Virginia Aldigé Hiday

• Ph.D.
• North Carolina State University

A Handbook for the Study of Mental Health - edited by Teresa L. Scheid June 2017

Objective: This study compared recidivism among mental health court (MHC) participants and MHC-eligible defendants in traditional criminal court (TCC) two years after MHC exit or court disposition to investigate longer-term MHC impacts and effects beyond provision of treatment and services. Methods: Archival data from the pretrial services agenc...

Mental health courts (MHCs), nontraditional problem-solving courts designed to address underlying causes of offending rather than apportion guilt and punishment, have been reported to reduce offending among persons with mental illness and consequently have been spreading. Graduation from a MHC has been found to be a major predictor of reduced recid...

Mental health courts (MHCs) operate on the principles of procedural justice (PJ). PJ highlights the importance of process over outcomes in encounters with authority. Subjective perceptions of having voice, being heard by decision-makers, and being treated with respect and concern by figures of authority are influential in assessment of fairness and...

This article investigated criminal recidivism 1 year postexit from a mental health court (MHC), which has, unlike prior MHCs studied, relatively short periods of court supervision. It benefits from a federal pretrial services agency that screens all arrestees for mental illness and dedicates a specialized supervision unit (SSU) to provide supervisi...

This chapter reviews the law’s role as society’s agent for controlling the deviant behavior of persons with mental illness and empirical research examining that role and its effects. In considering the civil law, it describes changes in use of involuntary hospitalization but focuses on use of outpatient commitment and other forms of leveraged treat...

There are now more than 300 mental health courts in the United States; yet studies on their effectiveness in reducing criminal recidivism are relatively few, and most follow defendants after entry into the court, during their participation, and sometimes, for a short period following exit. Using a preenrollment-postexit design that follows particip...

For most of history, society controlled mentally disordered behavior informally; but with ­modernization it developed formal organizational controls for the behavior it recognized as mentally disordered. This chapter examines relatively recent formal attempts by two systems, the legal and mental health systems, to define and execute control over pe...

Based on qualitative observation and quantitative data from eight mental health courts (MHCs), this article argues that observed reductions in recidivism from participation in MHC are caused in part by the role of the judge in conveying elements of procedural justice. Specifically, the judge provides: (1) a heightened level of interpersonal treatme...

Relatively few studies have evaluated whether mental health courts reduce criminal recidivism. This study evaluated an established court and followed for two years defendants who exited the program in the court's fifth year of operation. Court administrative data and state arrest records for 99 defendants who exited a mental health court in 2005 we...

The lively debate over mandated community treatment in general and outpatient commitment laws (OPC) in particular has raised many issues. At its core, the debate is over how and to what extent laws should be formulated to persuade, leverage or coerce (PLC) persons with severe mental illness living in the community to comply with medications that me...

Mental health courts have been proliferating across the country since their establishment in the late 1990's. Although numerous advocates have proclaimed their merit, only few empirical studies have evaluated their outcomes. This paper evaluates the effect of one mental health court on criminal justice outcomes by examining arrests and offense seve...

Much research, but not all, appears to show that persons with severe mental illness are more dangerous and violent than others; but it is misleading and feeds the stigma cannon. This paper critically reviews reported correlations between severe mental illness and violence, examines their statistical confounds, highlights studies which seek causal m...

This article presents a comprehensive review of empirical micro-level research which has attempted to evaluate changes in civil commitment law in the United States. It groups studies by category of the general question they address: Who are being processed through civil commitment and who are being committed? How dangerous are civil commitment cand...

Purpose of review: The aim of this article is to evaluate the social control exerted on persons with severe mental illness by civil commitment and arrest under conditions of increasing limits on mental hospitalization and on resources for community treatment and services. Recent findings: Although no accurate count of police encounters with persons...

This article briefly describes the historical conditions in the origin and development of outpatient commitment that framed the discourse on its merits and the empirical studies on its outcomes. It divides those empirical studies into two sets on the basis of the questions addressed and critically reviews them. The review pays particular attention...

