Showing papers by "John Monahan published in 2010"

Assessing Outcomes for Consumers in New York's Assisted Outpatient Treatment Program

Abstract: Objective: This study examined whether New York State’s assisted outpatient treatment (AOT) program, a form of involuntary outpatient commitment, improves a range of policy-relevant outcomes for court-ordered individuals. Methods: Administrative data from New York State’s Office of Mental Health and Medicaid claims between 1999 and 2007 were linked to examine whether consumers under a court order for AOT experienced reduced rates of hospitalization, shorter hospital stays, and improvements in other outcomes. Multivariable analyses controlling for relevant covariates were used to examine the likelihood that AOT produced these effects. Results: On the basis of Medicaid claims and state reports for 3,576 AOT consumers, the likelihood of psychiatric hospital admission was significantly reduced by approximately 25% during the initial six-month court order (odds ratio [OR]=.77, 95% confidence interval [CI]=.72–.82) and by over one-third during a subsequent six-month renewal of the order (OR=.59, CI=.54–.65) compared with the period before initiation of the court order. Similar significant reductions in days of hospitalization were evident during initial court orders and subsequent renewals (OR=.80, CI=.78–.82, and OR=.84, CI=.81–.86, respectively). Improvements were also evident in receipt of psychotropic medications and intensive case management services. Analysis of data from case manager reports showed similar reductions in hospital admissions and improved engagement in services. Conclusions: Consumers who received court orders for AOT appeared to experience a number of improved outcomes: reduced hospitalization and length of stay, increased receipt of psychotropic medication and intensive case management services, and greater engagement in outpatient services. (Psychiatric Services 61:976–981, 2010)

Cultural Cognition and Public Policy: The Case of Outpatient Commitment Laws

Abstract: What explains controversy over outpatient commitment laws (OCLs), which authorize courts to order persons with mental illness to accept outpatient treatment? We hypothesized that attitudes toward OCLs reflect “cultural cognition” (DiMaggio, P. Annl Rev Sociol 23:263–287, 1997), which motivates individuals to conform their beliefs about policy-relevant facts to their cultural values. In a study involving a diverse sample of Americans (N = 1,496), we found that individuals who are hierarchical and communitarian tend to support OCLs, while those who are egalitarian and individualistic tend to oppose them. These relationships, moreover, fit the cultural cognition hypothesis: that is, rather than directly influencing OCL support, cultural values, mediated by affect, shaped individuals’ perceptions of how effectively OCLs promote public health and safety. We discuss the implications for informed public deliberation over OCLs.

Twenty-Five Years of Social Science in Law

Abstract: In this Essay, we take the publication of the seventh edition of the casebook Social Science in Law (2010) as an opportunity to reflect on continuities and changes that have occurred in the application of social science research to American law over the past quarter-century. We structure these reflections by comparing and contrasting the original edition of the book with the current one. When the first edition appeared, courts’ reliance on social science was often confused and always contested. Now, courts’ reliance on social science is so common as to be unremarkable. What has changed - sometimes radically - are the substantive legal questions on which social science has been brought to bear.

Beyond Context: Social Facts as Case-Specific Evidence

Abstract: Experts often seek to apply social science to the facts of a particular case. Sometimes experts link social science findings to cases using only their expert judgment, and other times experts conduct case-specific research using social science principles and methods to produce case-specific evidence. This article addresses the scientific and legal merits of these two approaches and argues for the use of methodologically rigorous case-specific research to produce “social facts,” or case-specific evidence derived from social science principles. We explain the many ways that social fact studies can be conducted to yield reliable case-specific opinions, and we seek to dispel the view that litigation poses insurmountable barriers to the conduct of case-specific empirical research. We conclude that social fact studies are feasible for both plaintiffs and defendants, with or without special access to the parties involved in a case, and provide much sounder conclusions about the relevance of social science to a litigated case than do alternatives based on expert judgment.