Law and Crime | Psychotherapy Toronto

What Happens After Children Are Freed From Captivity?

July 18, 201900Caregiving, Cognition, Depression, Embarrassment, Featured news, Law and Crime, Shyness, Trauma July, 19

Source: James Sutton, creative commons

On occasion, we hear of extreme cases of child abuse, making family names like the Turpins infamous.

The 13 Turpin children were held captive in their house, where they were limited to only one meal a day and one shower a year. Twelve of the children were subject to extreme physical abuse, and one suffered from sexual abuse. The eldest child, who was 29 years old, weighed only 82 pounds.

Cases like these often publicize legal proceedings and atrocities committed by the parents, but disregard what happens to these children—the victims— in the aftermath.

Research on children held captive is sparse, however, there are some studies of other high-profile cases where children suffered extreme deprivation. A well-known one is Genie, a child who was isolated in a small bedroom where she was strapped to a toilet seat during the day, or trapped in a crib with wire covering. She received absolutely no stimulation and was only fed infant food.

When Genie was found at age 13, she was unable to perform basic functions, such as chewing, biting, standing or walking. She spent years trying to learn to speak but was unable to acquire language fully or normally. After years of testing by psychologists and physicians, her mother forbade further assessment of Genie, and she is now living in the care of the state of California.

Maude Julien, a psychotherapist from France who herself was subjected to captivity by her parents, now treats patients who are victims of trauma. In an interview with The Trauma and Mental Health Report, Maude describes her experiences growing up.

“For about 15 years, I practically never went out. I never went to school; my mother was my home-school teacher. My father wanted to create a superhuman, uncorrupted by this world,” Maude said. “I had to undergo a ‘training of the mind’ in order to become this ‘superhuman.’ He wanted me to believe that the world outside was terrible.”

Maude described the effects of severe trauma caused and explained her recovery process.

“I had to learn the simplest, most basic social conventions like speaking to strangers or finding my way around. Above all, I had to learn how to talk, because my long periods of forced silence had made me almost mute,” Maude said.

“Even though I was learning all this, I was still imprisoned behind the ‘gates’ of conditioning. I could still hear in my head, day and night, the tick-tock of my father timing everything,” she said.

Maude described her recovery as the need to “free herself from the mental and emotional hold” she was under. It took her more than ten years to overcome the consequences of her imprisonment.

Maude explains how reading, and connecting with animals and other people helped her cope with trauma. She attributes her ability to get out of the house to her music teacher and describes her second husband’s parents as an instrumental part in helping her mature.

“I was 24 when I met them and they helped the child inside me grow up. I felt unconditional parental love for the first time; it’s one of the greatest gifts in the world,” Maude said.

Children who have been held captive by a relative often think they deserve it and live with a heavy feeling of shame and guilt.

“It’s usually shame that prevents victims from seeking help,” Maude said. “They have also a feeling of isolation, because a predator like my father, makes the victim believe that he alone can love and protect them.”

Children reported in these high-profile cases may feel guilty for having “betrayed” their parents, yet may also feel relief for having escaped. She describes living with this duality as being very “painful.”

“They will have to free themselves from the ‘psychological leash’ imposed by their predator,” Maude said. “They will have to learn how to trust certain people, and they will have to learn how to recognize other predators and stay away from them. Most of all, they have to learn how to trust themselves.”

—Amanda Piccirilli, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

After Children Are Freed From Captivity

July 18, 201900Caregiving, Cognition, Depression, Embarrassment, Featured news, Law and Crime, Shyness, Trauma July, 19

Source: James Sutton, creative commons

On occasion, we hear of extreme cases of child abuse, making family names like the Turpins infamous.

Cases like these often publicize legal proceedings and atrocities committed by the parents, but disregard what happens to these children—the victims— in the aftermath.

When Genie was found at age 13, she was unable to perform basic functions, such as chewing, biting, standing or walking. She spent years trying to learn to speak, but was unable to acquire language fully or normally. After years of testing by psychologists and physicians, her mother forbade further assessment of Genie, and she is now living in the care of the state of California.

Maude described the effects severe trauma caused and explained her recovery process.

Maude described her recovery as the need to “free herself from the mental and emotional hold” she was under. It took her more than 10 years to overcome the consequences of her imprisonment.

“I was 24 when I met them and they helped the child inside me grow up. I felt unconditional parental love for the first time; it’s one of the greatest gifts in the world,” Maude said.