Culture and economic development influence how disability is perceived, distributed, and responded to. Physical disability resulting from disease, malnutrition, and accidents is more common in developing nations than in more developed nations (United Nations General Assembly, Resolution 37/53, Dec. 3, 1982). Poor prenatal nutrition, obstetric skill...

The authors' goal was to evaluate the effectiveness of outpatient commitment in reducing victimization among people with severe mental illness. One hundred eighty-four involuntarily hospitalized patients were randomly assigned to be released (N=99) or to continue under outpatient commitment (N=85) after hospital discharge. An additional group of pa...

This study examines self-reported coercion in subjects with severe mental illness who were randomly assigned in an experimental study to continue under, or be released from, involuntary outpatient commitment (OPC) subsequent to hospital discharge. After review of bivariate relationships, multivariable analyses demonstrated significantly higher leve...

This study examines potential improvement in treatment adherence during a study of involuntary outpatient commitment among individuals with severe mental illnesses. Involuntarily hospitalized subjects, awaiting discharge under outpatient commitment, were randomly assigned to be released or continue under outpatient commitment after hospital dischar...

A randomized controlled trial of outpatient commitment was conducted in North Carolina to provide empirical data on involuntary outpatient commitment and to evaluate its effectiveness in improving outcomes among persons with severe mental illnesses. A total of 331 involuntarily hospitalized patients awaiting discharge under outpatient commitment we...

Involuntary outpatient commitment (OPC) is a promising but controversial legal intervention that may reduce criminal justice contact in persons with severe mental illness (SMI). This article examines arrest outcomes in a 1-year randomized study of OPC in 262 participants with SMI in North Carolina. Extended OPC was found to be significantly associa...

Violent behaviour among persons with severe mental illness (SMI) causes public concern and is associated with illness relapse, hospital recidivism and poor outcomes in community-based treatment. To test whether involuntary out-patient commitment (OPC) may help to reduce the incidence of violence among persons with SMI. One-year randomised trial of...

The goal of this study was to evaluate the effectiveness of involuntary outpatient commitment in reducing rehospitalizations among individuals with severe mental illnesses. Subjects who were hospitalized involuntarily were randomly assigned to be released (N = 135) or to continue under outpatient commitment (N = 129) after hospital discharge and fo...

This study examined beliefs about the provisions of outpatient commitment and their effects among 306 people with severe and persistent mental illness who were awaiting a period of outpatient commitment. More than 80 percent of the respondents perceived that the court order for outpatient commitment required them to keep their appointments at the m...

People in the Shadows: The Many Faces of Mental Illness. Nowhere to Go: Homelessness and Mental Illness. Jails and Prisons. Walking Time Bombs: Violence and the Mentally Ill. Psychiatric Ghettos: Communities and Families. Looking Backward: Where We Have Been. New Initiatives in Funding. From Legal Folly to Common Sense: The Right to Get Well. From...

The need to better understand and manage risk of violent behavior among persons with severe mental illness (SMI) in community care is increasingly being recognized. Of particular concern is a subset of the SMI population characterized by a "revolving door" pattern of institutional recidivism and poor adherence to outpatient treatment. Little empiri...

The types and amounts of crime experienced by persons with severe mental illness were examined to better understand criminal victimization in this population. Subjects were 331 involuntarily admitted psychiatric inpatients who were ordered by the court to outpatient commitment after discharge. Extensive interviews provided information on subjects'...

Data from a sample of severely and persistently mentally ill involuntary patients indicated that differences in violence between males and females in the 4 months prior to hospital admission depended on the measure. In the bivariate analysis, males had a greater prevalence of violence on the two indicators which separated more serious violence from...

Increasing numbers of severely mentally ill individuals are being treated in nonhospital, community-based settings and public concern about potential violence by these individuals has increased, often as a result of tragic, albeit uncommon events. The present study examines potential predictors of serious violence among persons with severe mental i...

The need to better understand and manage risk of violent behavior among people with severe mental illness in community care settings is increasingly being recognized, as public-sector mental health systems face mandates to provide more cost-effective services in less restrictive environments. The potential for serious violence in a small proportion...

