Forensic Psych Midterm 1 Review PDF

ETHICAL ISSUES Ethics in Psychology All psychologists are bound by a code of ethics for practice and research. Canadian Psychological Association gives us four pillars o 1: Respect for Dignity of Persons and People – emphasis on inherent worth, non- discriminatio...

ETHICAL ISSUES Ethics in Psychology All psychologists are bound by a code of ethics for practice and research. Canadian Psychological Association gives us four pillars o 1: Respect for Dignity of Persons and People – emphasis on inherent worth, non- discrimination, moral rights, & distributive, social, and natural justice o 2: Responsible Caring – requires competence, maximization of benefit, and minimization of harm, and should be carried out in a way that respects dignity of persons and peoples o 3: Integrity in Relationships – Includes accuracy and honesty; straightforwardness & openness; maximization of bias; & avoidance of conflicts of interest o 4: Responsibility to Society – Includes contributing to the development of knowledge, beneficial activities, displaying respect for society, assisting in the development/betterment of society They are weighed differently Always try to prioritize the earliest principle in the pyramid (P1) Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans - TCPS2 Respect for Persons o Recognizing the intrinsic value of humans and the respect and consideration they are due. Free, informed, ongoing consent. Concern for Welfare o Researchers should aim to protect the welfare of participants and promote that welfare in view of any foreseeable risks Justice o The obligation of researchers to treat people fairly and equitably Ethics in Forensic Psychology Fundamental concerns associated with ethical guidance are generic to a wide range of professional practice. Same ethical principles are used across all areas of psychology However, certain ethical issues may be magnified in forensic settings APA Specialty Guidelines for Forensic Psychology: https://www.apa.org/practice/guidelines/forensic-psychology What ethical issues might a Clinical-Forensic Psychologist face? Disclosure issues; being a victim of a crime Completing interests; duty to the client and society as a whole Conflict of interest; happens in small communities - not a lot of psychologists to go around, especially forensic psychologists Inpatient unit or in a correctional facility; they are not able to switch around their psychologists Ethical Considerations for Forensic Psychologists  Dual Roles: o Psychologists must try to avoid dual relationships o Can be difficult to avoid: ▪ Conducting risk assessments of clients they have been treating in an in- patient/correctional setting ▪ Being called to provide evidence to a parole, review board. ▪ Balancing duty to client with duty to employer, public safety. o Not only conducting a risk assessment but then you are treating them as well, which can infuse bias into your treatment o Might be called to testify for parole or review board, and if you have been treating them and conducting their assessment and if you like them, you might have the bias to help them get out (how do you do this in an impartial way? You can't. o If you are working in a forensic institution and have a client who has been acting up and correctional officer asks you question about what his problem is, that is not your place to disclose such information Declarations of Conflict of Interest: o Previous relationship with client as a treatment provider o Previous contact or knowledge of client's family, friends o Countertransference (psychologist's emotional reaction to client) impacting objectivity o Responsibility to the client as assessor/treatment provider, and responsibility to society o Called to do a risk assessment on a client that you have been treating, that might be a bias o Small towns might have bias o Countertransference; the psychologists emotional reactions to the client based on their own experiences o Weighing responsibility that you have to the client and society as a whole might come into play when considering parole options (bias may impact ability to be impartial) Reporting laws may differ between provinces in Ontario… o Mandatory Reporting (You Must Report): ▪ Abuse/neglect of a child under 16 years old ▪ Sexual abuse of patients by health professionals ▪ When police make written request regarding missing person ▪ Abuse/neglect in long-term care home o Permissive Reporting (You May Report): ▪ Risk of physical harm to an individual or group ▪ Abuse/neglect of a child aged 16 or 17 o Cannot legally report someone have committed a crime, unless they have future risk to another individual (this would be permissive) o If it is someone who commits a crime against a child, you have to report that, especially if they are exposed to children Informed Consent and Limits to Confidentiality o Psychologists must obtain informed consent ▪ Who the psychologists is retained by (can't pretend to be someone else to attain information) ▪ Nature and purpose of assessment/treatment ▪ Nature of the psychologist-client relationship  ▪ Limits to confidentiality ▪ The client's right not to participate o Court ordered assessments/treatments ▪ Report/session notes will be submitted to court, review boards ▪ Client can refuse to comply, but might negatively impact sentencing, parole decisions Power Imbalance in Forensic Psychology In forensic context, recipient of services has limited "choices" they may exercise The forensic psychologist's professional opinion is given a lot of weight o Sentencing recommendations o Parole recommendations o Treatment o Release Power imbalance becomes greater when recipients do not have access to the same societal privileges (e.g., ability to vote, access to education, employment). The greater the power imbalance, the higher the risk of power abuses. The Issue of Cultural Incompetence Cultural competence is a critical part of ethical practice in psychology Individuals from marginalized groups are over-represented in the Canadian justice system. Cultural incompetence has huge implications for decision making. Communication: verbal and non-verbal communication differences between cultures (e.g., seeing lack of eye-contact as evasiveness). Diagnosis: accuracy of clinical diagnoses can be impacted by differences in openness/directness, emotional expression, difficulty differentiating between delusional beliefs and culturally normative worldviews. Assessment: many risk assessment and personality assessment tools are validated using White male samples and may not be appropriate for use with culturally diverse individuals. Cultural competence requires self-awareness: recognizing own limitations, biases, and knowing when to seek outside support. What ethical issues should Dr. McInnis consider? Dr. McInnis, a psychologist working in a federal correctional facility in Canada, is asked to conduct a risk assessment for Mr. Boucher, an inmate eligible for parole. During, the assessment, Mr. Boucher reveals plans to harm a fellow inmate after being released. Confidentiality vs. harm to others Dual roles Client rights, autonomy Public safety What ethical issues should Dr. Morgan consider? Dr. Morgan, a psychologist working in a federal penitentiary in Quebec, is asked to complete a psychological assessment of Mr. Duval, an individual with a history of sexual violence, to inform the Parole Board of Canada about his risk for reoffending. During the assessment, Mr. Duval refuses to participate in certain portions of the evaluation, stating that he fears his responses will be used to extend his incarceration. Despite the refusal, the Parole Board requests a report based on available records and Dr. Morgan’s professional judgment. Consent, limits to confidentiality Dual roles, institutional pressure Accuracy, validity of findings Potential harm to client What ethical issues should Dr. Walsh consider? Dr.Walsh, a forensic psychologist, works in rural Newfoundland. The town has a close-knit community, where many people are related or have longstanding personal connections. Dr. Walsh has lived and worked there for several years and knows most of the residents well, either personally or through their families. One day, she is contacted by the courts to conduct a risk assessment for Mr. Lewis, a 30-year-old male with a history of violent behavior. Mr. Lewis has recently been arrested for an altercation involving serious injury to another individual. He is suspected of being a risk to public safety due to past incidents of aggression and his ongoing struggles with anger management. There are no other forensic psychologists available for referral. Impartiality, bias Dual relationships and boundaries Informed consent, confidentiality Community influence UNDERSTANDING CRIMINAL BEHAVIOR What influences criminal behavior? Poverty (SES) Trauma Family background Education Mental Health status Substance Abuse Genetics Criminal Behavior is Complex: Biological theories Psychological theories Sociological theories Learning & environment Note Theory is not destiny: i.e., neither biology nor upbringing determine whether someone will engage in criminal behavior o Theory doesn't determine future outcomes (might increase chances but not determine) Theories are not incompatible: theories can be complementary and integrating can provide greater understanding o They are not stand alone Most theories based on White, Euro-centric values o Especially the case with social theories related to criminal behavior Biological Theories of Crime Dr. Miller wants to better understand the role that genetics play in men's criminal conduct. She recruits 500 men who have fathered sons: 250 fathers have a history of violent offending; 250 fathers have no history of any criminal behavior. After 10 year follow-up, Dr. Miller's results suggest that sons of fathers with a violent criminal history were more likely to be criminally involved compared to sons of fathers without a criminal history. o Learning from their fathers Behavioral Genetics Twin Studies o Monozygotic twins (i.e., identical twins, 100% DNA) o Dizygotic twins (i.e., fraternal twins, 50% DNA) o Able to untangle the genetics from the environment o Gold standard is twin studies: monozygotic twins specifically o Theoretically if you have twins living on complete opposite sides of the world, you should have the same outcome (monozygotic) Adoption Studies o Parent-offspring adoption: compare concordance rates between adoptive parent and child's criminal behavior vs bio parent and child o Sibling-offspring adoption: concordance rates between adopted siblings