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Physical Violence During Mandatory Psychiatric treatment

This study explores variables that predict physical violence in 614 (forensic) psychiatric inpatients. All violent incidents that occurred in a Dutch forensic psychiatric hospital between 2014 and 2019 (N = 3,713) were coded with the Modified Overt Aggression Scale+ based on daily hospital reports and patients’ medical records. Binary logistic regression analyses examined which patient variables could differentiate between patients with and without physical violence during treatment and between patients with single and multiple incidents of physical violence. Variables included in the analyses were gender, legal status, borderline personality disorder, antisocial personality disorder, schizophrenia spectrum disorder, psychopathy (Psychopathy Checklist–Revised [PCL-R] score), self-harm during treatment, impulsivity, intellectual disability, and length of stay. A clear association was found between self-harm and inpatient physical violence on all outcome measures and in all analyses. Adequate monitoring of self-harm is advised as a strategy to early identify patients with a high risk to threaten ward safety.

Violence Risk Assessment in Women

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 ).

Gender-sensitive Violence Risk Assessment

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.

Voices in the background

Adopted on the fifteenth anniversary of resolution 1325, Security Council resolution 2242 has recognized for the first time the substantial link between climate change and the “Women, Peace and Security” (WPS) framework. Despite this landmark resolution, the intersections of environmental factors, conflict and violence against women remain largely absent from the Security Council's WPS agenda. Competition over natural resources is generally understood as a driver of conflict. The risk of insecurity and conflict are further increased by environmental degradation and climate change. It is therefore clear that the environment and natural resources must be integrated into the WPS agenda. This should necessarily include a discussion of indigenous rights to land and the gender-related dimensions of environmental factors. Indigenous women are disproportionately affected by environmental degradation, caused by resource extraction and increasingly compounded by climatic changes. This in turn exacerbates other vulnerabilities, including sexual and gender-based violence and other forms of marginalization. This article argues, by reference to the situation in West Papua, that unfettered resource extraction not only amplifies vulnerabilities and exacerbates preexisting inequalities stemming from colonial times, it also gives rise to gendered consequences flowing from the damage wreaked on the natural environment and thus poses a danger to international peace and security. As such, the Security Council's failure to recognize the continuous struggle of women in indigenous and rural communities against extractive economies and climate change impact as a security risk forms a serious lacuna within its WPS agenda. Originally published by Oxford University Press in Global Studies Quarterly, Volume 1, Issue 3, September 2021, ksab018, https://doi.org/10.1093/isagsq/ksab018

Het gebruik van de Brøset Violence Checklist binnen de forensische psychiatrie

Achtergrond Het is bekend dat gestructureerde instrumenten voor taxatie van het kortetermijnrisico bijdragen aan het voorspellen van fysiek agressief gedrag bij patiënten in de acute psychiatrie. Doel Onderzoeken of de Brøset Violence Checklist (BVC), een instrument voor de inschatting van fysieke agressie op korte termijn, kan bijdragen aan het voorspellen van fysieke agressie-incidenten binnen de forensische psychiatrie en onderzoeken hoe het gebruik van de BVC wordt ervaren. Methode Tweemaal per 24 uur op min of meer vaste momenten werd voor alle patiënten die in 2019 verbleven op een crisisafdeling binnen een forensisch psychiatrisch centrum een BVC-score geregistreerd. De totaalscores van de BVC werden vervolgens gerelateerd aan fysieke agressie-incidenten. Daarnaast werden focusgroepen en interviews gehouden met sociotherapeuten om de ervaringen met het gebruik van de BVC te onderzoeken. Resultaten Uit de analyse kwam een significante voorspellende waarde van de BVC-totaalscore naar voren (AUC = 0,69; p < 0,01). Bovendien ervoeren de sociotherapeuten de BVC als gebruikersvriendelijk en weinig tijdsintensief. Conclusie De BVC heeft toegevoegde waarde voor de forensische psychiatrie. Dit geldt met name voor patiënten bij wie de primaire diagnose géén persoonlijkheidsstoornis betreft.

On Our Little Drones: Senses, Violence and the Space