Anne G Crocker

• Ph.D.
• Full professor at Université de Montréal

Police services have become highly involved in interventions with vulnerable populations over the years, notably with persons experiencing homelessness and mental illness. In order to best allocate resources for preventive interventions with this population, we aimed to examine patterns of police interactions in people experiencing both homelessnes...

While there is extensive literature examining the effectiveness of antipsychotic prescribing to patients with schizophrenia spectrum or other psychotic disorders in general psychiatric services, there is a dearth of studies examining antipsychotic prescribing practices and their effectiveness in forensic psychiatric services. Forensic psychiatric p...

Person-centered care and shared decision-making between inpatients and professionals have become guiding principles for mental health care, yet their integration in forensic services remains limited by security-driven and legal considerations. In this context, emerging models of shared risk assessment and risk management could transform forensic pa...

This study examined the characteristics and healthcare service trajectories of 98 men and 29 women found not criminally responsible on account of mental disorder (NCRMD) for a homicide in Canada using data from Criminal Review Boards and police reports, as well as health administrative databases for a subsample in Québec ( n = 51). Three quarters o...

Objectifs L’accès à un logement stable, abordable et sécuritaire constitue un déterminant important de la santé et de l’intégration dans la communauté des personnes ayant un trouble mental. Les études sur la satisfaction, la stabilité et les préférences résidentielles des personnes ayant un trouble mental ont surtout porté sur les expériences de ce...

Aim People living with mental illness are more likely than the general population to experience adverse housing outcomes, including homelessness. The aim of the current study is to examine residential status when participants have their first contact with mental health services, and the correlates of residential status at that moment. Methods Firs...

Les personnes qui présentent à la fois une déficience intellectuelle et des troubles du comportement (PDITC) ont parfois de la difficulté à obtenir des services adaptés à leurs besoins complexes. En effet, les institutions de psychiatrie légale, les établissements de santé et de services sociaux et les établissements correctionnels parviennent diff...

Recent research suggests that empirically validated risk factors for persons found not criminally responsible on account of mental disorder (NCRMD) are rarely mentioned by clinicians in reports for Review Boards in Canada. This study aims to better understand this observation by examining the styles of clinical reports (i.e., types of report accord...

In the field of forensic psychology, assessing the risk for violence is a core component of treatment planning and intervention monitoring. However, practitioners from the violent extremism (VE) field currently lack guidance on which tools to use when addressing the risk of VE in individuals with mental disorders. This study details challenges asso...

Using archival data from the National Trajectory Project-Community (NTP-C), the psychosocio-criminological characteristics of 1,468 individuals found NCRMD were examined.

Introduction: For people with a serious mental disorder, a community treatment order (CTO) is a legal response that requires them to undergo psychiatric treatment unwillingly under certain conditions. Qualitative studies have explored the perspectives of individuals involved in CTOs, including persons with lived experiences of a CTO, family member...

Although mental illness has a demonstrated link with violence, the prevalence of targeted (planned and goal‐directed) violence perpetrated by individuals with mental illness and its association with psychiatric symptoms is relatively unexplored. File information was compared for all 293 individuals found not criminally responsible due to mental ill...

Indigenous people are vastly over-represented among people incarcerated in Canada. We collected extensive clinical information and outcome data from RB files and obtained lifetime criminal records for 1800 individuals found Not Criminally Responsible on Account of Mental Disorder (NCRMD) in BC (n = 222), ON (n = 484), and QC (n = 1094). Indigenous...

Objective There is scant research on the effectiveness of permanent supportive housing for homeless women with mental illness. This study examines the effectiveness of Housing First with an unprecedentedly large sample of homeless women from five Canadian cities, and explore baseline risk factors that predict social, health and well-being outcomes...

L’objectif de cette note informative est donc de synthétiser les résultats d’études empiriques sur les trois sujets décrits ci-haut, soit 1) les changements du taux d’hospitalisations et de consultations à l’urgence, potentiellement liés à une augmentation des cas en psychiatrie légale, 2) les éclosions de COVID-19 dans les établissements sécurisés...