vs between full bio siblings. o Child who was adopted "should" be more likely to engage in crime if their bio parent does o If kids bio sibling was involved in criminal behavior then that sibling as well Sibling Studies o Full siblings (50% DNA) o Maternal, paternal half-siblings (25% DNA) o Larger sample sizes o Really have to rely on sibling studies: there is a larger sampling size, won't be as accurate though (genes aren't identical and huge age gaps) o Hard to pin point if and where the criminal behavior is stemming from in the genetic make up Genetics & Criminal Behavior  Meta-analysis of 3.5 million children: 2x the odds of committing a crime if one of your parents committed a crime (Bessemer et al., 2017). Adoption and twin studies: variance in criminal behavior explained by heritability (41%), shared environment (16%), and non-shared environment (43%) (Rhee & Waldman, 2002) Gene-crime link is not direct -- likely a function of various factors predisposing an individual to criminal behavior Genes + Environment or Genes * Environment? o How does environment play a role? Is it additive or do they interact with one another? Molecular Genetics & Criminal Behavior Caspi et al. (2002): First study demonstrating the interaction between gene and environmental impact on criminal behavior. o Gene called monoamine oxidase-A (MAOA); "warrior gene") ▪ Responsible for MAOA enzyme which breaks down neurotransmitters such as NE, 5-HT, and DH, all implicated in aggression and antisociality. ▪ Two existing versions: low activity (MAOA-L), and high activity (MAOA-H) o Is there a relationship between MAOA-L and the effects of childhood maltreatment in males? o Low activity reduced amount of neurotransmitter broken down so more issues with aggressive and impulsivity o Childhood maltreatment was impacting peoples brain activity (brain chemicals in the brain and how they are expressed o So, they looked at environmental interactions with MAOA gene (located on x chromosome so looked at males) Caspi et al. (2002) cont. Followed cohort of 1,037 children (52% male) in NZ town from birth to age 26. Assessed every 2-3 years 96% retention rate (!!) Measured: o Maltreatment between ages 3 and 11 o Variance of MAOA gene (high or low) o Reports of aggressive behavior by age 26 Went to a little New Zealand tow and recruited over 1000 participants and followed then for 26 years Assessed them every 2 year from birth to age 11 looking at childhood maltreatment, genetic makeup (low or high gene), and at age 26 they considered their history of aggression and criminal records if they were available  This is just one gene Many other genes likely to influence outcome of criminal behavior They found that maltreatment has a negative effect on boys Childhood maltreatment impacts aggressive behavior When compare both genes, it is almost twice for low activity Direct interaction with gene and environment Important Sub-Group Differences MAOA-L associated with higher risk for crime in incarcerated White individuals but not incarcerated non-White individuals (Stetler et al, 2014). MAOA-H predicts less violent behavior in maltreated White children; same effect not found in non-White children (Widom & Brzustowics, 2006). Studies considering the effect of trans-generational trauma on genetic expression. o Long-term, repeated trauma can impact how genes are expressed (epigenetic change) without altering the structure of the DNA. Some of those expressions in genes can be from environment, which impacts how gene is expressed Neurochemistry & Criminal Behavior Hormones o Testosterone's impact on aggression has been of interest to researchers. o Meta-analysis suggestive positive correlation between testosterone levels and aggression in men (Archer, 1991; Book et al, 2001). ▪ Small effect size o May depend on an interaction with cortisol levels ▪ E.g., men with high testosterone showed more aggression when they were also high in dominance and had high cortisol levels (Pfattheicher, 2017) o Testosterone is the most studied hormone, but small effect sizes  o Impact of environment that could impact how testosterone plays a role in aggression o High testosterone had high aggression when they also had high cortisol levels o Lots of variability based on the types of studies done Neurotransmitters o 5-HT plays important role in behavioral inhibition, mood regulation o Malfunctioning in 5-HT systems have been implicated in antisocial behaviors ▪ Low levels associated with increased impulsivity, irritability, aggression. ▪ Small effect size (Dalton et al., 2013) o Role even less clear than hormones o The malfunctioning of serotonin systems have implicated in anti-social behavior o Low levels = impulsivity and aggression The Brain & Criminal Behavior Pheneas Gage; iron rod through his frontal cortex, survived but became very rude and aggressive, not the same person as before Similar situations with contact sports CTE; condition where someone experiences repeated concussions, associated with impulse control issues, violence, depression, anxiety, early onset dementia Wrestler killed his family from the US and then himself; looked at his brain and found evidence of severe dementia; which was a factor CTE This has led to an increase in athletes to sign off permission to look at their brains after they die Brain Imaging Directly comparing brain structure and functioning of individuals known to have committed crimes versus those who have not Generally, individuals with antisocial/criminal traits show lower brain volume in areas of executive functioning, emotion regulation, decision making But higher brain volume in areas responsible for reward. Brain Imaging: Prefrontal Cortex, Limbic System Dugré et al. (2020): o Functional and structural impairments to prefrontal cortex more common among individuals with antisocial traits. o Prefrontal cortex associated with emotional regulation, social cognition, self-reflection, autobiographical memory, decision-making, impulse control, and cognitive flexibility. o Limbic systems (responsible for emotional and behavioral responses) had lower activation to threats Brain Imaging: Striatum Involved in reward, emotional processing, and behavioral regulation. Processes anticipation and receipt of rewards which drives motivation and reinforces behaviors. Increased striatal activity in individuals higher in impulsivity and antisociality. o Nealy 10% greater volume than individuals lower in impulsivity and antisociality.  o Heightened sensitivity to rewards which could lead to risky or criminal behavior. Neuropsychology Forensic neuropsychology: whether deficits in executive functioning (future, goal-oriented behavior) are related to antisocial traits/behaviors. o Looking at peoples cognitive functioning, memory, processing speeds, motor control o Lot of things you'd see in typical ADHD assessment Indirect study of brain functioning through battery of pen/paper, cognitive, motor tests Ogilvie (2011): o Poor executive functioning associated with antisocial traits (moderate effect size). o Effects were larger for correctional samples and when participants had comorbid ADHD. Limitations of Brain Imaging & Neuropsychology Correlation vs. causation: Are antisocial traits caused by abnormalities in brain structure/function or are abnormalities a result of antisocial living? Reductive: Often don't take into account other biological, psychological, sociological or environmental contributions Limited samples: Correlational samples might not generalize to the general population; control samples might be unique themselves (people who can take time to participate in lengthy brain imaging studies). Lack of longitudinal studies: Studies are cross-sectional (one point in time). Other Biological Considerations Prenatal conditions (in utero) Perinatal complications (during birth) Environmental toxins Pre- and Perinatal Conditions Disruption in fetal development (either in-utero or due to birthing complications) have been associated with antisocial behavior. o Fetal alcohol spectrum disorder (FASD): Over-representation of youth and adults with FASD in Canadian legal system (1% of general population, 10-20% of legally involved individuals; MacPherson, 2012) o Lead exposure in-utero may cause disruptions in development of prefrontal lobe and is associated with adult arrests (Wright et al., 2021). o Lack of oxygen during birth can cause impairments to cognitive functioning o HOWEVER, favourable environments (e.g., positive parenting, adequate access to healthcare) are protective. Alcohol & Drug Use Relationship between alcohol/drugs and aggression has been extensively covered o Relationship is consistent across gender; whether substance was alcohol, drugs, or both; age groups; and measure of aggression.  Automatism; state after taking or drinking substances Certain individuals engaging in violent behavior against their intimate partners while under the influence; for their defense they said that they didn’t intend to lose their behavior so they can’t be held responsible for all of it This has gone back and forth for years with the Supreme Court, public says you can’t use substance as an excuse (sexual assault is not okay even if under the influence) Lately this has been reversed, you can use over intoxication as a way to defend your actions, it is a type of automatism; you didn’t intend to become so intoxicated that you committed an offence so it lessens responsibility This is not very common though In Sum Research on biological theories of criminal behavior is expansive and impressive Can help us understand why some individuals may be predisposed to antisocial or criminal behavior Could at some point lead to medical advancements to treat these vulnerabilities Many biological associations with crime can be mitigated by healthy social environment As with other theories, most effective when integrated with other theories such as psychological and sociological perspectives. Theories of Criminal Behavior Biological theories helpful for gaining understanding, prevention (e.g., campaigns against substance use while pregnant). Reductive, limited ability to intervene biologically. Psychodynamic, learning, and social theories target variables that are dynamic (i.e., subject to change) Many interventions used today are based on these theories. Key Concepts Psychodynamic theories: internal and psychological forces that influence behavior. o Heavily inspired by Freud's description of the id, ego and superego. ▪ Ego (morality) mediates process between id and superego Learning theories: rooted in behaviorism. How information is encoded, processed