Children who have been held captive by a relative often think they deserve it, and live with a heavy feeling of shame and guilt.

—Amanda Piccirilli, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

Jurors Are Left Traumatized by Some Court Cases

April 19, 201900Decision-Making, Dopamine, Empathy, Featured news, Health, Law and Crime, Post-Traumatic Stress Disorder, Stress, Trauma April, 19

Source: Marica Villeneuve, Trauma and Mental Health Report artist, used with permission

On November 7, 2016, the Ministry of the Attorney General of Ontario reached a settlement with a juror diagnosed with vicarious post-traumatic stress disorder. The juror served on the trial of eight-year-old Tori Stafford’s killer.

The woman, who cannot be named due to a publication ban protecting the identity of jurors in this case, received the diagnosis months after performing her civic duty. Four years ago, she was one of 12 jurors in the trial of Michael Rafferty, the man charged and convicted of kidnapping, sexually assaulting, and murdering Stafford.

While sitting on the jury during the two-month trial, the woman visited scenes of rape, saw photographic evidence of the crime, and heard eyewitness testimony from Rafferty’s girlfriend and accomplice, Terri-Lynne McClintic.

In a submission to the Ontario Court of Appeal, the juror said that, almost immediately after the trial, she lashed out at her children, suffered from depression, had flashbacks to disturbing pieces of evidence, and experienced short-term memory loss and difficulties with concentration.

Over the course of a criminal trial, jurors are often exposed to disturbing graphic evidence. And while jury members are instructed to remain unbiased and evenhanded, the process can take a toll on their mental health.

Beyond the traumatizing effects of graphic evidence, the weight of the task itself can be harmful to jurors’ wellbeing. The high-stakes decision that members have been tasked with, which includes determining the fate of someone’s life, can be psychologically taxing. This pattern of stress and anxiety is frequently observed in other high-pressure jobs that involve exposure to traumatic information and heavy responsibilities, such as social work.

Patrick Baillie, a psychologist with Alberta Health Services, and former Chair of the Mental Health Commission of Canada, says that jury members are often not mentally prepared to sit through a criminal trial:

“These are twelve citizens who don’t typically have any involvement with the system, which is why we want them to serve as jurors, being given this extraordinary task with not a whole lot of mental support.”

In addition to the responsibility of remaining impartial, jurors are not allowed to share any details related to their deliberations. To protect the integrity of the trial, members are prohibited from discussing their personal views on the evidence, witnesses, or trial process, to ensure confidential information cannot be related back to discussions that took place in the jury room. Baillie explains:

“It is illegal to disclose the deliberation of a jury to anybody. So, [you] can’t tell a spouse and family and friends… people in [your] usual support system and the mental health professionals that [you] may want to come in contact with down the road. We need to make sure that jurors are not identified and to make sure the process is pure as it can be.”

Under these circumstances, jury members are left to process the psychological and emotional effects of the trial on their own.

Barbara Legate, the lawyer representing the juror from Stafford’s case, argues:

“We ask jurors to sit through days, weeks, and sometimes months of testimony and sometimes that testimony is very, very difficult, and we ask them to keep it to themselves, not discuss it with people outside.”

Until recently, Ontario judges were responsible for deciding whether jurors should be offered counseling at the end of a trial. Jurors would then either be connected with counselors provided by the Ministry of the Attorney General or would pursue counseling on their own.

Starting in January 2017, however, Ontario initiates a new program to provide free and accessible counseling services to anyone serving on a jury. The Ontario Attorney General Yasir Naqvi says the Juror Support Program will be available for anyone serving in a criminal or civil trial, or an inquest.

Jurors will be provided with information on the program at the beginning of a trial, and then again as it finishes. They will call a designated phone number, speak to a specialist who does an assessment, and have counseling made available to them. A third party will provide and cover the costs of the counseling services, but the government still determines who that third party will be. Naqui says:

“Jurors in difficult trials do face evidence that could be quite horrific, and we’ve heard those stories. It’s only appropriate that we provide appropriate services.”

-Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

When Male Rape Victims Are Accountable for Child Support

February 21, 201900Adolescence, Caregiving, Featured news, Law and Crime, Sex, Trauma February, 19

Source: Steve Halama at Unsplash, Creative Commons

When Shane Seyer was 12, he was sexually exploited by his 16-year-old babysitter Colleen Hermesmann. She became pregnant with Seyer’s child in 1989 and was charged with statutory rape shortly afterward. Instead of being convicted of rape, Hermesmann was declared a juvenile offender under the non-sexual offense of “contributing to child misconduct.” Seyer was subsequently court-ordered to pay child support.

In 1993, at the age of 15, Seyer appealed this decision to the Kansas Supreme Court, arguing he should not be liable for these payments. He maintained that his babysitter (Hermesmann) took advantage of him sexually when he was too young to give consent.

The Kansas Supreme Court ruled against him. The judgment stated that, because Seyer initially consented to the sexual encounters and never told his parents what was happening, he was responsible for supporting the child.

This court case set a precedent for male rape victims to make child-support payments. The financial needs of the children outweigh the court’s interest in deterring sexual crimes against male minors, even if statutory rape is the cause of conception.

More recently, in 2014, Nick Olivas of Arizona was forced to pay over $15,000 in back-payments to a woman who had sex with him when he was 14. She was 20 years old at the time. Commenting on the Olivas case and others like it, Mel Feit, director of the New York-based advocacy group the National Center for Men, told the Arizona Republic newspaper:

“To hold him unresponsible for the sex act, and to then turn around and say we’re going to hold him responsible for the child that resulted from that act is off-the-charts ridiculous… it makes no sense.”

Peter Pollard, co-founder of 1in6, an organization designed to help male assault survivors, explained in an interview with the Good Men Project why we downplay the severity of male sexual assault:

“We’re all raised in a culture that says boys are always supposed to initiate and enjoy a sexual experience and males are never supposed to see themselves or be seen as victims. The easiest default is to blame the victim, to say ‘he wanted it,’ ‘he must have chosen that.’”

These attitudes toward male sexual assault are apparent even in the way these men are treated during their court cases.

In 1996, the court heard the case of County of San Luis Obispo v. Nathaniel J in which a 34-year-old woman became pregnant after sexually exploiting a 15-year-old boy. He was also forced to pay child support, and then Deputy Attorney General Mary Roth alleged:

“I guess he thought he was a man then. Now, he prefers to be considered a child.”

Some professionals, such as Mary Koss from the University of Arizona who published the first national rape study in 1987, even argued that men and boys cannot be raped by women. In a radio interview, Koss stated:

“How would [a man being raped by a woman] happen… how would that happen by force or threat of force or when the victim is unable to consent? How does that happen? I would call it ‘unwanted contact.’”

Research indicates, however, that men can be stimulated and achieve an erection in times of fear and terror, despite not being aroused. Studies range from cases where men report arousal during assault, to scientific experiments that find men have erections under many non-sexual circumstances, including when they are unconscious.

In her research, Myriam Denov, a professor at McGill University who holds the Canada Research Chair in Youth, Gender and Armed Conflict, asserted:

“The professional assumption that sexual abuse by women is less harmful than similar abuse by men has potentially dangerous implications for [male] victims of sexual abuse. If professionals fail to recognize sexual abuse by women as potentially serious and harmful, child protection plans will not be made.”

She goes on to say that, as a result, the experiences of male victims who come forward to disclose sexual abuse by women may be trivialized. These misconceptions can lead to delayed referral to social services, or failure to provide victims with the care and support they require.

Until the idea that women cannot rape men and other rape myths are dispelled, cases where victims are misunderstood and mistreated, and even made to pay child support to their former abusers, are likely to continue.

– Ty LeBlanc, Contributing Writer

–The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

-Copyright Robert T. Muller

This article was originally published on Psychology Today

Prison Executioners Face Job-Related Trauma

October 12, 201800Decision-Making, Empathy, Featured news, Guilt, Law and Crime, Trauma October, 18

When an order of execution is issued by the courts in the United States, the prison warden or superintendent is responsible for the sentence being carried out—often by Corrections Officers (CO) who are unaware they will be tasked with killing a prisoner.

Complicating matters, human connections are frequently formed between guards and prisoners. According to Jerry Givens, who administered the death penalty in Virginia to 62 inmates over 25 years, COs may spend more time with death-row prisoners than with friends or family, and can develop empathy towards these inmates.

With potential bonds between death-row guards and prisoners in mind, a separate team of officers frequently conducts the actual execution. COs directly involved with the prisoners are often given smaller roles, such as walking the prisoners to the execution spot, or putting a hood over their head. This approach aims to reduce the emotionally damaging effects of executions on those in close contact with the inmates.

