- To identify the components of mental health and social services provided to pL - To discover if these components of services prevent crime among all types of .
- To measure the impact of varying legal powers of mental health professional.
- To assess the predictive validity of the HCR-20 in determining the risk of .
- To assess the validity of hair analysis for measuring medication use and al.
Crime and violence perpetrated by mentally ill persons are now significant social problems throughout the European community. The costs of these crimes, both financial and human, are enormous. This problem has developed since the policy of deinstitutionalizing the mentally ill was implemented, despite the existence of extensive networks of health and social services. Some small scale experimental community treatment programmes have proven to be effective in preventing criminality and violence among high risk patients. It is urgent to extend these findings in order to develop humane policies and services that will prevent crime and violence among persons suffering from these disorders. Not only would such programmes improve quality of life generally by reducing crime rates, it would significantly improve the quality of life of mentally ill persons and reduce stigma against them. The present proposal describes a concerted action by scientists from a number of European countries to identify the specific aspects of treatments, services, and laws that are necessary to prevent crime among the mentally ill, to develop common tools for risk assessment, and for (relatively) non-invasive objective measures of medication use and alcohol and drug consumption.
1. To identify the components of mental health and social services provided to persons with major mental disorders that are associated with an absence of criminality and violence;
2. To discover if these components of services prevent crime among all types of patients with major mental disorders or among specific sub-groups of patients;
3. To measure the impact of varying legal powers of mental health professionals to require patients to participate in community treatment on the prevention of crime and violence;
4. To assess the predictive validity of the HCR-20 in determining the risk of violence among patients discharged to the community;
5. To assess the validity of hair analysis for measuring medication use and alcohol and drug consumption.
A large, multi-site comparative investigation is the only way to examine the interactions of various types of social and mental health services, patient characteristics, and legal contexts. Sites in Finland, Germany, Sweden and Canada have been selected. In each country, the out-patient services provided to two samples of patients following hospitalisation will be examined. Within each site, the forensic sample will be composed of patients who have been hospitalised because of a crime; the traditional psychiatric sample will be composed of patients matched for age, sex, illness, and age at first admission, history of alcohol and drug use, and history of aggressive behaviour who were hospitalised with no official designation of criminality. A great amount of effort will go into assuring that subjects recruited in the different countries are similar. Only in this way will the study be valid. 07