Steven L. Proctor and Albert M. Kopak
This paper aims to extend previous findings by identifying the mental health correlates of both acute and chronic substance use behaviors among a large nationally representative…
Abstract
Purpose
This paper aims to extend previous findings by identifying the mental health correlates of both acute and chronic substance use behaviors among a large nationally representative sample of juvenile offenders.
Design/methodology/approach
Survey of Youth in Residential Placement interview data from 6,920 juvenile offenders (76% male) detained in 290 US facilities were analyzed to determine bivariate relationships between two indicators of substance use (acute and chronic) and seven mental health domains (depression/isolation, anxiety, anger, trauma, inattention, hallucinations and suicidality).
Findings
Prevalence rates of above average indications for all seven mental health domains were significantly higher among offenders under the influence of a substance at the time they committed their instant offense compared to those not under the influence. Offenders with above average indications in the seven studied mental health areas reported a higher level of chronic effects of substance use relative to those with average or below mental health indications.
Practical implications
The results have important implications for the assessment and treatment of co-occurring mental health issues among juvenile offenders with substance use issues. Juveniles with above average mental health indications may be more prone to experiencing a number of substance-related problems. Observed results may guide the implementation of routine assessment procedures at the juvenile detention level. Intake specialists should screen and administer comprehensive mental health assessments for juveniles who report substance intoxication at the time of their instant offense. Juvenile offenders who report clinical levels of mental health symptoms should receive a comprehensive assessment of substance use and related problems.
Originality/value
Although the co-occurrence of substance use and mental health issues among juvenile justice involved populations is well documented, previous research studies in this area have included a number of limitations. Relatively small offender sample populations, often from a single facility, warrant further work with a large, nationally representative sample of juvenile offenders. Inconsistency in measures of substance use and the failure to distinguish between acute and chronic measures of substance use in prior studies also require further investigation. This study contributes to the extant co-occurring substance use and mental health knowledge base by identifying the mental health correlates of both acute and chronic substance use behaviors among a large nationally representative sample of juvenile offenders.
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Albert M. Kopak, Steven L. Proctor and Norman G. Hoffmann
Effective substance use treatment is a viable way to reduce criminal justice contact among drug-involved offenders, but there is still a lot to learn about which indicators have…
Abstract
Purpose
Effective substance use treatment is a viable way to reduce criminal justice contact among drug-involved offenders, but there is still a lot to learn about which indicators have the greatest impact on treatment outcomes. The purpose of this paper is to determine which clinical indicators influenced the likelihood of rearrest among male drug-involved offenders.
Design/methodology/approach
This prospective longitudinal study examined indicators of 12-month post-treatment rearrest for male criminal justice-involved substance use treatment patients. Multinomial logistic regression results drawn from a sample of 1,531 adult male patients who were mandated to substance use treatment indicated that there were different factors related to the likelihood of one as well as multiple post-treatment arrests.
Findings
Demographic risk factors, such as age and unemployment, were associated with significant increases in the probability of experiencing an arrest within 12-months of treatment discharge. Substance use relapse was also a significant indicator of the likelihood of rearrest and contributed to an increase in the odds of one post-treatment rearrest as well as multiple rearrests. A drug dependence diagnosis, relative to a diagnosis for alcohol dependence, was associated with an increased likelihood of rearrest. Participation in outpatient treatment was associated with a lower likelihood of rearrest.
Practical implications
These findings emphasize the need for treatment providers to concentrate heavily on demographic risk reduction to minimize the chance that male patients are rearrested after treatment. Relapse prevention, on the other hand, is critical in the effort to minimize the number of post-treatment rearrests in this population.
Originality/value
The results from this study provide evidence to empirically support the refinement of substance treatment programs for male patients involved in the criminal justice system.
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Josefien J.F. Breedvelt, Lucy V. Dean, Gail Y. Jones, Caroline Cole and Hattie C.A. Moyes
The purpose of this paper is to assess whether mental health symptoms affect one-year reoffending rates upon release from prison for participants engaging in substance dependence…
Abstract
Purpose
The purpose of this paper is to assess whether mental health symptoms affect one-year reoffending rates upon release from prison for participants engaging in substance dependence treatment in the UK.
Design/methodology/approach
A retrospective cohort study was used to assess reconviction outcomes upon release. The Comprehensive Addiction and Psychological Evaluation (CAAPE) was administered to 667 inmates admitted to the programme. The effect of mental health, drug use, and static risk factors on reoffending was assessed at one-year post release.