and retained. Specific conditions that promote or inhibit different forms of learning. o Lots of different conditions that influence how we learn, can even inhibit Social learning theories: learning that takes place by observing others being reinforced or punished for their prosocial and antisocial behavior in addition to what we learn from associating with others. Psychodynamic Theories/Writings Covered: Theory of Maternal Deprivation (Bowlby) Unravelling Juvenile Delinquency (Glueck & Glueck) Social Control Theory (Hirschi)  General Theory of Crime / "Self-Control Theory" (Hirschi & Gottfredson) Psychodynamic Theories Bowlby's Theory of Maternal Deprivation o Based on idea that children require consistent, continuous maternal care for healthy development. o Disruption in mother-child relationship would result in irreversible long-term impacts (i.e., inability to develop meaningful prosocial relationships) and criminal behavior o Higher level of maternal deprivation in those with criminal histories than those without (Bowlby, 1944). o Unrepresentative, poor control group matching. Supposes that paternal care has no impact on child development. o Insinuates that effects of maternal deprivation are irreversible. o Theory doesn't hold up with larger samples (Hirschi, 2002; Nye, 1982) o Attachment theory o He thoughts all children require consistent and maternal care for healthy development o Inability to develop maternal bond would influence and disrupt meaningful and healthy relationships with others, which would influence delinquent behavior in later life o Found higher levels of maternal deprivation were associated with delinquent behavior, however, this didn't hold up with larger sample when replicated Glueck & Glueck: Unravelling Juvenile Delinquency o Interested in understanding causes of criminal behavior and developing interventions o Rejected single-cause theories of crime such as poverty of poor moral character o Multidisciplinary approach: an emphasis on environmental, social, psychological, biological factors o Compared lives of 500 (male) justice-involved youths with 500 (male) non-justice involved youths o Also conducted longitudinal research with sub-sample of these youths. o Interviewed youths, their parents, teachers. o Parenting factors considered: supervision, parenting style, family cohesion o Husband-wife duo who didn't buy into idea of one single cause for crime, felt that any type of theory used to explain crime should be multi-disciplinary o Attributed differences between groups to parenting factors o Parents of justice-involved youths had greater instances of emotional disturbances, lower intelligence, higher substance use, and history of criminal involvement o Parents of justice-involved youths had less warmth, cohesiveness, and youths were less attached to their parental figures especially their fathers Hirschi's Social Control Theory: o Attachment: People avoid committing crimes because they value their connection with others. o Commitment: Commission of crime risks losing investments in previous conventional pursuits (e.g., getting an education, employment, housing, family). o Involvement: Time and energy spend in socially conventional pursuits limits time available for criminal activity  o Belief: The view that people should obey common rules and respect for societal value system o Values, attachment, beliefs are inherited from parental figures. o Most tested theory in criminology (Akers & Sellers, 2004). o Delinquent behavior resulted when their bond with society is broken (they don’t belong or connect with the community) are more likely to engage in behavior that is deviant o 4 elements of social bonds that influence conformity and if there is a disruption then they are more likely to engage in criminal behavior Hirschi & Gottfredson General Theory of Crime, or "Self-Control Theory" (1990) o Level of self-control predicts offending in the presence of opportunity o States that self-control is established by ages 8-10 and stable through life Support for this theory across variety of cultures (Hessing et al., 2001; Pratt & Cullen, 2000; Vazsonyi et al., 2017). Only accounted for 19% of variance in criminal behavior - so, cannot be the *sole* cause of crime  Too simplistic: Factors beyond parental socialization and self-control can influence criminal behavior Assumes self-control is "static" (unchanging). But self-control can be improved through targeted intervention (i.e., LEARNING new ways of behaving) Learning & Social Learning Theories Covered: Operant Conditioning (B.F. Skinner) Differential Association Theory (Sutherland) Social Learning Theory (Aker) Personal, Interpersonal, and Community Reinforcement (PIC-R) Theory (Andrews & Bonta) Learning Theories Operant Conditioning - B.F. Skinner: o Emergence, maintenance, and cessation of behaviour is determined largely by environmental consequences. o Positive Reinforcement: behaviour followed by a pleasant stimulus increases behavior (given money for chores). o Negative Reinforcement: behaviour followed by removal of unpleasant stimulus increases behavior (parent stops nagging once chores are done). o Positive Punishment: behaviour followed by unpleasant stimulus decreases behavior (teacher calls you out in class for talking). o Negative Punishment: behaviour followed by removal of pleasant stimulus decreases behavior (removing phone privileges for acting out). o Immediacy: The sooner the reinforcement or punishment follows the behavior, the better o Consistency: The more often consequences follow the behavior, the more effective the consequence will be o Intensity: The stronger the consequence, the more effective it will be Applying Operant Conditioning Principles to Criminal Behavior Common to see operant conditioning used in interventions (e.g., token economies in prisons, psychiatric facilities; positive punishment where a fine or jail time given to decrease behavior). Direct application to understanding criminal behavior is less common. Jeffery (1965): Whether someone commits a crime depends on whether they’ve been reinforced for the behavior in the past. o Reinforcing stimuli should outweigh the aversive stimuli o Someone experiencing only sanctions in response to criminal behavior should be less likely to continue. Learning theory doesn’t consider internal (cognitive) processes or social context. Operant conditioning principles play central role in social learning theories of crime. Social Learning Theory & Criminal Behavior Emphasizes the roles that internal processes and social context play in learning criminal behavior  Essentially, criminal behavior is learned through social interactions Sutherland's Differential Association Theory (1947) The likelihood of committing a crime is influenced by the social norms present in the particular groups to which one belongs Introduced three new concepts: o Normative Conflict o Differential Association o Differential Group Organization Normative Conflict o Groups conflict over basic interests, values, and behavior (i.e., a conflict over what would be considered "appropriate behavior"). o Some groups view the law as a set of rules to be followed no matter what o Other groups view the law as a set of rules to be violated depending on certain circumstances o A by-product of industrial revolution that introduced and advanced divisions of labor, socio-economic inequalities Differential Association: Individual Criminal Acts o Criminal behavior is learned in a process of communication in intimate groups o Through groups, people learn skills to commit crimes in addition to motives, attitudes, rationalizations, and justifications for committing criminal behavior o There must be an opportunity to commit crime Differential Social Organization: Group Rates of Crime o The extent to which communities are socially organized/disorganized against crime informs the crime rate o Social disorganization: inability of a community to solve its issues and achieve shared values o Social organization in favour of crime: organization and structures fostering criminal behavior o Shaw and McKay (1969): Mafia members (social organization in favor of crime influencing young boys/men living in socially disorganized communities. Akers' Social Learning Theory Expands on Sutherland's Differential Association Theory Includes the behavioral mechanisms (operant conditioning) by which the social learning process occurs Likelihood of someone exhibiting (and continuing) criminal behavior depends on how the behavior has been reinforced or punished People learn how to define behaviors as good or bad through interactions with significant groups/peers o Observe and imitate others' behaviors Andres & Bonta's Personal, Interpersonal, and Community Reinforcement Theory (PIC-R) Integrative theory  Learned behavior: Criminal behavior is strengthened by reinforcement and weakened by punishment Factors that encourage/discourage criminal behavior: o The individual (personally mediated events, e.g., rewarding oneself after seeing the impact of a criminal act). o Others (interpersonally mediated events, e.g., approval from peers) o Act itself (e.g., "rush" associated with getting away with crime) Behavior is further influenced by: o Personal factors: Cognitive and personality traits (impulsivity, problem solving skills, offence-supportive beliefs) o Interpersonal factors: Relationships with family, peers, others, that provide social reinforcement for criminal or prosocial behaviors o Community factors: Broader environmental and cultural influences (poverty, differences in opportunities, community norms). Balance of influences: criminal behavior occurs when reinforcements for criminality outweigh the reinforcements for prosocial behavior Criminal behavior is dynamic and changeable MENTAL ILLNESS IN THE CANADIAN CRIMINAL JUSTICE SYSTEM What is a Mental Disorder? Syndrome characterized by clinically significant disturbance in an individual's cognition, emotional regulation, or behavior Typically associated distress or impairments in important areas of functioning Different from an expected or culturally acceptable response to a commonly experienced event (e.g., grief in response to death of a loved one; stress after losing one's job) Socially deviant behavior and conflicts that are primarily between the individual and society are not considered mental disorders unless the deviance or conflict stems from a dysfunction in the individual. DSM In North America, the primary tool used to diagnose mental disorders is the Diagnostic and Statistical Manual (DSM) of Mental Disorders This would be used to help consider different symptoms person is experience and to help categoize them for specific treatment How Does Someone Get Involved in the Criminal Justice System? 