Violent behavior among individuals with severe mental illness has become an important focus in community-based care. This study examines the joint effect of substance abuse and medication noncompliance on the greater risk of serious violence among persons with severe mental illness. Involuntarily admitted inpatients with severe mental illness who w...

In this sample of 331 people with severe mental disorders, 20% reported being arrested or picked up by police for a crime at some time in the 4-month period before their hospital admission, most commonly for alcohol or drug offenses or crimes of public disorder (e.g., loitering or trespassing). Risk of a police encounter was significantly related t...

The dominant medical model's focus on the individual in etiology, prognosis, and treatment has influenced the description of the violence associated with mentally ill persons in both medical records and research reports such that it appears separate from the social context in which it occurs, separate from social and interpersonal interactions, and...

Our analysis confirms the findings of previous studies that considerable variation exists in patient perceptions of coercion. That we find such variance even among our sample members who were all legally involuntarily hospitalized supports the findings of previous studies that objective legal status and subjective feelings of coercion are not equiv...

Many experimental trials of community mental health interventions fail to develop testable conceptual models of the specific mechanisms and pathways by which relevant outcomes may occur, thus falling short of usefully interpreting what happens inside the experimental "black box." This paper describes a conceptual model of involuntary outpatient com...

Involuntary outpatient commitment (OPC) is a civil justice procedure intended to enhance compliance with community mental health treatment, to improve functioning, and to reduce recurrent dangerousness and hospital recidivism. The research literature on OPC indicates that it appears to improve outcomes in rates of rehospitalization and length of st...

Given the controversy that coercive treatment has generated in psychiatry and law, it is surprising that there is not a wealth of data on the extent and outcomes of coercion. One would expect that the most basic data on the incidence of formal, legal involuntary hospitalization within a nation would be published by each government. Most nations, ho...

Coerced mental health treatment in the community that is mandated by court order is known as outpatient commitment. This official mandatory mental health treatment in the community grew out of the 1960s and 1970s civil rights reform of mental health law when basic principles of due process and protection of individual liberties were applied to ment...

For years a debate existed in the literature concerning whether or not mentally ill persons were more dangerous than others. Empirical work was hampered by conceptual and methodological shortcomings, and was therefore unable to settle the debate. Recently, methodologically sophisticated studies have produced evidence which indicates a modest associ...

Involuntary outpatient commitment has been used as a method of improving tenure in community programs for individuals with severe and persistent mental illness. This paper reviews literature on research about involuntary outpatient commitment and suggests questions and methods for future research. Literature describing research studies of involunta...

Inescapable Decisions examines the disarray in the American health care system and proposes major corrective strategies. Mechanic shows that the high-technology interventionist type of medicine commonly practiced in the United States has lost its sense of priorities and balance. Expensive and sometimes dangerous procedures of unknown efficacy are u...

This study examined one part of the criminalization thesis, which holds that the dangerousness standard of reform civil commitment law has led to the frequent arrest of mentally ill persons. It followed a large statewide sample of civil commitment candidates for 6 months through arrest records to observe their number and type of arrests. It found t...

This study examined one part of the criminalization thesis, which holds that the dangerousness standard of reform civil commitment law has led to the frequent arrest of metally ill persons. It followed a large statewide sample of civil commitment candidates for 6 months through arrest records to observe their number and type of arrests. It found th...

To gauge whether more stringent civil commitment criteria have led to the criminalization of mentally ill persons, forcing them into jails and prisons instead of treating them, a statewide sample of 1,226 civil commitment candidates in North Carolina was tracked for six months after their commitment hearings. Only 72 sample members were arrested du...

This paper describes the use and effectiveness of outpatient commitment in inducing compliance with treatment among chronically mentally ill "revolving door" patients, those who recurrently become dangerous and revolve though civil commitment courts as well as state mental hospitals. Patients characteristics, treatment modalities, and mental health...