Findings
Logistic regression analysis showed that symptoms of Major Depressive Disorder at the start of substance dependence treatment increased the likelihood to reoffend, whilst Obsessive Compulsive Disorder symptoms and length of sentence decreased the likelihood to reoffend. Antisocial Personality Disorder symptoms show a trend towards increasing the likelihood to reoffend. In addition, previously established risk factors for reoffending, including dependence on heroin, crack/cocaine, and poly drug use significantly increased the likelihood of reconviction.
Practical implications
Depressive symptomatology pre-treatment could affect reoffending outcomes for participants in substance dependence treatment in prison. An integrative approach addressing both substance misuse and mental health factors is pivotal. Future efforts to address both simultaneously can be made to improve assessment, training, treatment, and through care for prisoners in substance dependence treatment.
Originality/value
Few studies have assessed the effect of mental health factors on reoffending outcomes for offenders in substance dependence treatment. A large sample was studied in an understudied population of UK prisoners in substance dependence treatment. The results have implications for clinical settings where mental health symptoms are not addressed concurrently with substance dependence. This finding can inform policy makers and practitioners who provide substance dependence treatment in prison.
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Christine Shearer, Jennifer Bea Rogers-Brown, Karl Bryant, Rachel Cranfill and Barbara Herr Harthorn
Research has found a subgroup of conservative white males have lower perceptions of risk across a variety of environmental and health hazards. Less research has looked at the…
Abstract
Research has found a subgroup of conservative white males have lower perceptions of risk across a variety of environmental and health hazards. Less research has looked at the views of these “low risk” individuals in group interactions. Through qualitative analysis of a technology deliberation, we note that white men expressing low risk views regarding technologies for energy and the environment also often express high social risks around potential loss of control. We argue these risk perceptions reflect identification with corporate concerns, usually framed in opposition to government and mirroring arguments made by conservative organizations. We situate these views within the broader cultural struggle over who has the power to name and address risks.
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In 2015, Idris Elba declared ‘I’m probably the most famous Bond actor in the world … and I’ve not even played the role’. Speculation about Elba taking on the role of the world’s…
Abstract
In 2015, Idris Elba declared ‘I’m probably the most famous Bond actor in the world … and I’ve not even played the role’. Speculation about Elba taking on the role of the world’s most famous spy has circulated for over a decade, fuelled by current Bond Daniel Craig’s assertion that the role has ruined his life. This chapter will examine the role of fans in driving hype about the future of Bond, focusing on the case study of alt-right outrage at the potential casting of Elba. The anti-Elba camp have framed their outrage as informed by authorial intent, and the desire to maintain canon, with claims that Ian Fleming’s Bond was, and should always be white and Scottish. Bond’s expansive narrative universe has remained constant since its inception, enabling fans of the series to form an emotional connection and sense of ownership over the text as a cohesive brand, a form of ‘affective economics’ (Hills, 2015; Jenkins, 2006a). By situating the debate over Elba’s suitability within the timeline of the Bond franchise, the author will posit that the rigid casting and structure of the film series to date enables feelings of fan ownership to flourish. Whilst the influence of vocal fan groups has altered the future direction of numerous popular texts, this chapter will suggest that the sameness of Bond-as-brand provides the justification for fan backlash towards potential change. In sum, this chapter will highlight the Elba-as-Bond rumours as a reflection of the contemporary political moment which seeks to flatten out difference under the auspice of protecting the canon and tradition of ‘brand Bond’.
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An inquiry into the constitution of the experience of patienthood. It understands “becoming a patient” as a production of a subjectivity, in other words as a process of…
Abstract
Purpose
An inquiry into the constitution of the experience of patienthood. It understands “becoming a patient” as a production of a subjectivity, in other words as a process of individuation and milieu that occurs through an ontology of production. This ontology of production can, of course, also be understood as a political ontology. Therefore, this is, first of all, an inquiry into a mode of production, and, secondly, an inquiry into its relation to the issue of social justice – because of effects of digital divisions. In these terms, it also reflects on how expert discourses, such as in medical sociology and science studies (STS), can (and do) articulate their problems.
Approach
An integrative mode of discourse analysis, strongly related to discursive institutionalism, called semantic agency theory: it considers those arrangements (institutions, informal organizations, networks, collectivities, etc.) and assemblages (intellectual equipment, vernacular epistemologies, etc.) that are constitutive of how the issue of “patient experience” can be articulated form its position within an ontology of production.