1. Come in contact with police a. If it is minor, police will talk to them and release them back to community b. If they feel like person is dangerous to themselves or others, they will bring them to the hospital to get evaluated 2. Sometimes people will be released or they will be put on a hold (under evaluation in the hospital) 3. If they want to uphold them (danger to themselves) then that person will have to go through a review/appeal process to make sure they are not a danger to themselves or others (still not in the legal process yet) 4. If a criminal event occurred from interaction with police, the individual will be brought to court and put through a psychological assessment a. If they find they are good, will be sent back to court b. If they find that individual is unfit to stand trial, they will be diverted to psychiatric hospital 5. If found fit, they will go through probation, parole, or detention 6. Eventually released by parole board and then back in community What is a Major/Severe Mental Illness? Individuals with a major or severe mental illness are more likely to be diverted to the forensic mental health system rather than going through correction systems.  Major/Severe Mental Illness: "A mental, behavioral, or emotional disorder (excluding developmental and substance use disorders) resulting in serious functional impairment that substantially interferes with or limits one or more life activities" (APA, 2018) Usually includes mood, anxiety, and psychotic spectrum disorders. Major/Severe Mental Illness and Criminal Justice System People with major/severe mental illness who get involved with criminal justice system typically experience a disorder that impacts their connection with reality (i.e., psychosis) Psychosis may consist of: o Delusions - inflexible beliefs without basis in reality; unlikely to abate even in presence of contradictory evidence o Hallucinations - sensory disturbance (visual, auditory, tactile, olfactory) Fitness to Stand Trial An accused must be able to participate in their own defence o Understand nature or object or the proceedings o Understand possible consequences of proceedings o Communicate with counsel If deemed unfit, will be diverted to mental health system to restore fitness prior to trial Can be deemed fit and then unfit when they are going to prison Who Assesses Fitness? Unlike the US, in Canada, only medical practitioners can conduct court-ordered assessments of fitness and criminal responsibility o Do not need a background in psychiatry or experience with forensic populations Canadian psychologists can conduct psychological testing for medical practitioner Psychologists are not able to provide medical evidence used to provide treatment or make final decision on individual so if an individual has a medical issue, they cannot talk on that behalf Assessing Fitness Fitness Interview Test Revised (FIT-R) Semi-structured interview assesses the 3 psychological abilities in the code's fitness standard Fitness to Stand Trial If unfit, will be released on conditions or hospitalized and reassessed after 45-60 days If treatment refused, a judge will make a treatment order if all of the following are true: o The proposed treatment is likely to restore treatment in 60 days; o The individual will remain unfit without treatment; The benefit of treatment is greater than risk of harm; o The proposed treatment is the least invasive option; o The hospital where treatment will be delivered agree there is room and they are able to treat. Treatment CAN be involuntarily administered Treatment CANNOT include electric shock therapy or surgery on the brain How is Fitness Restored? #1 tool is medication: antipsychotics, mood stabilizers, antidepressants Education: on court processes, important terms (e.g., oath, plea) roles of lawyers, judges, juries, their own rights, etc. o Make sure people understand why they are there and the roles of others Once fitness is restored, individual returns to court to stand trial o Outcome will be either criminal sanctions or a finding of not criminally responsible on account of mental disorder (NCR-MD) What if Fitness is Not Restored? If unfit after 90 days, referred to review board Review board reviews case on annual basis Crown must also prove there is sufficient evidence to try the case every 2 years If sufficient evidence is no longer available to prosecute, the case is dropped When fitness is unlikely to be restored (e.g., permanent brain damage), court can provide absolute discharge if: o Accused is unlikely ever to become fit o Accused does not pose significant threat to public safety o Stay of proceedings is in interest of proper administration of justice Presumptions in Canada's Legal System Several elements must be present for criminal guilt to be established: o Mens Rea: "guilt mind" or criminal intent o Actus Reus: "guilty act" or a wrongful dead o Causation: a person's actions caused the offence to occur (e.g., reckless driving caused the death of a pedestrian) o Absence of a viable defence: no mitigating circumstances that can reduce culpability for committing the criminal act (e.g., self-defence) ▪ Materially relevant to NCR-MD ("Insanity defence") ▪ One's state of experiencing mental health symptoms can impede Section 16 of Canada's Criminal Code States: 1. No person is criminally responsible for an act committed or an omission made while suffering from a mental disorder that rendered the person incapable of appreciating the nature and quality of the act or omission or of knowing that it was wrong. 2. Every person is presumed not to suffer from a mental disorder so as to be exempt from criminal responsibility, until the contrary is proved on the balance of probabilities 3. The burden of proof that an accused was suffering from a mental disorder so as to be exempt from criminal responsibility is on the party that raise the issues. How common is the NCR-MD defence? Less than 1% of all criminal court cases in Canada Who is Found NCR-MD? Study of 1,800 males and females designated NCR-MD in BC, QC, ON 84% male Average age = 37 years old Primary offences: o Uttering threats (27.4%) o Assaults (26.5%) o Property crimes (16.9%) o Homicide (6.9%) o Sex offences (2.3%) o Other (e.g., drugs, dangerous driving, weapons, disturbing the peace; 20%) Primary Diagnoses: o Psychotic disorder (e.g., schizophrenia; 70.9%) o Substance use disorder (30.8%) o Mood disorder (e.g., bipolar disorder; 23.2%) o Personality disorder (10.6%) *Usually with another disorder if you are going to use the NCR-MD* Victim/Complainant: o Family (33%) o Professional (e.g., Police Officer; 22.9%) o Stranger (22.7%) o Other known person (e.g., roommate, friend; 20.7%) Half (49%) had a prior criminal conviction or had been previously found NCR-MD What Happens When Someone is Found NCR-MD? Decision is made by Provincial Criminal Review Board consisting of mental health professionals, legal professionals, and community members. Generally, 3 options: o Detention (i.e., committed to secure mental health facility); o Conditional discharge (i.e., released with conditions and remaining under review board jurisdiction);  o Absolute discharge (i.e., remain in the community and no longer under review board jurisdiction) *Cases are up for review annually. Review boards will review files and make decisions based on individual's progress* Review Board Dispositions for NCR-MD Detention: 44% Conditional discharge: 37.3% Absolute discharge: 18.7% Factors reducing likelihood of receiving conditional or absolute discharge: o Higher number of past offences o Having psychotic spectrum diagnosis o Severity of index (current) offence o Previous crimes against a person (e.g., assault) Challenging Misconceptions: NCR-MD as a "Legal Loophole" People found NCR-MD are: o 4x more likely to be detained than individuals who are criminally convicted for the same crime (e.g., 55% of individuals convicted of disturbing the peace were detained while 88% of individuals found NCR-MD for disturbing the peace were detained). o 5x less likely to be released from detention (after 1 year follow up, 42% NCR-MD individuals remained detained, compared to 1% of people criminally convicted). o 3x less likely to attain absolute discharge (after 3 years, 45% of NCR-MD individuals were under conditions, compared to 2% of people criminally convicted). Bill C-30 introduced "capping" of dispositions o Prevents people declared NCR-MD from serving more time in detention than they would if they had been criminally convicted (e.g., if offence was assault, cannot be detained for more than 10 years). o However, can apply for involuntary hospitalization if they are a continued risk to the public. Challenging Misconceptions: People classified NCR-MD have high reoffence rates The three-year follow-up recidivism rate is approx.: o 17% following detention verdict o 20% following conditional discharge o 22% following absolute discharge Recidivism in general offending population: 34% Recidivism in individuals treated for mental disorder in correctional setting: 70% Individuals found NCR-MD for a severe offence against a person were least likely to reoffend High Risk Accused Designation for NCR-MD The Not Criminally Responsible Reform Act o Part of the "tough-on-crime" era and in response to public discourse surrounding high- profile cases in the media.  