Vitacco Michael J, Vauter Rebecca, Erickson Steven K, Ragatz Laurie
Department of Psychiatry and Health Behavior, Georgia Regents University.
Eastern State Hospital.
Law Hum Behav. 2014 Aug;38(4):346-56. doi: 10.1037/lhb0000071. Epub 2013 Dec 30.
Detailed research on treatment and risk management approaches with not guilty by reason of insanity acquittees (NGRI) during their conditional release is needed as states increasingly use community-based services for these individuals. Grounded in case law, and supported by follow-up studies demonstrating low recidivism rates, states have been encouraged in their efforts to conditionally release NGRI acquittees. The authors evaluated a state-wide sample of 127 NGRI acquittees released into the community after spending a mean of 61.63 months (SD = 76.54) in the hospital. One hundred individuals were committed to the hospital for lengthier treatment (M hospital time = 77.23 months, SD = 79.84), but 27 individuals were released to the community after a relatively short hospital stay (M hospital time = 5.60 months, SD = 3.01). Regarding release, 96 individuals (75.6%) maintained their conditional release. After evaluating a host of demographic and standardized risk data, the following variables predicted revocation on conditional release: previous failure on conditional release, nonadherence with hospital treatment, dangerousness to others, and previous violent charges. A multivariate survival analysis determined criminal behavior and previous failure on conditional release predicted time to revocation. The results of this study demonstrate the importance of considering standardized risk variables in the community-based management of forensic patients. In addition, the data are supportive of continued attempts at moving insanity acquittees from the hospital to the community via conditional release.
随着各州越来越多地为因精神错乱而被判无罪的被释放者（NGRI）提供基于社区的服务，有必要对他们在有条件释放期间的治疗和风险管理方法进行详细研究。基于判例法，并得到后续研究表明其再犯率较低的支持，各州在有条件释放NGRI被释放者方面的努力受到了鼓励。作者评估了一个全州范围的样本，其中127名NGRI被释放者在医院平均住院61.63个月（标准差 = 76.54）后被释放到社区。其中100人被送往医院接受更长时间的治疗（平均住院时间 = 77.23个月，标准差 = 79.84），但有27人在相对较短的住院时间（平均住院时间 = 5.60个月，标准差 = 3.01）后被释放到社区。关于释放情况，96人（75.6%）维持了他们的有条件释放。在评估了一系列人口统计学和标准化风险数据后，以下变量预测了有条件释放的撤销：之前有条件释放失败、不遵守医院治疗、对他人有危险性以及之前有暴力指控。多变量生存分析确定犯罪行为和之前有条件释放失败预测了撤销时间。这项研究的结果表明，在对法医患者进行基于社区的管理时，考虑标准化风险变量的重要性。此外，这些数据支持继续尝试通过有条件释放将因精神错乱而被判无罪的人从医院转移到社区。