At the beginning of the pandemic, experts expected an increasing number of hospitalizations in forensic settings, uncontrollable outbreaks of COVID-19, and deterioration of mental health of residents within institutions. Certain publications corroborated these concerns; however, no synthesis of the results of empirical publications at the initial s...

Background The verdict of Not Criminally Responsible on account of a Mental Disorder (NCRMD) is increasingly used to access specialized mental health services in Canada and elsewhere. This situation highlights the importance of ensuring timely access to services in the community to prevent violence and justice involvement. The objective of the pres...

This study aimed to explore staff and patients’ views on the violence prevention climate in civil and forensic mental health settings. We conducted a cross-sectional survey of 110 inpatients and 198 staff members from three civil mental health hospitals (including two forensic units) and one forensic mental health hospital in Canada. Staff and pati...

The association of ideologically motivated violence with mental health disorders raises specific challenges for security agencies and clinical services. The aim of this paper is to describe the clientele of a specialized intervention program based in Montreal, Quebec, in terms of type of violent ideology and clinical presentation. We conducted a re...

In this article, we explore which configurations of risk and protective factors explain recovery in a sample of 60 forensic psychiatric patients 6 months after they have been discharged from a psychiatric institution. In line with the recovery-oriented paradigm that emerged in psychiatry, we focus on the role dynamic risk factors and dynamic protec...

Aims: High rates of mental illness among individuals experiencing homelessness, as well as documented contacts with psychiatric services prior to episodes of homelessness, indicate that early intervention could play a key role in homelessness prevention. Decision-makers and clinical teams need longitudinal data on housing trajectories following in...

The text proposes a protocol for a scoping review to explore what culturally safe forensic mental health services look like, identify its key components, and the best practices for implementation. The review aims to answer these two questions: What do we know about what culturally safe forensic mental health services may or should look like? How ca...

Objective The objective of this paper is to provide an overview of the provision and organization of forensic mental health services around the world. In particular, we attempt to address the following question: What system-level characteristics are important to consider in relation to the organization and structure of forensic mental health servic...

Objectives This article provides an overview of the approaches and instruments used to assess the risk of other-directed violence, with particular focus on risk formulation. Issues pertaining to the development and implementation of these instruments are briefly reviewed. Method A critical analysis of the literature pertaining to the methods and cu...

Objectives Exposure to repeated traumatic events during childhood and adolescence is associated with high prevalences of mental illness, addictions, physical health conditions, and psychosocial difficulties (Felitti et al., 2019). The most common consequence of exposure to trauma is violence towards self and others (Hughes et al., 2017). The very h...

Background Housing First does not, on average, reduce criminal justice involvement. This analysis aims to test whether the overall absence of an impact is due to intervention effect heterogeneity as a function of the pattern of lifetime criminal justice involvement, identified through latent class analysis conducted through earlier work. Methods Th...

Covid-19: Professional practices in closed institutional settings Introduction: While governments have focused efforts on implementing health measures such as physical distancing and confinement to protect communities from the spread of COVID-19, some researchers focused on the significant impact of these measures on mental health and well-being. P...

Introduction: While governments have focused efforts on implementing health measures such as physical distancing and confinement to protect communities from the spread of COVID-19, some researchers focused on the significant impact of these measures on mental health and well-being. Persons with mental disorders who are both institutionalized and j...

Objectives The objective of the present study is to describe the patterns of health service use and of prescription claims in the year preceding an offense leading to a verdict of not criminally responsible on account of a mental disorder (NCRMD). Methods Provincial health administrative databases were used to identify medical services, hospitaliz...

Background The public often perceives the insanity defense as a “get out of jail free card”. Conversely, several studies demonstrate the substantial control imposed upon these defendants. This study compares Review Boards decisions regarding people found not criminally responsible on account of mental disorder (NCRMD) to criminal courts decisions r...

Objectifs Cet article propose un survol des méthodes et outils d’évaluation du risque de violence hétérodirigée et aborde la question de la formulation du risque de violence. Il se termine par un survol des différents enjeux relatifs au développement et à l’implantation de ces outils. Méthode Une analyse critique de la littérature relative aux d...