Findings
The aim not being the production of a finite result, what is needed is a shift in how “the construction of patient experience” is produced by expert discourses. While the inquiry is not primarily an empirical study and is also limited to “Western societies,” it emphasizes that there is a relation between political ontologies (including the issues of social justice) and the subjectivities that shape the experiences of people in contemporary health care systems, and, finally, that this relation is troubled by the effects of the digital divide(s).
Originality
A proposal “to interrogate and trouble” some innovative extensions and revisions – even though it will not be able to speculate about matters of degree – to contemporary theories of biomedicalization, patienthood, and managed care.
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Steven D. Raymer, James Dobbs, Christopher P. Kelley and Douglas R. Lindsay
This paper examines the evolution of the core academic leader development course at the United States Air Force Academy. The course serves as a key part of student leadership…
Abstract
This paper examines the evolution of the core academic leader development course at the United States Air Force Academy. The course serves as a key part of student leadership development integrated into all four years of a student’s education and their roles within the organization. The curriculum focuses on skills, character, and critical thinking in leadership contexts. The desired effect is to engage students where they are in their development and to train them in the practice of effective, professional team leadership within their teams and the larger organization. Assessment strategies such as reflection, journaling, self-assessment, and practiced application of course material are designed to fit into students’ leadership experiences so students apply what they learn in an immediate, relevant context.
Elizabeth McCay, Celina Carter, Andria Aiello, Susan Quesnel, Carol Howes, Heather Beanlands, John Langley, Bruce MacLaurin, Steven Hwang, Linda Cooper and Christina Lord
The purpose of this paper is to evaluate the effectiveness of the dialectical behavior therapy (DBT) training which was provided to community agency staff (N=18) implementing DBT…
Abstract
Purpose
The purpose of this paper is to evaluate the effectiveness of the dialectical behavior therapy (DBT) training which was provided to community agency staff (N=18) implementing DBT in the community with street-involved youth.
Design/methodology/approach
Staff participated in a multi-component approach to training which consisted of webinars, online training, self-study manuals, and ongoing peer consultation. To evaluate assess the effectiveness of the training, questionnaires assessing evaluating DBT skills knowledge, behavioral anticipation and confidence, and DBT skills use, were completed at baseline, immediately post-training, four to six months post-training, and 12-16 months post-training. Additionally, the mental health outcomes for youth receiving the DBT intervention are reported to support the effectiveness of the training outcomes.
Findings
Results demonstrate that the DBT skills, knowledge, and confidence of community agency staff improved significantly from pre to post-training and that knowledge and confidence were sustained over time. Additionally, the training was clinically effective as demonstrated by the significant improvement in mental health outcomes for street-involved youth participating in the intervention.
Practical implications
Findings suggest that this evidence-based intervention can be taught to a range of staff working in community service agencies providing care to street-involved youth and that the intervention can be delivered effectively.
Originality/value
These findings help to close the knowledge-practice gap between evidence-based treatment (EBT) research and practice while promoting the implementation of EBT in the community to enhance positive youth outcomes.
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As maternal mortality increases in the United States, birth providers and policymakers are seeking new solutions to address what scholars have called the “C-section epidemic.”…
Abstract
As maternal mortality increases in the United States, birth providers and policymakers are seeking new solutions to address what scholars have called the “C-section epidemic.” Hospital cesarean rates vary tremendously, from 7 to 70 percent of all births. Based on in-depth, semi-structured interviews with 47 obstetricians and family physicians in the United States, I explore one reason for this variation: differences in how physicians perceive and manage risk in American obstetrics. While the dominant model of risk management encourages high levels of intervention and monitoring, I argue that a significant portion of physicians are concerned about high intervention rates in childbirth and are working to reduce cesarean rates and/or the use of monitoring technologies like continuous fetal heart rate monitors. Unlike prior theories of biomedicalization, which suggest that health risks are managed through increased monitoring and intervention, I find that many physicians are resisting this model of risk management by ordering fewer interventions and collecting less information about their patients. These providers acknowledge that interventions designed to mitigate risks may only provide an illusion of control, rather than an actual mastery of risks. By limiting interventions, providers may lose this illusion of control but also mitigate the iatrogenic effects of intervention and continuous monitoring. This alternative approach to risk management is growing in many medical fields and deserves more attention from medical sociologists.