o Eligible: Individuals who committed "serious personal injury offence" (e.g., homicide, aggravated assault). o Once given HRA designation, the review board cannot discharge them from hospital until designation is lifted by the Superior Court even if risk can be safely managed in community. Goosens et al. (2019): o 1 in 4 NCR-MD people would be eligible for HRA designation. o 3-year recidivism rates were higher for individuals who did not meet HRA eligibility. o But HRA designated individuals tool 2x as long to reach absolute discharge compared to non-HRA designated individuals o Lengthens hospitalizations with little evidence that it reduces violence or improves public safety. Lengthening stays can create longer waitlists for patients leading to insufficient care. Case Study: Vincent Li In July 2008, Vincent Li stabbed 22-year-old Tim McLean to death while travelling on a Greyhound bus in Manitoba. After passengers and driver disembarked, Mr. Li mutilated the body. 4-hour stand-off with RCMP Witness: "There was no rage or anything. He was like a robot." At trial in 2009, Mr. Li is found NCR-MD after being diagnosed with schizophrenia. o Believed God had told him to kill McLean or Li would face execution. o Remanded to high security mental health facility. Background:  o Born in China, obtained degree in computing, married, immigrated to Manitoba, Canada in 2001. o Converted to Christianity in 2005 after hearing voice from God telling him he was the "second coming of Jesus" and was destined to save people form an alien invasion. ▪ To prepare, he was ordered to travel though country via foot or bus. Carried knife with him for protection against aliens. ▪ Wife confirmed he would be gone for days at a time without cause. ▪ Would go days without eating, sleeping. Spent hours crying and telling wife about visions. ▪ Erratic behavior for 3 years prior to offence ▪ Travelled back and fourth to China without cause (once went to China for 1 day). ▪ Was found by OPP dehydrated on side of road attempting to walk from Toronto to Winnipeg ("I was following the sun"). Day/Night before offence o Stayed on bench outside grocery store o Seen "sitting bolt upright" with eyes wide open o Sold new laptop to teenage boy for $60 Psychiatrist opinion: Schizophrenia rendered him in-culpable Defence AND prosecution agreed with psychiatrist's opinion. Recommended he be found NCR- MD and involuntarily committed. Effects of Deinstitutionalization on the Prison Population Began in 1960 - 1980 Beds in psychiatric hospitals decreased from 4 per 1,000 to 1 per 1,000 Individuals who would have been diverted to mental health services in hospitals are instead processed through the criminal justice system As a result, correctional populations exhibit higher rates of mental health difficulties than the general population Mental Disorders and Stigma Stigma: negative attitudes, beliefs, or behaviors about or toward a group of people because of a particular attribute they share o Stigma against mental disorders is a huge barrier for help-seeking, receiving care Common misconception is that people with mental health difficulties are violent and unpredictable People with mental illness are more likely to be victimized than they are to perpetrate violent crimes against others Mental Health Commission of Canada (2013): o 40% of news articles negatively associated crime, violence, and danger with mental illness o Though there are trends indicating that media portrayal is improving, with more focus on treatment (Whitley & Wang, 2016) Public stigma includes prejudicial attitudes and discriminatory behaviors expressed toward people with mental illness o Related to challenges that people face when attempting to re-enter into the community after prison or after being released from hospital Negative views toward people with mental disorders can result in internalized stigma o People with mental health issues may accept and agree with negative stereotypes o Feelings of shame, guilt, and concealing illness from others o Further impacts help-seeking Structural stigma occurs the institutional level including policy and law Creates situations where people with mental illness are treated inequitably and unfairly, such as placement in segregation o People with severe mental illnesses are over represented in administrative segregation o Long-term segregation is linked to worsening mental health symptoms (Office of the Correctional Investigator, 2019) Mental Illness and Police Contact With people unable to access mental health services in the community, police officers are becoming the front line contact for many with mental health difficulties A lot of discretion given to police; decide how to manage a crisis, whether to arrest someone or not Brink et al. (2011) o 1 in 20 police encounters involve someone with mental health issues; o 50% of interaction between police and people with mental health issues involve alleged criminal behavior; o 2 in 5 people with mental illness have been arrested in their lifetime; o 3 in 10 have had police involved in their care pathway; o 1 in 7 referrals to emergency psychiatric inpatient services involve the police; People with mental illness are over-represented in police shootings, stun gun incidents, and fatalities  Recently an investigation into death by police - 6% of people killed in police encounters were dealing with some kind of mental illness Effort between police and mental health advocates to improve interactions between officers and people with mental health difficulties via Mobile Response Teams Mobile Crisis Response Team Ontario invested $4.5 million to help support development and implementation of mobile crisis response teams Uniformed officer accompanied by trained mental health professional o Provide community assessment and link to appropriate community services o Divert people from criminal justice system involvement o Divert people from hospital emergency department o Mitigate impact on police resources o Improving individual and/or caregiver experience Fahim et al. (2016): Results from Hamilton Mobile Crisis Rapid Response Team Pilot Partners police officer with experience mental health crisis worker Dispatched to calls with individuals who are exhibiting sings of mental illness, behavioral disturbance and/or substance use difficulties 49% reduction in overall rate of people in crisis being brought to hospital o Only 20% discharged without assessment (compared to 53% with police-only) o Of 80% seen by psychiatrist, 54% required hospital admission (compared to 29% police- only) o Average wait times shorter Similar findings from South Simcoe Police Service (Semple et al., 2020) It is a slow process with issues and gaps with services they can provide Prevalence of Mental Illness in Corrections Beaudette & Stewart (2016): 1,110 federally incarcerated men across Canada o Over 80% would qualify for any type of mental health disorder in their life o Those in prison 73% had a current mental health disorder ▪ Anxiety disorder and alcohol and substance use disorder make up most of that percentage  o In the community we see individuals that see psychosis or psychotic disorders is 1% and in prisons it is 5% CSC (2018): 160 federally incarcerated women across Canada o Really high rates of mental health disorders in the women's federal institutions as well o Borderline is quite high (women are more likely to be diagnosed with this) Population studies of mental disorder and crime Hodgins et al. (1996): Looked at all Danes born between 1944 and 1947 (358,180 people) Tracked to see who had been diagnosed with a mental disorder Tracked to see who had been involved with the legal system In men and woman, some associated between mental disorder and criminal involvement "It would be destructive for societies to allow the findings on the criminality of [persons with mental illness] and [persons with intellectual disability] to be used to further stigmatize these individuals. Rather, these data can be used constructively to provide more adequate, appropriate, and humane care to individuals who, thought no fault of their own, suffer from devastating disorders and at the same time to protect society." Mental Disorders and Crime  Most crime (80%) is not related to mental disorder (Gottfried & Christopher, 2017) Specific disorders cannot be reliably matched to specific crime (Peterson et al., 2014) Study of more than 23,000 criminally involved individuals with a mental disorder o Having a mental disorder did not predict reoffending o Psychosis was not a useful predictor of reoffending Phillips et al. (2005): Best predictors of reoffending in individuals in individuals with mental disorder were: o Age upon admission (younger age = higher risk of reoffence) ▪ If younger and diagnosed with SMD, likely hood of prognosis is worse o Number of days hospitalized (more days = higher risk of reoffence) o Number of previous offences (higher number of past offences = higher risk of reoffence) Offence-supportive attitudes are a better predictor of reoffending in individuals with mental disorders (Skeem et al., 2014) High rates of comorbid alcohol/substance use disorders may influence criminal behavior o Castillo & Alarid (2011): criminally involved people with alcohol/substance use disorder re-offended earlier than people without alcohol/substance use disorder Insufficient access to early mental health care may also influence criminal behavior (CSC, 2009): o At intake 11% of federally incarcerated men had received a prior psychological diagnosis (22% of women) o At intake, 6% of federally incarcerated men had previously received outpatient mental health care (9% of women) Mental Health Care in Corrections Five Regional Treatment Centres (RTCs) in Canada Operate as full hospitals and provide acute mental health care to federally incarcerated individuals (people sentences to 2+ years) NB, QC, ON, SK, BC 700 beds total - but number of people with mental health needs exceeds 700 Mental health teams in the prisons provide care in major institutions Psychological & Pharmacological Interventions Much of the treatment focus in the criminal justice system is on reducing risk to reoffend (Ie., targeting criminogenic needs, including offence-supportive attitudes). Individual treatment goals don't always match the treatment goals of the system o Difficulties in matching programs to person's needs and willingness to participate o E.g., Dialectical Behavioral Therapy (DBT) only offered for women Correctional Services Canada (CSC) offers a variety of correctional programs aimed at addressing the root causes of offending: o Violence Prevention Program o Substance Use Program o Family Violence Prevention Program o Sex Offending Programs CSC also offers Indigenous-specific programming: o Meet specific needs of Indigenous individuals who are federally incarcerated  o Consider Indigenous social history o Integrate Elder involvement o Correctional programs for Indigenous men and women: https://www.canada.ca/en/correctional-service/corporate/news-media/videos/bringing- grandchildren-home.html Difficulties indigenous peoples face is a missing identity, loss of background with who they are, intergenerational trauma Goal is to recognize that the modes of treatment that White Canadians might find useful are not relevant to those who are Indigenous Having Elders talk to these people are integral to ensuring that these individuals stick to their treatment program and reintegrate into the community Medication used to help manage symptoms, especially for people experiencing psychosis Behavioral therapy used to help ensure adherence to medication (e.g., providing positive social and material reinforcement for taking medication). Morgan et al. (2012): Interventions