Authorities also try to disperse feelings of responsibility for the killing by having multiple guards involved in the execution process. With lethal injection, the method of execution used in most States, three COs are assigned to turn a key switch that releases the lethal drug into the prisoner. Only one “live” switch dispenses the fatal chemical. The CO initiating the procedure that ultimately kills the prisoner is not known.

Despite such measures, guards can feel mentally tortured by their participation in executions, both before and after.

As illustrated in Into the Abyss, a documentary detailing the death sentence of convicted killer Michael Perry, many execution guards experience post-traumatic stress disorder (PTSD). One guard explained his acute symptoms at the outset of his descent into PTSD. He began crying and shaking uncontrollably when “the eyes of all the inmates he had executed began flashing before him.” Another developed nightmares, cold sweats, and sleeplessness.

Other guards, like Givens, have reported depression, inability to sustain relationships, and changes in personality. According to Rachel MacNair, author of Perpetration-Induced Traumatic Stress: The Psychological Consequences of Killing:

“The inner lives of guards who execute become like those of battlefield veterans who suppress memories from themselves and others.”

In 2007, two South Carolina COs who developed obsessive compulsive behaviour, nightmares, and other emotional disturbances filed civil lawsuits, claiming that their conditions resulted from performing executions. The COs alleged that they were coerced into carrying out executions and were not given any debriefing or counseling to help them deal with the emotional effects.

For some guards who need psychological treatment, it is simply not available. Other times, guards do not use available psychological help for fear of bei

Source: Feature: Fumigraphik at flickr, Creative Commons

ng labelled ‘weak’ by their colleagues. Additionally, guards may not have the opportunity to talk about their involvement in executions with members of their families. Givens explained:

“When I accepted the job, I never told my wife or kids or anybody. I didn’t want them to go through anything I had to go through. If I told someone, they would tell someone. It would have been like a snowball and gotten bigger and bigger and everyone would know exactly what I was doing.”

This secrecy protects guards from having to explain or defend their actions. But it also prevents them from obtaining help to lessen the ill-effects of the associated trauma. Lack of disclosure precludes obtaining support.

The unacknowledged stress experienced by guards on execution teams risks dangerous mental-health consequences. As Givens, who now campaigns to end the death penalty, put it:

“It’s not an easy task to do. If I had known what I had to go through as an executioner, I wouldn’t have done it. You can’t tell me I can take the life of people and go home and be normal.”

– Veerpal Bambrah, Contributing Writer. The Trauma and Mental Health Report.

-Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

This article was originally published on Psychology Today

The Making of a Murderer

July 6, 201800Child Development, Featured news, Genetics, Law and Crime, Parenting, Psychopathy July, 18

Source: sarahjgibson at DeviantArt, Creative Commons

In 1993, when Robert Thompson and Jon Venables from Liverpool, England were both 10 years of age, they killed a two-year-old boy. Thompson and Venables kidnapped the victim from a shopping centre, tortured him, and left him to die.

Stories like these raise many questions. Chief among them, how does something like this happen at all? Was it the result of bad parenting? The community certainly thought so, viewing the boys’ upbringing as the cause.

The trial had exposed evidence of domestic problems in both families. The judge stated that Thompson’s and Venable’s parents must take moral responsibility for their children’s actions. So members of the Thompson family had to assume new identities and go into hiding. They moved nine times to escape verbal and physical attacks. The Venables experienced similar threats.

In a recent interview with CNN, family therapist Tricia Ferrara put the onus on parents to understand when their child is in trouble. She said:

“All parents need a better understanding of child development so we can detect when the signals show a child may be moving in an anti-social direction.”

And a study conducted on the Columbine shootings, where two teenagers killed 12 students and a teacher at Columbine High School in Denver, suggested that the community saw parents as partly accountable for the murders.

There’s no doubt that parenting plays an enormous role in child development. Researchhas found that abuse, negative parenting, and prolonged malnutrition are linked to a proclivity toward physical violence.

But, there is also important research pointing to the role biology plays in predisposing some individuals to psychopathy, including violence. The BBC reported that neuroscientist Adrian Raine discovered a decrease in activity of the pre-frontal cortex in the brains of murderers, suggesting a genetic predisposition.

