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Corrections, Mental Health, and Social Policy: International Perspectives

by Robert K. Ax and Thomas J. Fagan, eds., (2007). Corrections, Mental Health, and Social Policy: International Perspectives. Springfield, IL: Charles C. Thomas, Publisher Ltd., $63.95, 418 + xxvii pages.

In this, the middle volume of their three-part series, Robert Ax and Thomas Fagan, co-editors of the Correctional Mental Health Handbook (SAGE, 2003) and Correctional Mental Health (SAGE, 2011), give more extended attention to international developments in correctional mental health, although the full collection of 14 articles is also well-grounded in American practice. In particular, Ax and Fagan, who were forensic psychologists in the Federal Bureau of Prisons for many years, frame this collection within record-setting U.S. prison populations.

 Ax and Fagan note that "the task of providing adequate mental health care to the burgeoning U.S. prison population, including those thousands with serious mental illnesses who have defaulted from the nation's disjointed mental health systems, increasingly compels a consideration of approaches and ideas beyond those generated in the domestic academic-practitioner community. Beyond this, the government of the U.S. is increasingly confronted with mental health concerns that transcend borders and national sovereignty. In this category are the treatment and management of terrorists, immigrants, political prisoners, transnational gang members, and drug traffickers, and those who have been victimized by imprisonment. These are matters which mental health professionals have chosen or been forced to confront for many years. Certainly, as the United States faces the social and political consequences of globalization, correctional mental health professional can benefit from the experiences of their foreign colleagues."

U.S. prison populations are starting to decline slightly, but Ax and Fagan remain on target.

Corrections, Mental Health, and Social Policy consists of four major sections covering corrections and mental health in the United States, corrections and mental health in Western European traditions, current mental health challenges for correctional systems, and future directions for the intersection of corrections and mental health. Individual chapters have strong reference sections and the volume is well-indexed.

Opening chapters describes American correctional mental health care within historical and international context. Co-editor Ax describes international influences on American practices from the Enlightenment to 1976. He notes, with concern, that "from its inception as a clinical specialty, correctional mental health care functioned within a rigid organizational hierarchy where treatment missions were necessarily subordinate to those of safety and security."  Indiana State University psychologist Jennifer Boothby stresses the value of examining international practices in the development of responses to contemporary correctional mental health problems, and R. Scott Chavez of the National Commission on Correctional Health Care discusses correctional mental health from a public health perspective.

The second section features articles on Western European democracies, such as Canada, England and Wales, France, and New Zealand, which have "cultural, intellectual, and institutional heritage" similar to the United States. The four articles in this section describe data-based, innovative policies and interventions in these nations. They also describe the evolution of psychological research on criminal offenders in these nations. In all these countries, as it has developed, increased reliance on incarceration-based "get-tough" practices has impeded progress.

Section three examines six matters that present particular challenges to, and lessons for, correctional systems: effective correctional treatment for mentally disordered offenders; the role of nongovernmental organizations; terrorism-related prison policy and practice; prison gangs; the death penalty; and different perspectives on correctional systems in China, Russia, and South Africa. In this latter article, Texas Tech psychologists Aven Senter, Robert Morgan, and Jon T. Mandracchia note that information about mental health treatment in non-Western countries is scarce, but they add issues in these nations seem similar to those we find in ours, including the influence of growing populations on concerns about health care and infectious disease.

Of central importance is an article from Canadians Paula Smith, Paul Gendreau, and Claire Goggin on "'What Works' in Predicting Hospitalization and Relapse: The Specific Responsivity Dimension of Effective Correctional Treatment for Mentally Disordered Offenders." This article raises concerns about the paucity of information on predicting outcomes for mentally disordered offenders. The meta-analyses conducted for this article suggest that various "moderators" (e.g., gender, treatment compliance, previous psychiatric stays) affect the magnitude of predicted outcomes. Of interest, the Camberwell Family Interview was found especially well-suited as a predictor of rehospitalization and relapse.

Closing out the volume, co-editor Fagan, along with Sheila M. Brandt, former editor of the important journal, Psychological Services, and Andrea L. Kleiver, observe how similar countries are in terms of the problems they face, but also how different they are in the remedies they put into practice. These authors then conclude with three lessons culled from international experience: the value of more information sharing, cooperation, collaboration, and integration of services between correctional and community-based organizations; the importance of learning from the experiences of others; and the value of making long-term decisions and policies based on data wherever and whenever possible.

Posted Fri, Aug 26 2011 2:07 PM by Tracey Vessels
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