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Eligibility criteria for participation in mental health jail diversion programs often specify that, to be diverted, a candidate must not pose a level of threat to public safety that cannot be managed in the community. Risk assessment tools were developed to increase consistency and accuracy in estimates of threat to public safety. Consequently, risk assessment tools are being used in many jurisdictions to inform decisions regarding an individual's appropriateness and eligibility for mental health jail diversion and the strategies that may be successful in mitigating risk in this context. However, their use is not without controversy. Questions have been raised regarding the validity and equity of their estimates, as well as the impact of their use on criminal justice outcomes. The purpose of this review is to provide an overview of the science and practice of risk assessment to inform decisions and case planning in the context of mental health jail diversion programs. Our specific aims include: (1) to describe the process and components of risk assessment, including differentiating between different approaches to risk assessment, and (2) to consider the use of risk assessment tools in mental health jail diversion programs. We anchor this review in relevant theory and extant research, noting current controversies or debates and areas for future research. Overall, there is strong theoretical justification and empirical evidence from other criminal justice contexts; however, the body of research on the use of risk assessment tools in mental health jail diversion programs, although promising, is relatively nascent.

Background: Although research has established the profound effects that intimate partner abuse can have on postpartum mental health, little is known regarding how this association may change as a function of the timing and type of abuse. This study examined associations of psychological, physical and sexual abuse experienced as adults before and during pregnancy with symptoms of postpartum mental health problems in a non-clinical sample of women., Methods: English-speaking mothers aged 18 years and older in the metropolitan area of a large, Western Canadian city were recruited to participate in a study of women's health after pregnancy. The study was advertised in hospitals, local newspapers, community venues, and relevant websites. One-hundred women completed standardized, self-report questionnaires during semi-structured interviews conducted by female research assistants at approximately 2 months postpartum. In addition to questions about their general health and well-being, participants answered questions about their experiences of intimate partner abuse and about their mental health during the postpartum period., Results: Almost two-thirds (61.0%) of women reported postpartum mental health symptoms above normal levels, with 47.0% reporting symptoms at moderate or higher levels. The majority reported some form of intimate partner abuse before pregnancy (84.0%) and more than two-thirds (70.0%), during pregnancy; however, the abuse was typically minor in nature. Multivariate models revealed that women who experienced intimate partner abuse-whether before or during pregnancy-reported higher levels of postpartum mental health problems; however, associations differed as a function of the timing and type of abuse, as well as specific mental health symptoms. Multivariate models also showed that as the number of types of intimate partner abuse experienced increased, so did the negative effects on postpartum mental health., Conclusions: Results of this study provide further evidence that intimate partner abuse is a risk factor for postpartum mental health problems. They also underscore the complex risks and needs associated with intimate partner abuse among postpartum women and support the use of integrated approaches to treating postpartum mental health problems. Future efforts should focus on the extent to which strategies designed to reduce intimate partner abuse also improve postpartum mental health and vice versus.

Many people involved with the United States criminal legal system have experienced trauma, the long-term effects of which can challenge capacity to recover, often resulting in an increased risk of contact with the criminal legal system. Training programs can help professionals improve their understanding of trauma and implement trauma-informed responses. Limited research exists on the impact of trauma-informed response training for criminal legal professionals (e.g., corrections officers, court personnel, and law enforcement), and less is known about the effectiveness of the train-the-trainer (TTT) model in this context. In this article, we describe a four-phase, mixed-methods evaluation of a trauma-informed response training program delivered in the context of a 16-h TTT event to 28 criminal legal professionals in the southwest United States. We examine pre- and post-training knowledge acquisition, training experience, and impact on participant behaviors and attitudes 60 days post-training. Results provide preliminary support for the positive impact of trauma-informed response training for criminal legal professionals. We discuss future directions for research on the effectiveness of trauma-informed response training for criminal legal professionals, including, critically, whether trauma-informed training contributes to improved outcomes for individuals involved with the criminal legal system. [ABSTRACT FROM AUTHOR]