that address psychological AND behavioral issues were associated with significant reduction in symptoms of mental illness and reoffence rates Changing Lives Changing Outcomes Kroner & Mills (2018) - Treatment program based out of Texas, US Program for incarcerated individuals with major mental health disorder Seeks to target mental health symptoms and criminogenic needs 9 core modules across 77 sessions o Preparing for change o Mental illness and criminal awareness o Thoughts and attitudes o Medication adherence o Coping with mental illness o Emotions management o Associates o Skill development o Substance use Effective in improving mental health symptoms and criminogenic needs. No research on whether it reduces reoffending yet. Mental Health and Segregation Individuals with serious mental illness have been over-represented in administrative segregation (confinement for those who cannot be safely managed in the general correctional population) Long-term segregation linked to worsening mental health symptoms o 1 in 5 unnatural deaths in Canadian federal institutions are due to suicide o 50% of suicides occurred in segregation cells o Most individuals had previous suicide attempts o Most had documented comorbid mental health disorders In 2015, Office of the Correctional Investigator ordered the removal of segregated units in federal institutions - replaced with Structured Intervention Units Structured Intervention on Units Individuals experiencing symptoms of severe mental illness transferred to SIUs to be managed away from general correctional population Intent is to address individual needs Legislation includes: o Frequent mental health assessments o Minimum 4 hours outside the cell daily o Minimum 2 hours of meaningful human contact every day Segregation Rebranded? 2021 internal review by SIU advisory panel o Indigenous people more likely to be sent to SIU (made up half of the SIU residents) o Some people were in the SIU for upwards of 30 days o Of individuals who were identified as having "deteriorating mental health", 75% were in SIUs for over one month o Most did not receive their full 4 hours out of cell nor 2 hours of "meaningful social contact." Changing Course: Mental Health Courts Mental heath courts: o Mental health diversion programs: aim to divert individuals with mental health issues pre-charge so they can be assessed and receive treatment ▪ Not specifically regulated in their operation (i.e., no shared mandate determining where they exist, how they should operate) ▪ Unique list of cases related to mental health issues collected and presented to a judge ▪ Access to physician referrals, emergency housing, medication ▪ Supervision and treatment plan presented to judge by care team ▪ Individual makes regular appearances to court to ensure adherence to treatment ▪ Terms for successful completion ▪ Asses by a court mental health worker for eligibility ▪ Client must be willing to participate and receive treatment ▪ Most are "non-serious" offences ▪ Pre-court meetings to discuss progress on existing clients, consult on new clients. Attached by Crown, defence, community worker, court mental health worker ▪ Accused can be involved in developing diversion plan ▪ Successful completion can result in withdrawn charges, reduced or deferred sentencing, monetary rewards ▪ Sanctions for not completing can include expulsion from diversion program, charges not withdrawn, detentioN. RISK ASSESSMENT What is Forensic Risk Assessment? Evaluating a person's likelihood of engaging in future harmful or criminal behavior based on past harmful or criminal behavior No risk assessment tool for predicting onset of offending Depending on assessment, can be done by psychologists, psychiatrists, social workers, parole, and correctional officers Informs decision making in a variety of areas Risk: o Civil commitment o Bail o Dangerous/Long-term offender designation o Conditions o Sentencing o Level of supervision o Conditional release o Level of security Why do we need to know risk? Decision-making: Informing legal decisions (e.g., sentencing, parole) Risk Management: identifying and addressing risk factors to reduce likelihood of future harmful behavior Resource Allocation: more resources (e.g., treatment Risk - Needs - Responsivity model is used in correctional settings for assessing and managing individuals' risk. There are 3 main principles: Risk: Intensity of intervention should match level of risk. Higher risk = higher intensity Need: Treatment should target criminogenic needs (factors directly related to criminal behavior). Responsivity: Intervention should be tailored to learning style, abilities, and cultural needs of the individual. "Risk assessment is a double-edge sword. It can be used to justify the application of severe sanctions or to moderate extreme penalties…However, the identification of the violent recidivist is not infallible" (Bonta, 2002). Risk assessments can significantly influence the lives of the people being assessed, this can be in a negative or positive light We are taking away liberties of people History of Risk Assessment Risk was seen as dichotomous: Someone is dangerous or not dangerous. 1960s: US Supreme Court ruling forced release of 300 people with mental illness who had committed a crime. Found they were detained for longer than appropriate Steadman & Cocozza (1974): followed 98 patients who had initially been deemed "too dangerous" to be released by mental health professionals o Over 4 years, 20 were re-arrested, only 7 for violent offence.  Thornberry & Jacoby (1979): followed 400 forensic patients released onto the community -- only 60 rearrested over 3 years. John Monahan 1981: "Psychiatrists and psychologists are accurate in no more than one out of three predictions of violent behavior over a several-year period among institutionalized populations that had both committed violence in the past and who were diagnosed as mentally ill." Risk Assessment Today Risk is seen as a spectrum - a dimension of probability Use of evidence-based risk assessment tools validated in large correctional samples Probability of reoffence reflects 2 considerations: o Probabilities may change over time ▪ As people get older they are less likely to commit crimes; they are tired o Risk level reflects an interaction among a person's characteristics, backgrounds, and possible future situations that affect whether person engages in violent/criminal behavior Base Rates The % of people in a population who will commit a crime/violent act. Base rates vary depending on the group being studied, what is being predicted, and the length of follow-up period over which the group is being monitored o E.g., base rate for sexual violence is low even over extended follow-up period o Base rate for violating conditions is high In general, easier to predict frequent events than infrequent events Types of Prediction Outcomes 4 different outcomes based on prediction; 2 false and 2 true False positives and false negatives are dependent on each other: minimizing number of false positives results in an increase in the number of false negative errors False positive errors: implications for the person being assessed (denial of freedom). False negative errors: implications for society (another person potentially victimized).  In some cases, could be tolerable to have high rates of false positives as long as consequences aren't too severe (high risk label leading to higher supervision). If false positive contributes to judge's decision to give life sentence, high price to pay Ultimately, a risk assessment tool should have good SPECIFICITY (ability to correctly identify people who will not offend) and SENSITIVITY (ability to correctly identify people who will offend). Risk Assessment Includes Both Prediction and Management Prediction is the probability that an individual will commit future criminal acts Management describes the development of interventions to manage or reduce the likelihood of offending "The critical function of risk assessments is violence prevention, not violence prediction" (Hart, 1998). Types of Risk Factors Static risk factors: characteristics that do not change over time (e.g., age at time of offence, number of past violent convictions). Dynamic risk factors: characteristics that can change with intervention or with time (e.g., substance use, offence-supportive attitudes). Also, called criminogenic needs (targets for change). o Acute dynamic risk factors: risk factors that rapidly change within days, hours, or minutes (e.g., negative mood and intoxication) Approaches to Risk Assessment Unstructured clinical judgement: Substantial amount of professional discretion and lack of guidelines. No rules about what risk factors should be considered, what sources of information to use, or how risk factors should be combined to make a decision about risk. Actuarial prediction: Decisions based on risk factors that are selected and combined based on empirical or statistical association with a specific outcome. Studies conducted where a number of risk factors have been measured, people followed for a specific period, and only those risk factors related to reoffending in this sample are selected. o Actuarial assessment has been repeatedly found to be more reliable than unstructured (Mossman, 1994; Bonta et al., 1998; Manson & Morton-Bourgon, 2009). o Critique: rely only on static risk factors ▪ Don’t consider dynamic risk factors, risk will never be able to decrease, can only increase, no consideration for other factors in your risk Structured professional judgement: Guided by a predetermined list of risk factors selected from the research and professional literature. Judgement of risk level based on evaluators professional judgement of presence and severity of risk factors. o Includes static and dynamic risk o Allows for the consideration of contextual and cultural information o Good reliability, predictive validity (Garrington & Boer, 2020; Pederson et al., 2010) Actuarial Example: Static-99R (Predicting sexual recidivism in adult males) Structured Professional Judgement Example: HCR-20 Historical Clinical Risk Management Violence Lack of insight Professional services and plans Other antisocial behavior Violent ideation or intent Living situation Relationship instability Symptoms of major mental Level of personal support disorder Employment instability Instability Stress or coping Substance use Treatment or supervision response Treatment or supervision response Major mental disorder Personality disorder Traumatic experience Violent attitudes Treatment or supervision response Important Risk