Purpose – The purpose of this paper is to examine the prevalence of psychopathology including substance use disorders in a sample of detained female systematic offenders.Design/methodology/approach – All case files of female systematic offenders who had been subjected to a special court order for systematic offenders in the period 2004-2014 were studied. A total of 81 fairly complete case files were selected for the study. These were all systematic offenders as they had been sentenced for at least 25 offences with an average of 102 offences over a period of 17.5 years. Findings – All except one woman were addicted to substances in the past year, with an average duration of addiction of 21 years. In addition, 53 per cent were diagnosed with another DSM Axis I disorder and 73 per cent were diagnosed with a personality disorder. Furthermore, 32-59 per cent were found to haveintellectual dysfunctions. In total, 12 per cent had one type of the above disorders, 43 per cent two types, 31 per cent three types and 14 per cent all four types. The prevalence rates of these disorders were higher than those reported in other prison studies.Research limitations/implications – It is concluded that female systematic offenders can be characterised as problematic in many respects. Even in such a problematic group treatment can be provided.Originality/value – The present study is the only study that provides prevalence data of mental disorders among female systematic offenders.
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Although girls and women represent only a minority of the forensic mental health and prison populations, studies worldwide suggest that there has been a steady increase in the number of females being convicted for committing offenses, especially violent offenses. In this chapter, an overview will be provided on the specific risks and needs of female offenders and the relevance of gender-responsive treatment in forensic mental health services. First, the literature into the prevalence and nature of offending by females will be reviewed, with a focus on violent offending. Next, the most recent knowledge in the field will be summarized with respect to gender-sensitive risk assessment and gender-responsive treatment in forensic mental health care. Finally, some recommendations will be provided for mental health professionals working with females in forensic mental health services and for future research.
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Women and girls represent only a minority in the penitentiary system and in forensic mental health care. About 6%–10% of both prison and forensic psychiatric populations in Western countries comprise women (see for the most recent offi cial statistics in the UK w ww.gov. uk/government, in Canada w ww.statcan.gc.ca, and in the US w ww.bjs.gov) . However, there seems to be widespread agreement that in the past 20 years female offending has been on the rise, especially violent offending and particularly among young women ( Miller, Malone, and Dodge, 2010; M oretti, Catchpole, and Odgers, 2005) . Overall, a disproportionate growth of females entering the criminal justice system and forensic mental health care has been observed in many countries (for reviews, see Nicholls, Cruise, Greig, and Hinz, 2015; Odgers, Moretti, and Reppucci, 2005 ; Walmsley, 2015) . In addition, it should be noted that the ‘dark number’ for women is suggested to be bigger than for men. Offi cial prevalence rates of female offending might constitute an underestimation as women usually commit less reported offences, for example, domestic violence (N icholls, Greaves, Greig, and Moretti, 2015) . Furthermore, it has been found that – if apprehended – girls and women are treated more leniently by professionals and the criminal justice system. Generally, they receive lower prison sentences and are more often admitted to civil psychiatric institutions instead of receiving a prison sentence or mandatory forensic treatment after committing violence ( Javdani, Sadeh, and Verona, 2011 ; Jeffries, Fletcher, and Newbold, 2003 ). Hence, although female offenders compared to male offenders are a minority, female violence is a substantial problem that deserves more attention. Our understanding of female offenders is hindered by the general paucity of theoretical and empirical investigations of this population. In order to improve current treatment and assessment practices, our knowledge and understanding of female offenders should be enlarged and optimised (d e Vogel and Nicholls, 2016 ).
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Previous research has shown that female persistent offenders have multiple psychiatric and psychosocial problems, such as substance use disorders, other mental disorders, financial problems and housing problems. The present study examined recidivism and predictors of recidivism in a sample of 74 Dutch female high level persistent offenders who had been subjected to a special court order for persistent offenders, called ISD [Inrichting Stelselmatige Daders]. The criminal records were studied to gain insight in the criminal charges against women after release from the ISD. Results showed that 43% of the persistent female offenders had registered justice contacts within one year after release, of which the majority concerned non-violent property offences. However, the number of offences was found to be significantly reduced after their release. No offence-related, demographic, substance-related, psychiatric or personal history characteristics were found to be predictive for general recidivism.
