Mentally Disordered Offenders Under Community Supervision

Offenders with serious mental illness (schizophrenia, bipolar, major depression) are overrepresented in criminal justice settings. Most offenders – both with and without mental illness – are not incarcerated but instead are supervised in the community on probation and parole. Offenders with serious mental illness are more likely to fail on community supervision than their relatively healthy counterparts. With a focus on community supervision in North America, this entry distills research on (1) explanations for why offenders with mental illness are at increased risk for supervision failure and (2) promising- and evidence-based practices for reducing this risk

The Utility of Patients\u27 Self-Perceptions of Violence Risk: Consider Asking the Person Who May Know Best

OBJECTIVE: The authors compared the predictive accuracy of two risk assessment methods that are feasible to use in routine clinical settings: brief risk assessment tools and patients\u27 self-perceptions of risk. METHODS: In 2002-2003, clinical interviewers met with 86 high-risk inpatients with co-occurring mental and substance use disorders (excluding schizophrenia) to carefully elicit the patients\u27 global rating of their risk of behaving violently and to complete two brief risk assessment tools-the Clinically Feasible Iterative Classification Tree (ICT-CF) and the Modified Screening Tool (MST). Two months after discharge, patients were reinterviewed in the community to assess their involvement in violence. RESULTS: Patients\u27 self-perceptions of risk performed quite well in predicting serious violence (area under the curve [AUC]=.74, sensitivity=50%), particularly compared with the ICT-CF (AUC=.59, sensitivity=40%) and the MST (AUC=.66, sensitivity=30%). Self-perceived risk also added significant incremental utility to these tools in predicting violence. CONCLUSIONS: Patients\u27 self-perceptions hold promise as a method for improving risk assessment in routine clinical settings. Assuming it replicates and generalizes beyond the research context, this finding encourages a shift away from unaided clinical judgment toward a feasible method of risk assessment built on patient collaboration