Factors Historical: aspects of the person's background and previous behaviors that can inform future behavior Dispositional: those that reflect personality traits, tendencies, and include demographic, attitudinal, and personality variables Clinical risk factors: symptoms that contribute to criminal behavior like substance use combined with major mental health symptoms Situational: aspects of the environment that can elevate risk like access to victims, weapons, lack of social support, stress. All vary in terms of how much they are subject to change Some factors are "general" and useful in predicting a variety of criminal behaviors Historical Risk Factors Past criminal behavior: e.g., past violent behavior predicts future violent behavior Age of onset: people who start their criminal behavior earlier are more likely to repeat offending behavior o Farrington (1991): 50% of boys in this study who committed violent offences prior to 16 year old were convicted of a violent offence in early adulthood Childhood maltreatment: associated with increased risk for violence. Adverse childhood experiences predicts initiation into delinquency, but continued abuse predicts chronic offending (Lemmon, 2006). Dispositional Risk Factors Gender: Men at higher risk than women for general offending. Men engaged in more serious violent acts. Personality and Attitudinal Characteristics: o Impulsiveness: difficulty in regulating behavior in response to impulses increases likelihood of engaging in criminal behavior o Antisocial personality: callous unemotional interpersonal style, manipulation, lack of remorse, impulsivity, irresponsibility. Predicts violent and sexual offending (Martin et al., 2019; Seto & Barbaree, 1999). o Offence-Supportive Attitudes: attitudes supportive of crime are predictive in reoffending in both men and women (Andrews et al., 2011; Rettinger & Andrews, 2010) Clinical Risk Factors Substance Use: o Direct effects: i.e., pharmacological effects of substances make it more likely that people commit crime. o Indirect effects: i.e., commission of crimes to obtain substances o Major mental disorder + substance use = higher risk Situation Risk Factors  Lack of social support: absence of strong support systems. Social supports should also ideally be positive and prosocial. Environment: unstable housing, employment instability -- releasing someone into shared rooming house with others engaged in criminal behavior, using substances, increases risk of reoffending Access to victims: Returning to live with intimate partner whom they have abused, having access to children if they have offended against a child. Strengths-Based Approach: Considering Protective Factors Risk assessment is "deficit focused." Considering strengths could: o Improve predictive validity of assessment tools o Improve treatment planning o Reduce stigma toward justice-involved people Protective factors: factors that enable or assist desistance from offending Conceptualization may differ between researchers Does the absence of a risk factor produce a protective factor? (e.g., sobriety, lack of antisocial peers) o Should exist as stand-alone factor rather than the absence of risk Initial research on protective factors conducted with youths: o Prosocial involvement; strong social support; positive social orientation (e.g., school, work); strong attachments; and intelligence (Caldwell et al., 2004; Caprara et al., 2001) For adults, there have been few studies on protective factors: o Employment stability and strong family connections (DeMatteo et al., 2005) o Prosocial involvement, positive childhood attachment (Seto et al., 2023) Tool developed for testing protective factors: SAPROF - protective factors for violence risk o Internal factors o Motivational factors o External factors Risk: What about Women? In 2017, 25% of people accused of criminal offence were women (Savage, 2009) Women represented 8.5% of admissions to federal custody in 2016-2017 (Public Safety Canada, 2018). Women less likely to commit violent crime than men Most risk assessment tools predicting violent re-offending developed for men  Are there unique predictors of violent reoffending for women (i.e., female salient predictors)? While rates of childhood abuse are high for both men and women in correctional settings, women report higher rates thans men.  Other considerations for risk factors: Relational an family factors o Girls are more negatively impacted by family conflict, esp. mother-daughter conflict (Giodana & Copps, 2019) o Negatively impacted by parental stress (Hipwell & Loeber, 2006) o Negatively influenced by criminally active romantic partners than males (Van Voorhis et al., 2010) Self-Concept o Poor self-esteem and poor self-efficacy are identified as risk factors for women but not men (Koons et al., 1997; Van Voorhis, 2022) ▪ E.g., does not believe they can achieve a specific goal, like getting a job, providing for self. Risk: What about Indigenous Peoples? Indigenous people make up 5% of the population in Canada, but account for 25-30% of the federaly incarcerated population. All risk tools commonly used were developed and validated with White men Are these risk tools about to effectively predict general, violent, and sexual recidivism for Indigenous people? Many established risk factors do seem to effectively predict recidivism among Indigenous people (Gutierrez et al., 2013): The Central Eight Risk/Needs Factors: o Criminal history o Pro-criminal attitudes o Pro-criminal associates o Antisocial personality o Employment/education o Family/marital o Substance use o Leisure/recreation Risk of Being Deemed "High-Risk" Indigenous people are more likely to be classified as "High-Risk". Subject to harsher sentences, stricter conditions of release, or increased surveillance. o Indigenous men are placed in maximum-security institutions at twice the rate of non- indigenous men. o Indigenous women were placed in maximum-security at more than three times the rate of non-Indigenous women (made up nearly 70% of maximum-security placements; Office of the Auditor General, 2022). Higher risk classifications can limit access to rehabilitative programs or supports. Potential to perpetuate the inequalities already present. Ewert v Canada (Correctional Services Canada) Ewert was a 53-year-old Métis man serving 2 life sentences. Sued CSC on the grounds that they were using culturally biased risk assessments with Indigenous people - stated this damaged his rehabilitation process. Claimed a violation of S.7 of the Canadian Charter of Rights and Freedoms (i.e., right of life, liberty, and security) and CSC was not complying with S.4 of the Correctional and Conditional Release Act (i.e., "correctional policies, programs, and practices respect gender, ethnic, cultural, and linguistic differences and are responsive to the special needs of women, Indigenous peoples, persons requiring mental health care and other groups.")  2018, Supreme Court of Canada dismissed Ewert's charter arguments, but majority agreed that CSC had breached its obligations under the CCRA. "The gap between indigenous and non-Indigenous offenders has continued to widen on nearly every indicator of correctional performance…Although many factors contributing to the broader issue of Indigenous over-incarceration and alienation from the criminal justice system are beyond the CSC's control, there are many matters within its control that could mitigate these pressing societal problems…Taking reasonable steps to ensure that the CSC uses assessment tools that are free of cultural bias would be one." Risk Tools and Cultural Diversity The view that risk tools are "ethnically neutral" overlooks genuine cross-cultural differences in: o Behavioral practices and expectations o Health beliefs o Social/environmental experiences o Phenomenology o Illness narratives o "Deviant" conduct o Worldview Structured Professional Judgement tools allow professionals to incorporate culture-specific information. o But this relies on the professional having a baseline understanding of multiculturalism and how risk factors can present differently based on cultural background o Can also incorporate own Western biases Risk item content reflects practices, perceptions, norms, beliefs, and behavioral expectations of Western, independent culture (vs collectivist culture). o Western Risk Factor ▪ Family disruption ▪ Unstable childhood supervision ▪ Caregiver separation ▪ Lack of insight into criminality, mental health condition ▪ Active symptoms of major mental health disorder (e.g., psychosis) o Non-Western Practice, Belief, Norm ▪ Common for children to be raised by extended family members at different times ▪ Interconnections of various factors indicate health ▪ Speaking with deceased, religious, or spiritual fervor, seeing or hearing spirits o Issue ▪ May be perceived as higher risk than their situation merits ▪ Alienation from an assessment only including individual - level factors -- view of health should include ecological, holistic risks ▪ Culturally appropriate behaviors viewed as active state of psychosis Risk item content may also unintentionally penalize people who have limited control over their surroundings o Risk Factor ▪ Low education success/attainment  Issue: Could be function of poorly resourced schools, lack of community support rather than disinterest in education ▪ Noncompliance with supervision, conditions Issue: unavailability of community support services, culturally or linguistically appropriate programs, transportation rather than negative attitude toward intervention ▪ Lack of social support network Issue: Difficulty with acculturation can inhibit success in building up meaningful community support Acknowledging limitations in reports Assessments ideally don’t by culturally competent assessor and preferably someone of the same background of the individual being assessed SENTENCING & PAROLE Meet Zach Zachary Hawco, a 32-year-old man from Toronto, has been arrested and charged with armed robbery after holding up a convenience store with a knife. Security footage shows him demanding cash and cigarettes from the clerk while appearing intoxicated. No one was physically harmed during the robbery, but the clerk reported feeling terrified and has since struggled with anxiety. Zach's trouble with the law began in his late teens, with multiple convictions for assault (from bar fights) and petty theft over the years. His criminal behavior is closely tied to his long-standing struggle with alcohol and opioid use. He dropped out of high school in Grade 11 and has struggled with stable employment ever since. Zach's early