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Showing papers by "John Monahan published in 2005"


Journal ArticleDOI
TL;DR: The multiple ICT model may be helpful to clinicians who are faced with making decisions about discharge planning for acutely hospitalized civil patients and may reflect the "shrinkage" expected in moving from construction to validation samples.
Abstract: OBJECTIVES: An actuarial model was developed in the MacArthur Violence Risk Assessment Study to predict violence in the community among patients who have recently been discharged from psychiatric facilities. This model, called the multiple iterative classification tree (ICT) model, showed considerable accuracy in predicting violence in the construction sample. The purpose of the study reported here was to determine the validity of the multiple ICT model in distinguishing between patients with high and low risk of violence in the community when applied to a new sample of individuals. METHODS: Software incorporating the multiple ICT model was administered with independent samples of acutely hospitalized civil patients. Patients who were classified as having a high or a low risk of violence were followed in the community for 20 weeks after discharge. Violence included any battery with physical injury, use of a weapon, threats made with a weapon in hand, and sexual assault. RESULTS: Expected rates of violence...

231 citations


Journal ArticleDOI
TL;DR: A fairly consistent picture emerged in which leverage was used significantly more frequently for younger patients and those with more severe, disabling, and longer lasting psychopathology; a pattern of multiple hospital readmissions; and intensive outpatient service use.
Abstract: OBJECTIVES: A variety of tools are being used as leverage to improve adherence to psychiatric treatment in the community. This study is the first to obtain data on the frequency with which these tools are used in the public mental health system. Patients' lifetime experience of four specific forms of leverage—money (representative payee or money handler), housing, criminal justice, and outpatient commitment—was assessed. Logistic regression was used to examine associations between clinical and demographic characteristics and receipt of different types of leverage. METHODS: Ninety-minute interviews were conducted with approximately 200 adult outpatients at each of five sites in five states in different regions of the United States. RESULTS: The percentage of patients who experienced at least one form of leverage varied from 44 to 59 percent across sites. A fairly consistent picture emerged in which leverage was used significantly more frequently for younger patients and those with more severe, disabling, a...

195 citations


Journal ArticleDOI
TL;DR: In this article, the authors identify four dimensions distinguishing 1stfrom 2nd-generation mental health courts: the acceptance of felony versus misdemeanant defendants, preversus post-adjudication models, the use of jail as a sanction, and the type of court supervision.
Abstract: Mental health courts (MHCs) generally began to appear in 1997. Today, more than 80 courts exist in the United States. In the present article, the authors argue that the 2nd generation of MHCs has arrived. The authors compare 8 previously described courts (P. A. Griffin, H. J. Steadman, & J. Petrila, 2002) with 7 newer courts that have not been previously described in the psycholegal literature. The authors identify 4 dimensions distinguishing 1stfrom 2nd-generation courts: (a) the acceptance of felony versus misdemeanant defendants, (b) preversus postadjudication models, (c) the use of jail as a sanction, and (c) the type of court supervision. The 4 dimensions are interdependent in that the acceptance of more felony cases contributes to the rise in processing cases postadjudication, using jail as a sanction and more intensive supervision. Potential reasons for the evolution of a 2nd generation are discussed.

120 citations


Journal ArticleDOI
TL;DR: Results indicate that general traits captured by a measure of the 5-factor model, particularly antagonism, were relatively strongly associated with violence and shared most of their violence-relevant variance with a leading measure of psychopathy.
Abstract: Recent work suggests that predictors of violence are similar for individuals with and without mental illness Although psychopathy is among the most potent of such predictors, the nature of its relation to violence is unclear On the basis of a sample of 769 civil psychiatric patients, the authors explore the possibility that measures of psychopathy provide a glimpse of higher order personality traits that predispose individuals toward violence Results indicate that general traits captured by a measure of the 5-factor model, particularly antagonism, were relatively strongly associated with violence and shared most of their violence-relevant variance with a leading measure of psychopathy Because interpersonal and affective features of psychopathy are less important than basic traits of antagonism in postdicting violence, it may be appropriate to broaden focus in risk assessment to patients' basic personality traits

108 citations


Journal ArticleDOI
TL;DR: Results show that, in comparison with individuals involved in the criminal justice system, mental health court clients are more likely to be older, White, and women than individuals in the generalcriminal justice system.
Abstract: The number of mental health courts in the United States is rapidly increasing, from one in 1997 to nearly 100 in 2004. However, to date there is comparatively little research regarding these specialty courts. The present study reports data on the referral and disposition decision-making processes of seven mental health courts. Information on all referrals to the seven courts over a three-month period was gathered. Results show that, in comparison with individuals involved in the criminal justice system, mental health court clients are more likely to be older, White, and women than individuals in the general criminal justice system. Furthermore, this over-representation occurs at the point of referral, rather than at the point of the court's decision to accept or reject a referral. In addition, the length of time from referral to diversion is much longer in these mental health courts than in other types of diversion programs. Implications of these findings are discussed.

104 citations


Journal ArticleDOI
TL;DR: The authors argue that framing the legal debate on mandated community treatment primarily in terms of "coercion" has become counterproductive and that the debate should be re-framed as a contract.
Abstract: Approximately half the people receiving treatment in the public sector for mental disorder have experienced some form of “leverage” in which deprivations such as jail or hospitalization have been avoided, or rewards such as money or housing have been obtained, contingent on treatment adherence. We argue in this essay that framing the legal debate on mandated community treatment primarily in terms of “coercion” has become counterproductive and that the debate should be re-framed in terms of “contract.” Language derived from the law of contract often yields a more accurate account of the current state of the law governing mandated community treatment, is more likely to be translated into a useful descriptive vocabulary for empirical research, and is more likely to clarify the policy issues at stake than the currently stalemated form of argumentation based on putative rights. Our hope is that adopting the language of contract may help to identify those types and features of mandated community treatment that are genuinely problematic, rather than perpetuating the unhelpful and misleading assumption that all types of leverage amount to “coercion.”

54 citations


Journal ArticleDOI
TL;DR: The Supreme Court's 1993 decision in Daubert v. Merrell Dow Pharmaceuticals, Inc., holding that the admissibility of scientific evidence depends on its scientific merit, has made American law receptive to valid science to an unprecedented degree.
Abstract: The Supreme Court's 1993 decision in Daubert v. Merrell Dow Pharmaceuticals, Inc., holding that the admissibility of scientific evidence depends on its scientific merit, has made American law receptive to valid science to an unprecedented degree. We review the implications for psychology of the law's taking science seriously. We consider the law before Daubert, and the ways that Daubert as well as modifications to the Federal Rules of Evidence have affected the admissibility of expert testimony. We describe the ramifications of these changes for psychology used as authority to create a general legal rule, as evidence to determine a specific fact, and as framework to provide context. Finally, future prospects for improving psychological testimony are offered: Court-appointed experts will increase the psychological sophistication of judges and juries, and evidence-based practices on the part of psychologists will increase the sophistication of the expert testimony that they proffer in court.

45 citations