The factors contributing to aggressive behaviours among individuals with intellectual disability (ID) are not fully understood. The goal of the present study was to examine whether vulnerability factors such as ID severity, speech, or motor impairments moderated gender differences in aggressive behaviours. Adults (n=296) with ID were recruited, and...

Given the increasing literature on forensic assertive community treatment (FACT), we conducted a systematic review and meta-analysis to explore the effectiveness of FACT among justice-involved individuals with severe mental illness. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Sixteen stu...

Introduction: Violence in psychiatric settings has negative consequences on patients, staff, and the institution alike. Efforts to prevent violence cannot currently be assessed due to a lack of suitable indicators. The Violence Prevention Climate Scale (VPC-14) is a validated tool that can be filled out by both staff and patients to assess the viol...

This paper adopts a conventionalist approach to shed light on the problems of measurement and reification that underlie the quantification of desistance from crime in the scientific literature. Analysis of 100 papers spanning three decades indicates that approaches based on theoretical classification have recently lost ground in favour of sophistic...

The knowledge–practice gap remains a challenge in many fields. Health research has shown that professional networks influence various aspects of patient care, including diffusion of innovative practices. In the current study, we examined the potential utility of professional networks to spread the use of violence-risk-assessment tools in forensic p...

The knowledge-practice gap remains a challenge in many fields. Health research has shown that professional networks influence various aspects of patient care, including diffusion of innovative practices. In the current study, we examined the potential utility of professional networks to spread the use of violence-risk-assessment tools in forensic p...

(ENGLISH FOLLOWS.) RÉSUMÉ. Plusieurs programmes et services ont été développés en vue d’adapter les interventions policières et les processus judiciaires aux besoins des personnes ayant des troubles mentaux, de surcroît lorsque celles-ci sont en situation d’itinérance. La présente étude adopte un devis qualitatif descriptif afin d’explorer l’expér...

Most countries have implemented guidelines and policies in response to COVID-19 that have had a direct impact on institutionalized or incarcerated persons with mental health problems. Although these strategies are essential to protect these vulnerable persons from the pandemic, they can also have significant consequences on recovery, well-being, as...

As the COVID-19 outbreak spreads around the world, countries have been implementing “social/physical distancing” directives and policies. These vary from strong encouragement from governing bodies to stay home, to requirements to self-isolate/quarantine to various degrees, to police-enforced national quarantines. These directives are implemented to...

Individuals experiencing both homelessness and mental illness have high rates of interaction with public safety and criminal justice institutions. Several cross-sector diversion programs have been developed over the past decades as alternatives to incarceration. Most of these initiatives rely on the commitment and expertise of frontline practitione...

This study identified factors that predicted which of 713 clinically documented incidents of aggression—threats to kill, assault, or sexual assault—committed by 404 forensic psychiatric patients were linked to court findings of guilt. Individuals had, on average, 1.7 aggressive incidents and were found guilty of an average of 0.3 offenses against p...

In Canada, Review Boards (RBs) determine dispositions for individuals found Not Criminally Responsible on Account of Mental Disorder (NCRMD; equivalent to NGRI). These tribunals rely on expert reports that should address risk by using empirically-supported factors. However, previous research concluded few HCR-20 items were mentioned in reports subm...

This study aimed to characterize lifetime criminal involvement among homeless people with mental illness in Canada ( N = 1,682). A latent profile analysis yielded five classes. Most participants fell within the Fewer Needs (75.5%) group, characterized by less complex psychosocial histories and few criminal charges. Participants with Extensive Crimi...

Objectives Exposure to adverse childhood experiences (ACEs) is associated with increased risk of criminal justice involvement and repeated victimization among homeless individuals. This study aimed to (1) examine whether the relationship between cumulative ACE score and odds of experiencing criminal justice involvement and victimization remains sig...

Objective This study investigates the association between impulsiveness and six dimensions of recovery among homeless people with mental illness. Method The sample was composed of 418 participants of a randomized controlled trial of Housing First, a recovery-oriented program that provides immediate access to permanent housing. The reliable change...

Persons with mental illness who experience homelessness are at increased risk of penalization and interactions with police services. However, there is a dearth of quantitative literature on the impact of time on the street on the incidence of police interactions. The objective of this study is to examine the dynamic prospective association between...