Sexual violence victimization is a prevalent public health concern. However, little research has investigated the factors linking sexual violence victimization to suicidal thoughts and behaviors (STBs). The current study tested the applicability of the psychological mediation framework, a coping‐mental health model, for the prevention of STBs among victims of sexual youviolence. Furthermore, the current study explored whether sexual orientation moderated the progression from sexual violence victimization to STBs. Data were drawn from an online survey of victimization experiences and health (N = 2175). Bootstrap mediation tested whether the association of sexual violence victimization and STBs was mediated by emotion regulation strategies (cognitive reappraisal and expressive suppression) and psychopathology (anxiety, depression, and posttraumatic stress disorder). Multiple‐groups analysis tested whether links within the mediation effects varied by sexual orientation. Bivariate findings showed that: (1) sexual minority persons were more likely to report sexual violence victimization and (2) cognitive reappraisal was more meaningfully associated with mental health among sexual minority persons. Sexual violence victimization was associated with STBs via a serial mediation through emotion regulation and psychopathology. The association between psychopathology and STBs was stronger among sexual minority compared with heterosexual respondents. Physical violence victimization was associated with STBs for heterosexual but not sexual minority persons in a follow‐up model. Findings support an emotion regulation‐mental health framework for the prevention of suicide among victims of sexual violence. Research and training implications are discussed. [ABSTRACT FROM AUTHOR]

Risk assessment has come to be recognized as a key component of evidence-based practice and policy in psychiatric and correctional agencies. At the same time, however, there is significant debate in scientific, policy, and public arenas regarding the role of risk assessment instruments in mental health and criminal justice decision-making, and questions regarding the level of evidence supporting their usefulness. It is in light of these conflicting realities that the current commentary considers Williams, Wormith, Bonta, and Sitarenios' (2017) re-examination of the Singh, Grann, and Fazel (2011) meta-analysis and recommendations made in “The Use of Meta-Analysis to Compare and Select Offender Risk Instruments.” Additional limitations in the extant risk assessment research are identified and their implications for evidence-based practice and policy are discussed. [ABSTRACT FROM PUBLISHER]

Over the past decade, Mental Health Courts (MHCs) have spread rapidly across the U.S. These courts aim to reduce recidivism among adults with mental illnesses through diversion into community-based treatment. Extant research suggests that MHCs can be effective in reducing recidivism, but also demonstrates that effectiveness varies as a function of characteristics of the participants (e.g., criminal history) and the program (e.g., coercion). Less is known regarding the extent to which process-related factors (e.g., length of participation, time between referral and receipt of services) impact effectiveness. Prior research also is limited by a focus on recidivism during MHC as opposed to postexit. To address these knowledge gaps, we examined recidivism 1 year postexit for a group of MHC participants (n = 57) and offenders receiving treatment as usual (TAU; n = 40), total N = 97. We also investigated the influence of individual characteristics and process factors on changes in jail days 1 year preentry to 1 year postexit for MHC participants. Overall, results provide some evidence supporting the effectiveness of MHCs. MHC participants had significantly fewer jail days, but not charges or convictions, relative to TAU participants. Among MHC participants, graduation from the MHC, presence of co-occurring substance use, and longer length of MHC participation were associated with greater reductions in jail days. Other process factors were unrelated to reductions in recidivism. Findings suggest that MHCs may be particularly effective for high-risk participants and that time spent in a MHC has positive effects on recidivism, regardless of graduation status. [ABSTRACT FROM AUTHOR]

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Mental health professionals are routinely called upon to assess the risk of violence presented by their patients. Prior surveys of risk assessment methods have been largely circumscribed to individual countries and have not compared the practices of different professional disciplines. Therefore, a Web-based survey was developed to examine methods of violence risk assessment across six continents, and to compare the perceived utility of these methods by psychologists, psychiatrists, and nurses. The survey was translated into nine languages and distributed to members of 59 national and international organizations. Surveys were completed by 2135 respondents from 44 countries. Respondents in all six continents reported using instruments to assess, manage, and monitor violence risk, with over half of risk assessments in the past 12 months conducted using such an instrument. Respondents in Asia and South America reported conducting fewer structured assessments, and psychologists reported using instruments more than psychiatrists or nurses. Feedback regarding outcomes was not common: respondents who conducted structured risk assessments reported receiving feedback on accuracy in under 40% of cases, and those who used instruments to develop management plans reported feedback on whether plans were implemented in under 50% of cases. When information on the latter was obtained, risk management plans were not implemented in over a third of cases. Results suggest that violence risk assessment is a global phenomenon, as is the use of instruments to assist in this task. Improved feedback following risk assessments and the development of risk management plans could improve the efficacy of health services. [ABSTRACT FROM AUTHOR]