International Journal of Risk and Recovery

Forensic Psychiatry in Pakistan: An Update

Wajahat Ali Malik — 2021-11-27

Pakistan is a lower-middle income country in South Asia where forensic psychiatry is often not recognized as a distinct subspecialty of psychiatry. Although evolution toward this direction has begun, more development in this field is needed. Before Pakistan’s Mental Health Ordinance of 2001, much of the mental health legislation and intitutional infrastructure pertaining to the mentally ill offender can be traced back to the Indian Lunacy Act of 1912. The past two decades have witnessed important legal developments in the role of psychiatry in Pakistan’s criminal justice system. This has been seen through the devolution of health-care provision and by an extension of psychiatric service provision from the federation (federal government) to the four provinces. Despite the sparse resources allocated to psychiatry, competent yet scarce psychiatry residents are graduating from Pakistan’s accredited residency programs with an interest in forensic psychiatry. The objective of this article is to reflect on the past, while examining the current state of existing forensic mental health in Pakistan. This article will also address the future trajectory of forensic psychiatry in Pakistan and supports the establishment of forensic psychiatry as a subspecialty in Pakistan.

Coping With COVID-19: Pandemic Life and Problematic Sexual Behaviour

Heather Moulden — 2021-12-19

Examination of the Structured Assessment of Protective Factors for Violence Risk - Youth Version (SAPROF-YV) in Canadian Adolescents

Aisha Christiansen — 2021-11-27

The Structured Assessment of Protective Factors for Violence Risk - Youth Version (SAPROF-YV) is a new measure of protective factors. It is used with a risk-focused tool, such as the Structured Assessment of Violence Risk in Youth (SAVRY), to provide a more balanced and comprehensive assessment of violence risk in adolescents. Our study investigated the relationship between the SAPROF-YV and aggression in a sample of 69 adolescents. Using a retrospective follow-up study design, we reviewed files at an inpatient treatment centre and a probation office. The
SAPROF-YV showed good convergent and discriminant validity with the SAVRY. The SAPROF-YV was predictive of the absence of minor verbal aggression. While the SAPROF-YV added incremental predictive validity to SAVRY Protective factors for minor verbal aggression, it did not add incrementally to SAVRY Risk factors in the prediction of any type of aggression. We discuss implications for future research and clinical applications.

The Impact of the Illusory Truth Effect and Location of Testimony in Juror Deliberations

Alexandrea Johnston — 2021-05-05

The illusory truth effect (ITE) is the tendency to believe false information as being accurate after it has been presented repeatedly over time. ITE has been shown to hold true in many different contexts; however, there have been no studies that examine the influence of ITE in jurors’ deliberation. Given the importance of weighing legally relevant facts in the decision-making process, and the potential influence of ITE, this study examined whether the repetition of key evidence in testimony matters in this context. This study also examined whether critical information would be influenced by the location of ITE. In that context, jurors may process critical information differently when introducing ITE early (i.e., primacy effect) or later (i.e., recency effect) in the vignette of a murder case. To examine this effect, 100 participants were recruited and asked to read a vignette where pertinent evidence related to a murder was strategically repeated throughout the case narrative. Participants were assigned to one of four groups: control; ITE throughout vignette; ITE at the beginning of vignette; and ITE at the end of vignette. After reading the vignette, participants were asked to complete a short questionnaire and provide a final decision about various aspects of the case. Results revealed that repetition of pertinent evidence matters. The placement of evidence also has the potential to influence jurors’ perceptions of certain case relevant details. These findings suggest that within a sensitive legal context, such as jurors weighing evidence of an accused’s culpability, ITE could alter one’s perception of the facts.

Report on the Distribution of the Social Determinants of Health and Health Equity in a Forensic Psychiatry Program

Samantha Perrotta — 2021-12-19

The social determinants of health are important factors that shape a person’s well-
being, life expectancy, and quality of life. The environments in which people live, work, and play are paramount in determining their overall health. As such, viewing health as an outcome, not only of individual choices and biomedical factors but also of socioenvironmental influences, can be an important lens to guide health-care practice. This report examined the social determinants of health of people admitted to inpatient units in a forensic psychiatry program in a major Canadian urban centre. Twenty health variables were collected from the Resident Assessment Instrument–
Mental Health form. A deprivation scale was created to understand social and material inequality on a gradient. Findings showed that those surveyed had high rates of poor social determinant of health factors, such as low educational attainment, insecure housing, and lack of secure employment before their admission to the program. Chi-square tests showed associations between material deprivation, race, and comorbidity status. The findings may influence a multisectorial approach to mental illness prevention, management, and recovery practices.