L’autorisation judiciaire de soins se situe au carrefour de considérations cliniques et juridiques. Malgré une efficacité contestée, des études récentes démontrent une augmentation du recours à cette mesure d’exception à l’échelle internationale. La présente analyse est inspirée d’une rencontre des théories foucaldienne et goffmanienne. Elle s’appu...

Involuntary treatment orders (ITOs) represent coercive leverage for treatment adherence against the will of individuals incapable of providing consent. ITOs have failed to demonstrate benefits in quantitative studies, but little attention has been paid the growing body of qualitative evidence on ITOs. The current study is an interpretative meta-syn...

Objective: Impulsiveness has been shown to be associated with negative outcomes in psychiatric samples. This study investigates the association between impulsiveness and six dimensions of recovery: clinical, physical, functional, criminological, social, and existential. Method: The sample was composed of 418 homeless individuals with mental illne...

Purpose To quantify the demand for forensic psychiatric services in Ontario over the past 25 years and investigate whether the sociodemographic, clinical and offense-based characteristics of forensic patients have changed over time. Methods We investigated all forensic admissions from 1987 to 2012 resulting in a disposition of Not Criminally Respo...

FREE ACCESS UNTIL MAY 12 2019: https://authors.elsevier.com/a/1YmeaheKdgNgN The goal of this study is to identify patterns of various forms of aggression in the general population and their psychosocial and environmental correlates. Data from the Montreal Epidemiological Catchment Area study (N = 1855) were analyzed using latent class analysis an...

Background Understanding public attitudes towards people with intellectual disability (ID) can help orient activities to promote the social inclusion of this group. The ATTitudes toward Intellectual Disability (ATTID) questionnaire is a validated 67‐item tool used to assess attitudes towards people with ID from a multidimensional perspective. It is...

Objective: Housing First is increasingly put forward as an important component of a pragmatic plan to end homelessness. The literature evaluating the impact of Housing First on criminal justice involvement has not yet been systematically examined. The objective of this systematic review is to examine the impact of Housing First on criminal justice...

Background Few studies have examined attitudes that may promote the social inclusion of persons with an intellectual disability (ID) among health care providers (HCPs). Yet these attitudes could impact the accessibility and quality of services provided to this population, as well as the general attitudes of HCPs. The objectives of this study were t...

Using data from the National Trajectory Project, we compared 50 individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD) for sexual offences with 50 age- and gender-matched individuals found NCRMD for nonsexually violent offences. We also described the concurrent offenses, the symptoms at the time of the offense and the ch...

In 2014, the Canadian government amended the Criminal Code, allowing courts to designate some individuals found not criminally responsible on account of mental disorder (NCRMD) as high-risk accused (HRA). As a result, individuals found HRA face significant new restrictions for transitioning through the forensic system. This study examined the relev...

There is little study of the impacts of screening on distal outcomes such as recovery or adverse incidents during incarceration. Furthermore, screening practices vary greatly between jurisdictions; many focus on history taking as opposed to current symptoms. Method. We conducted an observational cohort study of all admissions (N = 13,281) to Canadi...

We examined the predictive validity of individual, service, and neighborhood factors for aggression by 1,491 forensic clients found Not Criminally Responsible on account of Mental Disorder (NCRMD), under the jurisdiction of a Review Board, and thus subject to supervision conditions. Younger patient age and personality disorder diagnosis were associ...

Objective: Disparities in mental health care exist between regional and demographic groups. While screening is recommended as part of a correctional mental health strategy, little work has been done to explore whether it can narrow regional and demographic disparities in access to care. We compared treatment access rates by sex, race, age, and reg...

While there is general consensus about the need to increase access to mental health treatment, it is debated whether screening is an effective solution. We examined treatment use by inmates in a prison system that offers universal mental health screening. Method: We conducted an observational study of 7,965 consecutive admissions to Canadian prison...

PurposeNational initiatives, such as the UK Improving Access to Psychological Therapies program (IAPT), demonstrate the feasibility of conducting empirical mental health assessments on a large scale, and similar initiatives exist in other countries. However, there is a lack of international consensus on which outcome domains are most salient to mon...