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Background. Violent criminal offenders with personality disorders (PD’s) can cause immense harm, but are often deemed untreatable. This study aimed to conduct a randomized clinical trial to test the effectiveness of long-term psychotherapy for rehabilitating offenders with PDs. Methods. We compared schema therapy (ST), an evidence-based psychotherapy for PDs, to treatment-as-usual (TAU) at eight high-security forensic hospitals in the Netherlands. Patients in both conditions received multiple treatment modalities and differed only in the individual, study-specific therapy they received. One-hundred-three male offenders with antisocial, narcissistic, borderline, or paranoid PDs, or Cluster B PD-not-otherwise specified, were assigned to 3 years of ST or TAU and assessed every 6 months. Primary outcomes were rehabilitation, involving gradual reintegration into the community, and PD symptoms. Results. Patients in both conditions showed moderate to large improvements in outcomes. ST was superior to TAU on both primary outcomes – rehabilitation (i.e. attaining supervised and unsupervised leave) and PD symptoms – and six of nine secondary outcomes, with small to moderate advantages over TAU. ST patients moved more rapidly through rehabilitation (supervised leave, treatment*time: F(5308) = 9.40, p < 0.001; unsupervised leave, treatment*- time: F(5472) = 3.45, p = 0.004), and showed faster improvements on PD scales (treatment*- time: t(1387) = −2.85, p = 0.005). Conclusions. These findings contradict pessimistic views on the treatability of violent offenders with PDs, and support the effectiveness of long-term psychotherapy for rehabilitating these patients, facilitating their re-entry into the community
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Most violence risk assessment tools have been validated predominantly in males. In this multicenter study, the Historical, Clinical, Risk Management–20 (HCR-20), Historical, Clinical, Risk Management–20 Version 3 (HCR-20V3), Female Additional Manual (FAM), Short-Term Assessment of Risk and Treatability (START), Structured Assessment of Protective Factors for violence risk (SAPROF), and Psychopathy Checklist–Revised (PCL-R) were coded on file information of 78 female forensic psychiatric patients discharged between 1993 and 2012 with a mean follow-up period of 11.8 years from one of four Dutch forensic psychiatric hospitals. Notable was the high rate of mortality (17.9%) and readmission to psychiatric settings (11.5%) after discharge. Official reconviction data could be retrieved from the Ministry of Justice and Security for 71 women. Twenty-four women (33.8%) were reconvicted after discharge, including 13 for violent offenses (18.3%). Overall, predictive validity was moderate for all types of recidivism, but low for violence. The START Vulnerability scores, HCR-20V3, and FAM showed the highest predictive accuracy for all recidivism. With respect to violent recidivism, only the START Vulnerability scores and the Clinical scale of the HCR-20V3 demonstrated significant predictive accuracy.
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"Background: Victimization is highly prevalent in individuals with mild intellectual disability (MID) or borderline intellectual functioning (BIF) and is an important risk factor for mental health problems and violent behavior. Not much is known, however, about victimization history in women with MID-BIF admitted to forensic mental health care. Aims: The aim of this multicenter study is to gain insight into victimization histories and mental health problems of female forensic psychiatric patients with MID-BIF. Methods: File data were analyzed of 126 women with MID-BIF who have been admitted to one of five Dutch forensic psychiatric hospitals between 1990 and 2014 and compared to data of 76 female patients with average or above intellectual functioning and to a matched sample of 31 male patients with MID-BIF. Results: All forensic paients had high rates of victimization, but women with MID-BIF showed an even higher prevalence of victimization during both childhood and adulthood and more complex psychopathology compared to female patients without MID-BIF. Compared to male forensic patients with MID-BIF, women with MID-BIF were more often victim of sexual abuse during childhood. During adulthood, the victimization rate in these women was more than three times higher than in men. Conclusions: Victimization is a salient factor in female forensic patients with MID-BIF and more gender-responsive trauma-focused treatment is needed."
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The increased use of instruments for assessing risks and needs in probation should lead to intervention plans that meet the criteria for effective practice. An analysis of 300 intervention plans from the Dutch probation service showed that the match between the assessed criminogenic needs and the goals and interventions in the intervention plan is fairly low. It was also found that the so-called risk principle is not fully applied by probation officers. In addition, personal goals that the offender values are often not taken fully into account. Finally, the intervention plans have a strong focus on improving human capital, while improving social capital and basic needs often is not part of the intervention plans, even if they were assessed as dynamic criminogenic needs.
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Research shows that victimization rates in forensic mental health care are high for both female and male patients. However, gender differences have been found in types and patterns of victimization (more sexual abuse and more complex trauma for women), cognitive appraisal, and response to traumatic events. Gender-responsive treatments focusing on trauma have been designed to adhere to these gender differences; however, despite promising research results, these interventions are yet to be introduced in many settings. This study examined how trauma is addressed in current clinical practice in Dutch forensic mental health care, whether professionals are knowledgeable of gender differences in trauma, and how gender-responsive factors such as self-esteem, self-efficacy, social relations, and coping skills are considered in treatment for female patients. We used a mixed-method design consisting of an online survey and 33 semi-structured interviews with professionals and patients. The results suggested that Dutch forensic mental health care could address trauma more structurally, and professionals could be more aware of gender differences and gender-responsive factors. Early start of trauma treatment was deemed important but was not current practice according to patients. Based on this study, guidelines were developed for gender-responsive, trauma-informed work in forensic mental health care.
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The body of evidence that the working alliance is associated with positive outcomes for mandated clients is growing. The aim of this research was to investigate the influence of several characteristics of probation officers (POs) and offenders on the course of the working alliance during probation supervision. This study examined the patterns on the four alliance subscales: Trust, Bond, Goals-Restrictions, and Reactance of the Working Alliance With Mandated Clients Inventory (WAMCI) in 201 offenders and their 137 POs. Three patterns on each alliance subscale were found: deteriorating, improving, and stable. Multinomial logistic analysis revealed that change of POs and the preference of the PO to maintain rules were associated with a deteriorating Trust pattern. From the perspective of the offenders, being motivated to take part in supervision was associated with a stable pattern on every alliance subscale, but having problems with substance use increased the likelihood of a deteriorating pattern on every alliance subscale.
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