And, research by Elizabeth Cauffman and colleagues from the University of California found that good parenting doesn’t always lead to the outcomes we imagine. In fact, anti-social encouragement by a romantic partner was correlated with the highest level of offending in youth, even when warm relationships endured with parents.

In a TVO documentary Genetic Me, professor Daniel Nettle claimed that personality is stable throughout a person’s life. Individuals have tendencies for some things and not others. Nettle suggests that people are born with predispositions for certain personality traits. He adds, though, that the environment has some effect on bringing out theses inclinations, and that people can fight against them.

NPR reported that there are additional factors that play into a person’s development, perhaps explaining why not all children raised by the same parents are violent. Children in the same families have distinct personalities and varied interests that elicit different parenting. Plus, children experience independent social environments outside the home.

Perhaps the complexity of the matter is described best by neurobiologist James Fallon, who studies the brains of psychopathic killers. He explained in a TED Talk that an interaction occurs between environment and genetics. When presented with a particular brain image, he noted it was clearly a psychopath’s brain. What was most shocking—it was his own brain. Fallon, though, is not a killer, and had a happy upbringing. But, he has a family history of homicide. The first documented murder of a mother by a son was committed by a member of his family, several generations back.

Fallon said that, although some individuals, mostly male, have genes or brain damage that make them more susceptible to becoming murderers, their childhood experiences can make all the difference. For instance, the MAOA gene in particular can give rise to a violent individual if the gene is combined with experiences of brutality.

Where do murderers come from? Like all the big questions in mental health, an either-or perspective leaves little room for complexity. In the great genetics versus environment debate, the making of murderers—indeed, the making of us—requires that we look somewhere in-between.

–Anika Rak, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

This article was originally published on Psychology Today

Fascination With Murder—Should You Be Concerned About It?

May 24, 201800Anxiety, Ethics and Morality, Featured news, Law and Crime, Psychoanalysis, Psychopathy May, 18

Source: calvinnivlac at flickr, Creative Commons

Fascinated with murder, friends and comedians Georgia Hardstark and Karen Kilgariff wanted the opportunity to openly talk about death. They started weekly podcast “My Favorite Murder” to discuss the grizzly details of crimes that interested them. Although these conversations might seem callous and unseemly to victims’ loved ones and some members of the public, the podcasts serve as a safe space for the women to confront the dark side of human nature.

In the first episode, Hardstark and Kilgariff confess their fear of being murdered, and how discussing that fear and the atrocities of true crimes eases any associated anxiety. They disclose that the process of “talking about the thing you’re afraid of” is immensely helpful. That process, they reveal, is one of the primary motivators behind the show.

Presented as a comedy, the podcast is broadcast from Feral Audio, and can also be found under the comedy category in the iTunes podcast charts. This combination of murder and humor has proven quite popular, as the podcast is regularly featured in the iTunes top comedy chart. And the show’s private Facebook group boasts over 130,000 members, or “murderinos,” as they call themselves.

So, what’s the appeal of a true crime comedy podcast? In an interview with the Huffington Post, one listener says:

“They’re honest about their fears surrounding rape, murder, kidnapping, etc. They’re terrified of those things just like the rest of us! Somehow diving into the subject helps diffuse the pain of it. It might be a weird way to desensitize ourselves from a nasty world, but, it helps!”

If that’s the case, do all consumers of true crime media have crippling fears of murder and kidnapping? Skeptics see this explanation of using the podcast as ‘exposure therapy’—wherein through systematic exposure to one’s fears, anxiety is reduced—as a justification to discuss a taboo subject matter.

Perhaps, this is not an issue of anxiety, but of the dark, unspoken desires people dare not speak.

Hardstark and Kilgariff argue that, though taboo, an interest in murder and true crime is widespread. In an interview with SBS Australia’s The Feed, the two report:

“It’s very common, but for some reason saying I have an interest in this is supposed to be a shameful thing, but it’s not. It’s very normal.”

Many listeners of the podcast report having found their “home” of sorts, a tribe where it’s okay to talk about the horrific murders that have always captivated them. Listeners appreciate Hardstark’s and Kilgariff’s candor. Another listener asserts:

“It’s a dark subject matter, but it’s treated very respectfully, and somehow Georgia and Karen manage to feed that morbid curiosity that we all share, but in a way that never forgets the consequences of violence.”

