practitioner
This paper examines the effects of the Fast Track preventive intervention on youth arrests and self-reported delinquent behavior through age 19. High-risk youth randomly assigned to receive a long-term, comprehensive preventive intervention from 1st grade through 10th grade at four sites were compared to high-risk control youth. Findings indicated that random assignment to Fast Track reduced court-recorded juvenile arrest activity based on a severity weighted sum of juvenile arrests. Supplementary analyses revealed an intervention effect on the reduction in the number of court-recorded moderate-severity juvenile arrests, relative to control children. In addition, among youth with higher initial behavioral risk, the intervention reduced the number of high-severity adult arrests relative to the control youth. Survival analyses examining the onset of arrests and delinquent behavior revealed a similar pattern of findings. Intervention decreased the probability of any juvenile arrest among intervention youth not previously arrested. In addition, intervention decreased the probability of a self-reported high-severity offense among youth with no previous self-reported high-severity offense. Intervention effects were also evident on the onset of high-severity court-recorded adult arrests among participants, but these effects varied by site. The current findings suggest that comprehensive preventive intervention can prevent juvenile arrest rates, although the presence and nature of intervention effects differs by outcome.
Prevention; Arrests; Delinquency; Longitudinal; Juveniles
This study examined the community reentry process among 413 serious adolescent offenders released from juvenile court commitments in two metropolitan areas. Data are provided about postrelease court supervision and community-based services (CBSs) during the first 6 months in the community as well as indicators of antisocial activity, formal system involvement, school attendance, and employment. Findings indicate that a far greater proportion of offenders reported receiving supervision than CBSs, but when utilized, the frequency of CBS use was high, and intensive services reduced the odds of formal system involvement. In addition, court supervision increased the likelihood of positive adjustment during community reentry. These results held after controlling for social context variables, including peer deviance, parental monitoring, and contact with caring adults.
juvenile offenders; community reintegration; aftercare; reentry