life was marked by instability. He frequently ran away from home as a teenager to escape the violent arguments between his mother and her boyfriend. With little supervision and no positive role models, he gravitated toward older peers who introduced him to substance use and minor criminal activities. Despite past attempts  at rehabilitation through court-mandated substance use treatment and probation, Zach continues to re-offend. At the time of the robbery, he was on probation for a theft under $5,000 charge. After Arrest Some individuals will receive bail and be released with conditions (e.g., promise to appear, report to police, keep the peace, not use substances, etc.). Given the severity of Zach's crime, he must stay in jail (remand) until he is either found not guilty, or found guilty and sentenced. During intake at the jail, Zach is interviewed by corrections and healthcare staff regarding security concerns that could impact his placement within the jail (e.g., risk of escape, gang affiliations, incompatibilities) or evidence of health concerns that might need further assessment and intervention (e.g., serious mental health concerns, injuries, suicidal intent) Five Months Later… After spending five months on remand, Zach decides to take a plea deal (90% of cases are resolved by plea bargain rather than trial). He receives a sentence of 36 months (3 years). Sentences of 2+ years are served in federal institutions. Sentences of less than 2 years are served in provincial facilities. While in Federal Facility Zach is assessed and placed in a medium-maximum security facility After 1 year, he is re-assessed for suitability for transfer to reduced security.  He is met regularly with his parole officer who follows his progress, ensures he is sticking to his correctional plan, and will also write a report if Zach decides to apply for parole. Parole can be revoked if conditions are violated or they commit a new offence Other sentencing options other than imprisonment? Absolute discharge: person is found guilty but will not be convicted and will have no criminal record Conditional discharge: essentially on probation - must follow rules in the community for specified period of time. If successful, discharge will become "absolute" and stricken from record Restitution: payment made to the victim to cover expenses resulting from a crime Fines, community service: fines are money paid to the court. Sometimes fine is paid through community service Conditional sentence: prison sentence served in the community. Must follow set of rules for a period of time. If they succeed, the sentence is suspended (not served). If they break the rules, may be required to serve rest of time incarcerated What do judges consider sentencing? What is the purpose of sentencing? Sentencing occurs after an individual has been found guilty or has taken a plea deal. According to CSC: "to ensure respect for the law and the maintenance of a just, peaceful, and safe society. This is achieved through the imposition of just sanctions on individuals." Deter them from re-offending, and rest of society Victims could feel good that they got justice Denouncing unlawful conduct and subsequent harm to society and survivors Deterring sentenced individuals and society at large from committing crime Removing people who have committed crime from society Assisting in the rehabilitation of people who have committed crime Providing reparation to survivors of crime Promoting a sense of responsibility in people who have committed crime In Canada, sentencing practices incorporate retribution, denunciation, incapacitation, and deterrence Retribution: society has the right when harmed to harm the perpetrator. Punishment should be proportionate to the crime. Denunciation: communicates society's condemnation of the crime Incapacitation: application of crime control by incarcerating individuals who have committed a crime. In doing so, no longer a risk to the public Deterrence: imposing longer and harsher sentences to prevent future criminal behavior Deterrence Sanctions imposed by the court are expected to deter both the sentences person (specific deterrence) and the broader public (general deterrence) from committing more crime. Zach received 3yrs for armed robbery: If punishment and deterrence are sole concerns, then a longer sentence would be preferable. In past govt, increase in mandatory minimum sentences. Longer sentence would have the greatest merit if it could be demonstrated that it reduced Zach’s likelihood of reoffending. Length of Sentences in Canada A snapshot of 2020-2021 ▪ Median length of custody in Canada was 34 days ▪ 70% of custodial sentences were 6 months or less ▪ 4% of custodial sentences were for a longer term of 2+ years ▪ Homicide and attempted murder received longest median custodial sentences. ▪ Shortest custodial sentence lengths were for disturbing the peace (2 days); failing to appear (5 days); and drug possession (8 days) Public Opinion Roberts et al., (2007): 74% of respondents held the view that Canadian sentencing is too lenient. Purpose of sentencing: Strongest public support emerged for promoting sense of responsibility and securing reparations for the survivor. Over 50% supported mandatory minimum sentencing. Do longer/harsher sentences work? Gendreau et al. (1999) Conducted a meta-analysis of 222 studies looking at the impact of sentencing on reoffending in Canada. Those given longer sentences (avg 30 months) had a 2-3% increase in reoffence rate compared to those given shorter sentences (avg 17 months). Those incarcerated for avg 10.5 months had 7% increase in reoffence rates compared to those given community sanctions. Sentencing and Recidivism in Other Countries United States ▪ Dennison (2013: Reoffence rates stabilized with moderate (4-10yr) to high (11 - 25yr) sentence lengths. ▪ Budd & Desmond (2014): Longer prison sentences were associated with increased reoffence rates in people who were convicted with sex offences. Sweden ▪ Weswasi et al. (2022): Sentence length was not associated with reoffending. Re-offending between people who has custodial sanction (provincial or federal) and non-custodial sanction Effects of other forms of sanctions on recidivism *Positive effect size means increase in recidivism; Negative effect size means decrease in recidivism Fines and restitution are the only things that had an effect, but they weren't significant - too small Nothing had an impact of re-offending that they saw What about capital punishment? 76 countries across the world have the death penalty, with 53 maintaining it in law and practice. The United States is the only country in the Americas that still permit the death penalty with civilians. Reid (2013): 63% of Canadians supported the reinstatement of the death penalty for the crime of homicide. ▪ Highest support from people in Manitoba, Saskatchewan (75%) and Alberta (73%) and people who were politically right leaning (78%). Capital Punishment as Deterrence Political justification: has the unique general deterrent capacity to save further lives or significantly reduce other capital offences. Hood, 2002: ▪ Compared countries that had death penalty with those that have not: found no difference in frequency of capital crimes. ▪ Further comparisons between neighbouring states with and without capital punishment found no difference in capital crime rates. Texas: no relationship between capital punishment and murder rate -- higher execution rates did not yield lower murder rate. Canada: murder rate has declines on average since death penalty was abolished. Why are punishment-only models ineffective? Assumes people who commit crimes operate within a "rational choice model". ▪ Idea that people who commit crime carefully weigh pros/cons associated with commission of crime. If crime carries too high a cost (e.g., life in prison), then person will not carry out crime despite short-term benefit (e.g., acquiring money). ▪ Most criminal behaviour is dominated by “here and now” thinking (Bonta & Andrews, 2017).  Very impulsive ▪ Mental illness, substance use does not generally allow for rational choice. Most criminal behavior is dominated by "here and now" thinking. ▪ The premise of punishment-based models -- fear of lengthy imprisonment, capital punishment deterring criminal behavior -- is inconsistent with “here and now” thinking. ▪ Punishment-based models do not follow the basic tenets of learning theory: Immediacy Consistency Intensity ▪ Punishment should be immediate, certain, and severe. Additional reason punishment based models might fail (Petrich et al., 2021) Based on incorrect assumption that sentenced individuals prefer community-based sentences to prison. Those deeply entrenched in criminal justice system perceive prison time as less difficult in comparison to community-based sentences like probation. Incarceration is a crime-causing or criminogenic environment. Around other people who have anti-social values and have a long history of criminal acts. Might have to engage in criminal acts in order to survive. Incarceration separates people from prosocial support systems, increases barriers to legitimate and meaningful employment upon release due to factors such as stigmatization and legal barriers. Alternative Sentencing: Restorative Justice Restorative justice focuses on repairing and healing wounds of survivors and communities. Unites survivors and perpetrators of harm. Requires voluntary participation by both the survivor and perpetrator. Can also involve members of the community. Perpetrator must recognize the harm caused, accept responsibility, and be actively involved in attempting to heal the situation. “Restore” relationship by addressing the damage done to prevent further crimes. Can occur at different points of criminal justice process: with police at pre-charge, crown at post-charge, courts at pre-sentence, corrections at post-sentence, and parole. Principles of Restorative Justice Restorative programs are often characterized by four key values: ▪ Encounter: Create opportunities for victims, offenders, and community members who want to do so to meet to discuss the crime and its aftermath ▪ Amends: Expect offenders to take steps to repair the harm they have caused ▪ Reintegration: Seek to restore victims and offenders as whole, contributing members of society. ▪ Inclusion: Provide opportunities for parties with a stake in a specific crime to participate in its resolution Chart 2: Cases completed in adult criminal courts and youth courts by offence type, Canada, 2018/2019 In 2018-2019, over 30k cases referred to restorative justice process (93%