Forensic psychologist Paul G. Mattiuzzi contends that a fascination with murder is nothing out of the ordinary, and in fact, is practically built-in to people. Said plainly:

“The crime of murder is a most fundamental taboo and, also, perhaps, a most fundamental human impulse.”

Mattiuzzi maintains that the allure comes from the many questions we ask ourselves—Why did they do it? Could I do that? Was there nothing that could have stopped this?He says:

“When it’s art, all of those questions make it what we call a ‘thriller’ or a ‘mystery’. When the body is real, the ‘thrill’ may be gone, but the questions and the fascination remain.”

Psychology professor at Santa Clara and Stanford Universities, Thomas Plante, suggests:

“To deny our dark side might ultimately harm us more than accepting it and coping proactively with our inner most dark thoughts and impulses.”

Further still, the coupling of delicate subject matter with comedy or light-heartedness seems to have positive effects. Plante explains:

“Taking a light touch with dark thoughts may actually help us not act on them. Just because you have an itch doesn’t mean you need to scratch it!”

This is not to say that anyone with a passing interest in true crime secretly longs to kill, but exploring that curiosity with a “light touch” could help ease any discomfort that comes along with that interest.

Given the enduring popularity of true crime in entertainment—as seen from documentaries such as “Making a Murderer” and “The Jinx”—society’s collective fascination with murder is not going away any time soon. So, in the meantime, why not laugh about it?

—Fernanda de la Mora, Contributing Writer, The Trauma and Mental Health Report.

—Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

This article was originally published on Psychology Today

For Mentally Ill, Jail Diversion Program Gives Second Chance

March 8, 201830Featured news, Health, Law and Crime, Loneliness, Politics, Psychiatry, Psychopathy March, 18

Source: octopusdevon at flickr, Creative Commons

On February 8, 2015, Natasha McKenna—a 37-year-old who suffered from mental illness—died following an incident in which she was tasered four times by law enforcement.

After a week-long delay in transporting her to a county jail in Virginia, where she would be provided with mental-health resources, she became agitated. In an effort to regain control, officers used a stun gun on her multiple times. Despite CPR to revive her, McKenna passed away shortly after.

McKenna had been diagnosed with schizophrenia, bi-polar disorder, and depression when she was just fourteen. Her case highlights a growing issue in county jails and prisons across America: resources are scarce for offenders with mental illness.

In 1992, the National Alliance for the Mentally Ill (NAMI) and Public Citizen’s Health Research Group released a report revealing alarmingly high numbers of people with serious mental illness incarcerated in the United States. The subsequent 2002 report showed that little had changed in the preceding ten years.

But shortly after McKenna’s death in 2015, Fairfax County Jail—where she had been held—created a Jail Diversion Program (JDP). The objective of this program is to divert low-risk offenders in mental-health crises to treatment rather than send them to a prison setting that exacerbates their symptoms.

JDPs are designed so that authorities, alongside certified crisis clinicians, have the capacity to decide whether a non-violent offender who suffers from a mental disorder is directed to a JDP where they can receive treatment, or is arrested. JDPs give offenders the opportunity to work with a trained mental-health clinician, ultimately transforming how resources are provided.

Sarah Abbot, the program director of Advocates—a JDP in Massachusetts that works with the Framingham Police Department—believes that JDPs are crucial in early intervention for mentally ill offenders.

During an interview with the Trauma and Mental Health Report, Abbot explained:

“JDP’s effectively divert people with mental illness from the criminal justice system, and have been shown to be successful in the prevention of unnecessary arrests for those who suffer with a mental illness. Police choose to transfer offenders to JDPs 75% of the time.”

Abbot believes that early intervention via JDPs is key to preventing those with a mental illness from reoffending. In 12 years of operation, Advocates has successfully diverted 15,000 individuals from the criminal justice system into treatment.

During calls related to misdemeanors, police respond to the scene with a JDP clinician. After consulting the clinician, the officers use their discretion, along with information from victims and bystanders, to decide whether or not to press charges. Alternatively, the officer can choose to secure treatment for the offending individual at a JDP.

In the latter case, the clinician performs an assessment to determine if the offender meets the criteria for inpatient care. If so, they are diverted from arrest and placed in a local mental-health facility where they receive intensive treatment through the support of counsellors, social workers, psychologists, and psychiatrists.

