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Examining violence among Not Guilty by Reason of Insanity state hospital inpatients across multiple time points: the roles of criminogenic risk factors and psychiatric symptoms

Published online by Cambridge University Press:  08 January 2020

Darci Delgado Open the ORCID record for Darci Delgado [Opens in a new window] ,
Sean M. Mitchell ,
Robert D. Morgan Open the ORCID record for Robert D. Morgan [Opens in a new window]  and
Faith Scanlon
Darci Delgado*
Affiliation:
California Department of State Hospitals, Sacramento, California, USA
Sean M. Mitchell
Affiliation:
Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, USA Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
Robert D. Morgan
Affiliation:
Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
Faith Scanlon
Affiliation:
Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
*
*Author for correspondence: Darci Delgado (Email: [email protected])
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Abstract

Objective

Institutional violence in state hospitals is a public health problem that has been severely understudied. Given the personal (ie, staff and patients) and fiscal harms associated with institutional violence, more research into contributing factors for violence is needed. The overarching aim of this study then was to examine associations among psychiatric symptoms, criminal risk factors, and institutional violence.

Methods

Participants were 200 male, female, and transgender forensic mental health inpatients adjudicated Not Guilty by Reason of Insanity and committed to the California Department of State Hospitals. Participants completed a psychiatric symptom measure, and measures of and associated with criminal risk. Institutional violence was recorded from file review and includes physical violence toward staff or patients for 6-months prior to and post patient participation in this study.

Results

After adjusting for previous institutional violence, results indicated that psychiatric symptoms were not associated with follow-up institutional violence; however, criminal risk was associated with follow-up institutional violence. Unexpectedly, 2 aspects of criminal risk, antisocial cognitions and associates, were not associated with follow-up institutional violence after adjusting for previous institutional violence. Results also provided a tentative cutoff score on the Self-Appraisal Questionnaire for predicting follow-up institutional violence.

Conclusions

These results have important implications for treating and managing patients at risk for institutional violence, including the need to assess criminogenic risk and leverage treatments that target these risk factors as a best practice approach.

Keywords

Violencecriminal riskpsychiatric symptomsstate hospitalNGRIinpatient.
Type
Original Research
Information
CNS Spectrums , Volume 25 , Issue 5 , October 2020 , pp. 714 - 722
Copyright
© Cambridge University Press 2020

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Footnotes

The findings and conclusions in “Examining violence among Not Guilty by Reason of Insanity state hospital inpatients across multiple time points: the roles of criminogenic risk factors and psychiatric symptoms,” are those of the authors and do not necessarily represent the views or opinions of the California Department of State Hospitals or the California Health and Human Services Agency.

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