July 2005: This Month's Highlights
Assessment Tools for Mentally Ill Offenders
Most of the articles in this issue of Psychiatric Services are organized under the theme of mental health and the law, starting with two papers on assessment tools for persons who have been involved with the criminal justice system. John Monahan, Ph.D., and his coauthors describe their study of the validity of the multiple iterative classification tree model in distinguishing between patients with high and low risk of violence in the community after discharge from a psychiatric facility (page 810). And Henry J. Steadman, Ph.D., and associates report on a study they conducted to validate the Brief Jail Mental Health Screen—a revision of the Referral Decision Scale—in a large sample from four jails in Maryland and New York (page 816).
Risk Factors and Criminal Justice Involvement
Also under the criminal justice theme are three articles on risk factors for incarceration and other adverse consequences among individuals with various substance use and mental disorders. Linda A. Teplin, Ph.D., and her colleagues determined the prevalence of 20 HIV-AIDS risk behaviors among juvenile detainees with and without mental disorders or substance use disorders (page 823). Dale E. McNiel, Ph.D., and coauthors assessed relationships between homelessness, mental illness, and incarceration in a large sample of inmates of the San Francisco County Jail system (page 840). Finally, Cameron D. Quanbeck, M.D., and associates studied the relationship between criminal arrest and gender, substance abuse disorder, and use of community mental health services among inmates in the Los Angeles County Jail who had a diagnosis of bipolar I disorder and a history of psychiatric hospitalization (page 847).
Jail Diversion for Persons With Mental Illness
Continuing the criminal justice theme are three articles related to jail diversion. Roger A. Boothroyd, Ph.D., and his coauthors report on outcomes of 116 clients of a mental health court in Broward County, Florida, compared with 110 defendants from a regular magistrate court (page 829). Marcus T. Boccaccini, Ph.D., and colleagues examined rediversion patterns in two postbooking jail diversion programs in Florida to assess the extent to which the programs served repeat clients (page 835). Finally, Heidi A. Herinckx, M.A., and her coauthors present the results of their study of rearrest and linkage to mental health services in a sample of 368 misdemeanants with severe and persistent mental illness who were served by the mental health court in Clark County, Washington (page 853).
Mandated Treatment for Mentally Ill Offenders
Wrapping up the law-related theme are an article and several smaller pieces on mandated treatment. In their article on page 858, Ralph A. Catalano, Ph.D., and colleagues describe how they tested the hypothesis that evaluations for involuntary psychiatric hospitalizations that were initiated by law enforcement personnel in Florida increased in the weeks after September 11, 2001. In a brief report on page 863, David A. Pollack, M.D., and his coauthors present outcomes of patients in a low-intensity, short-duration involuntary outpatient commitment program. In another brief, Daniel Frank, M.D., F.R.C.P.C., and associates describe their study of psychotic patients' time until readmission to the hospital before and after receipt of a compulsory treatment order (page 867). And in the Law and Psychiatry column, Paul S. Appelbaum, M.D., discusses a recent report evaluating outcomes of patients treated under "Kendra's Law," New York State's five-year-old statute authorizing involuntary outpatient commitment (page 791).
Impact of a New Diabetes Diagnosis With Schizophrenia
Although second-generation antipsychotics have been found to be as effective as first-generation agents in treating schizophrenia, evidence suggests that they are associated with side effects such as weight gain and increased risk of diabetes. However, little is known about how clinicians respond to new-onset diabetes among patients with schizophrenia. Douglas L. Leslie, Ph.D., and Robert A. Rosenheck, M.D., studied changes in antipsychotic pharmacotherapy and health care costs after a new diagnosis of diabetes in a large sample of veterans with schizophrenia. Their findings are reported on page 803.
Briefly Noted …
• The Practical Geriatrics column explains how privatization of Medicare has further restricted Medicare's psychiatric coverage (page 795).
• Economic Grand Rounds asks how consumers would choose between expensive medications and a package of comparably priced psychosocial interventions (page 799).
• The author of Taking Issue ponders the future of Medicaid-funded mental health care (page 783).