The purpose of JDPs is to de-escalate encounters with mentally ill offenders and create a cooperative environment for assessing the situation. Abbot views their contribution as a form of compassionate justice:

“If we can keep mentally ill individuals out of the criminal justice system, their lives will ultimately be better by default. How much better depends on the quality of the treatment they receive and the individual’s commitment to success.”

The literature on JDPs suggests that placing these individuals in treatment programs within their community, where they have the support of family and friends, inevitably results in lower rates of relapse in comparison to incarceration.

Abbot believes that JDPs are vital in keeping individuals away from the isolation of a jail cell:

“My hope is that we divert people like Natasha McKenna into proper treatment, because once they are in a cell, things can escalate quite quickly.”

If somebody with a mental illness has an arrest on their record, JDPs keep doors open to them for education, employment, and housing. JDPs have the potential to protect individuals like McKenna, and provide offenders suffering from mental illness with a second chance at living stable lives post-arrest.

–Nonna Khakpour, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

This article was originally published on Psychology Today

Workplace Alcohol Tests: Where Do We Draw the Line?

February 22, 201840Addiction, Alcoholism, Career, Featured news, Health, Law and Crime, Work February, 18

Source: Bousure at flickr, Creative Commons

Keeping our personal and professional lives separate is something many of us strive for. But, as Johnene Canfield recently discovered, we only have so much control over this process. In the spring of 2015, Canfield was fired from her six-figure position as a Minnesota Lottery official after a DUI conviction and a stint in rehab for alcohol abuse. The following October, she filed a lawsuit to reclaim her job.

Canfield’s former employers say the reason they dismissed her was to ensure the safety of other employees and clients, as well as to preserve employee productivity at the Minnesota Lottery. But these reasons reveal how problem drinkers are viewed as incapable of workplace competence.

According to Linda Horrocks, a former health care aide at Flin Flon’s Northern Lights Manor, a long-term care home for seniors, “Employers often act based on what they think they know about addiction and alcohol addicts”—but not necessarily on the reality of living with addiction. Horrocks, like Canfield, was fired for alcohol addiction.

She was eventually re-hired by the Northern Regional Health Authority, the health-governing body in northern Manitoba that oversees employment at Northern Lights Manor. But her employer required her to sign an agreement to abstain from drinking on and off the job, and to undergo random drug and alcohol testing.

In an interview with the Trauma and Mental Health Report, Horrocks said:

“I didn’t object to the testing, but I didn’t want to commit to never drink again on my own time. My union even advised me against signing this agreement, because I would just be setting myself up for failure—I hadn’t gone through treatment yet. And so, I was fired again.”

Horrocks maintains that the employers’ offer to help her abstain from alcohol completely was based on misconceptions about alcoholism and treatment.

“The managers knew a little bit about alcoholism, as family and acquaintances had gone through treatment. They just decided that the counselling that I was going through with Addictions Foundation of Manitoba was not enough because it is a harm-reduction program, not a direct path to complete abstinence.”

Horrocks understands why some may think that abstinence is the only way:

“After all, if you’re a recovering alcoholic, alcohol is deemed ‘your enemy.’”

Proponents for abstinence-based treatments argue that periods of abstinence can repair brain and central nervous system functions that were impaired. Having problem drinkers self-moderate alcohol intake has had variable success in the past. For some, the temptation of having “just one drink” can be a precursor to relapse. And for them, total abstinence may be a better approach.

But Horrocks explains, abstinence may not be the best approach for everyone. The harm reduction model accepts that some use of mind-altering substances is inevitable, and that a minimal level of drug use is normal. This approach also recognizes research showing experimental and controlled use to be the norm for most individuals who try any substance with abuse potential.

Harm reduction seeks to reduce the more immediate and tangible harms of substance use rather than embrace a vague, abstract goal, such as a substance-free society. During intervention talk sessions, therapists explore and attempt to modify drinking patterns or behaviours with the client. The clinicians support autonomous decision-making and independent goal setting related to drinking.

Evidence published in the Canadian Medical Association Journal shows that these programs aim to reduce the short- and long-term harm to substance users and improve the health and functioning of these individuals. There are also benefits to the entire community through reduced crime and public disorder, in addition to the benefits that accrue from the inclusion into mainstream life of those previously marginalized.

Benjamin Henwood and colleagues from the University of Southern California also show that those who work on the front-line of severe mental illness and addiction prefer the harm-reduction approach to complete abstinence. Yet few employers have taken this approach into account when deciding the fate of employees with proven substance abuse problems outside of the workplace.