Studied a sample of 727 civil commitment candidates both in and out of the hospital for 6 mo following their postcourt hearings to determine their postcourt dangerousness. Dangerousness was measured by dividing it into 5 legal components of behavior: type, object, frequency, weapon/means, and severity of outcome. Using data from ward charts, readmi...

The authors interviewed adult civil commitment excandidates about their perceptions of commitment six months after discharge. Scales were developed for the following constructs: perceived need of commitment, perceived personal consequences of commitment, view of medication, view of primary hospital physician, and view of hospital experience. Excand...

PART ONE: SITES Decision-Making Discourse Part 1 Decision-Making Discourse Part 2 A Policy Intervention The Pre-Admission Clinic Going Private Ceremonial Forms in a Medical Oncology Clinic PART TWO: CONSTITUTING SUBJECTS Coercive Interpretation in the Clinic The Social Constitution of the Down's Syndrome Child Consumerist Medicine in a Cleft-Palate...

Data collected in a statewide study of psychiatric patients involved in civil commitment hearings in North Carolina were used to evaluate the effectiveness of outpatient commitment as a less restrictive alternative to involuntary hospitalization. Six months after the commitment hearings, outcome data for patients who were committed to outpatient tr...

This study presents data from a large statewide sample of civil commitment respondents, which challenge beliefs about the deleterious effects of the dangerousness standard on the mentally ill and on mental hospitals. Using objective behavioral criteria, this study finds that the mentally ill brought into the civil commitment process and those commi...

Most research on Acquired Immune Deficiency Syndrome (AIDS) has been medical and most social science research on AIDS has been concerned with social factors in its spread and with social-psychological effects of contracting AIDS. This study was conducted to examine public attitudes toward, and public knowledge about AIDS. Knowledge about AIDS was m...

Using data from official court records and observations in court hearings throughout one state with a typical reform statute, this study investigates the elderly against whom petitions are brought for involuntary civil commitment. In relation to their proportion in the population, the aged are only slightly more likely than younger persons to becom...

The author surveyed 101 attorneys and judges involved in civil commitment procedures to answer the question of how they view psychiatrists, mental hospitals, and the mentally ill. She found that these lawyers and judges tended to view psychiatrists in favorable terms, that their attitudes toward mental hospitals reflected their perception of the we...

Regression analysis is applied to civil commitment decisions to evaluate the importance of psychiatric opinion, externally visible "facts," and judges' attitudes. Indices were constructed of evidence of dangerousness, based on information presented at court hearings, and of judges' attitudes toward psychiatrists, mental hospitals, and the mentally...

Using quantifiable attorney behavior measures, instead of outcome measures, both before and during court hearings, this study attempts to evaluate legal representation under reform civil commitment procedures. Counsel representing involuntary commitment respondents full time were well prepared. Court appointed counsel, though better prepared than r...

Reviews the contributions of research on the sociology of mental health law to the understanding of the conditions and costs of various legal paths to social order, individual liberty, and mental health. It is argued that a focus on issues of legal effectiveness has led to the neglect of theory testing and development, and D. Black's (1972, 1976) t...

For two years, all court-ordered outpatient treatment in one civil commitment court was followed for the maximum time of an initial commitment, three months. Based on involuntary readmissions and involuntary commitments, outpatient commitment for the dangerously mentally ill was found to have a high success rate; only 12.5% of the respondents were...

All mentions of specific types and dimensions of dangerous behavior, given by witnesses in testimony in 414 civil commitment hearings of allegedly dangerous mentally ill adults in one state, were recorded. A positive association between involutary commitment and evidence of dangerous behavior as defined by appellate courts was found. Commitments in...

A self-selected sample of primary care physicians (general practitioners, family specialists, internists, obstetricians/gynecologists) in a southern county completed structured, precoded questionnaires on a random sample of their patients. Approximately 16% of the patients were diagnosed as having mental health problems. Most common were psychologi...

The effect of migration on fertility in a less developed nation is studied in this analysis by a comparison of three groups of women: 1) rural sedentary; 2) rural to rural migrants; and 3) rural to urban migrants. Age specific fertility rates and child-woman ratios reveal a declining gradient of fertility with social distance from the rural home co...