Horrocks’s and Canfield’s experience begs the question, where do we draw the line? How much say do employers have over their employees’ personal lives? It may just be that employers need to better respect the privacy of workers, so long as workplace productivity is not affected. And if employers maintain substance abuse policies that bleed over into the personal lives of staff, consideration of a harm-reduction approach is key.

–Veerpal Bambrah, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

This article was originally published on Psychology Today

Stigma Surrounds HIV-Positive Children in China

February 15, 201800Bias, Featured news, Health, Law and Crime, Trauma February, 18

Source: quaerion at DeviantArt, Creative Commons

In 2014, a young boy (pseudonym ‘Kunkun’ for anonymity) was banished from his village in Sichuan, China after being diagnosed with AIDS. The villagers did not understand the disease, so feared for their safety. In a CNN article, resident He Jialing expressed his concerns for his daughter who went to school with Kunkun at the time:

“My daughter is around his age, and goes to a boarding school now. What happens if she gets bitten while playing with him here at home? That boy is too dangerous.”

There are roughly 740,000 active cases of HIV in China. Misinformation and intense stigma surrounding HIV and AIDS often result in tragic consequences for HIV-positive children. For example, infected children are frequently banned from their schools and abandoned by their loved ones.

Xu Wenqing, an HIV/AIDS specialist with UNICEF China, revealed to The World Post that HIV-positive children are often segregated from their peers in school:

“If their HIV status has been disclosed, it’s very common that parents of other children complain to the school and force the school to separate their children from HIV positive children.”

But a boarding school in China called the Green Harbor Red-Ribbon School was created in 2006 to house roughly 30 HIV-positive children between the ages of 6 and 19. The school is a refuge for those who have been ostracized by their communities because of their illness. Other organizations are intervening as well.

At an orphanage run by the non-government Fuyang AIDS Orphan Salvation Association, children receive food, housing, education, and the necessary medications to control the virus. The director, Zhang Ying, explained to Reuters that psychological improvements are seen in the children under their care:

“Our children have a healthier state of mind now. When I first started to get to know these children, they had low self-esteem and were afraid of being discriminated against by others. After these few years, by staging different kinds of activities for them, the children no longer feel inferior and are more confident about themselves.”

Although a source of refuge for children, boarding schools and orphanages are not a long-term solution. They cannot cope with the sheer number of children who have HIV. In the case of Green Harbor, the haven can only protect children to age 19, at which point they are expected to leave. Unfortunately, the stigma faced by HIV-positive adults is also problematic.

In 2010, a court in China ruled against a man who said that he was wrongfully denied a job after his prospective employer discovered he was HIV-positive. The judge’s ruling contradicted an earlier law that was meant to protect infected individuals from being discriminated against by employers. The law stated:

“No institution or individual shall discriminate against people living with HIV, AIDS patients and their relatives.”

Even with legal protection, those with HIV are still regularly banned from schools and jobs, perpetuating the ignorance and fear surrounding a positive status. And, although medical treatment of AIDS is becoming increasingly accessible in China, a 2009 United Nations report stated many infected people do not seek treatment due to lack of knowledge or to concern that their status will be exposed.

Lack of consistent medical care, or lack of any treatment for that matter, presents huge risks to those with HIV. Without medication, HIV can develop into AIDS and cause death. Nonadherence to medication can lead to the development of drug-resistant strains of HIV that may lower quality of life, since patients may require stronger medications with more serious side effects. All the more reason to reduce the stigma associated with positive-HIV status, and to support treatment for those battling the virus.

In an effort to combat these problems, China’s first lady Peng Liyuan appeared in public advertisements holding hands and playing with HIV-positive children at the Red-Ribbon School. Plus, in 2010, a law limiting HIV-positive individuals’ entrance into and movement within China was lifted, but more needs to be done.

People with HIV in China are still ostracized, and laws meant to protect them from discrimination are circumvented. Until awareness and access to disease education improve, cases of people being denied schooling and jobs due to HIV status are likely to continue. Furthermore, children who do not live in a protected environment or who are too old for an orphanage will be left fending for themselves.

–Abbiramy Sharvendiran, Contributing Writer, The Trauma and Mental Health Report.

–Chief Editor: Robert T. Muller, The Trauma and Mental Health Report.

This article was originally published on Psychology Today

Category: Law and Crime