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The aim of this thesis was to describe how mentally disordered offenders would be affected by reintroducing the accountability requirement within Swedish legislation, based on social workers’ preconceptions. Mental illness creates a number of issues within criminal justice systems. Almost all countries worldwide have an insanity defense in order to obtain de-criminalization of mentally disordered offenders. However, mentally disordered offenders are criminalized within Sweden’s current legislation. Therefore, the government is proposing a legislative reform. The reform suggests that the accountability requirement will be reintroduced within Swedish legislation. Within this inquiry semi-structured face-to-face interviews were conducted with six forensic social investigators. In light of Becker’s labeling theory and Goffman’s theory of stigma the results reveal social, psychological and behavioral consequences of the new legislation. The participants believe that, de-criminalization provides social and psychological advantages for mentally ill persons. Nevertheless, excusing people from responsibility might produce irresponsible behavior. Since responsibility is an essential part in rehabilitation as well as preventing criminal recidivism.

The relevance of individuals' values to clinical situations is increasingly recognised in political and clinical contexts. Enhancing an individual's capacity to live consistently with their values is assumed to facilitate mental well-being and quality of life (QoL). However, little research has empirically investigated whether this focus is appropriate. This collection of studies will examine the relationship between values, well-being and QoL. "Valued living" is a core aim of Acceptance and Commitment Therapy (ACT) but it has received little empirical attention. The values identified within ACT may not be equally applicable to all clinical populations. Encouraging value-consistent action is often assumed to be inappropriate to offender populations. Schwartz‟s universal model of human values is introduced to inform understanding of the relationship between values and well-being and whether mentally disordered offenders (MDOs) have similar values to a non-psychologically distressed comparison group. Method Study 1 investigated the relationship between values, quality of life (QoL), psychological distress and psychological inflexibility (cognitive fusion and experiential avoidance) amongst a sample from the non-clinical sample (N = 109) using an online survey. Study 2 compared a subsample from study 1 with MDOs detained in medium security (N = 15) on the same measures. Study 3 explored participants‟ beliefs about the origin and maintenance of meaningful values. Responses were coded according to ACT literature and analysed using content analysis. Results Amongst the non-clinical population, QoL was positively correlated with „valued living‟, and negatively correlated with psychological inflexibility and distress. Psychological distress and psychological inflexibility correlated positively with the Openness to Change value domain and conservatism correlated negatively with psychological distress. No other relationships were observed between psychological flexibility or distress and value domain in the non-clinical population. MDOs had higher rates of psychological distress and lower psychological flexibility and QoL than the non-distressed population; they also attributed less importance to the self-transcendence value domain and more to self-enhancement. Benevolence was ranked significantly lower by the MDO sample. Other large effect sizes were detected reflecting differences between the samples, but they were not statistically significant. Intrinsic reinforcement was considered an important factor that maintained values as meaningful to all participants. Self-report data suggests that there are similarities and differences to how each sample conceptualises values. Discussion A clinical focus on values appears to be justified. The addition of Schwartz‟s model provided insight into the values of MDOs. The clinical and theoretical implications of the results are discussed as are the strengths and limitations of the study.

No / Secure provision for women in both the Criminal Justice System and the Health Service has evolved in the last decade, in line with emerging gender-specific policy. Notable gains have been the approach to self-harm in prison and a reduction in the inappropriately high levels of secure hospital care. Although treatment pilots in UK settings are in progress, much practice remains poorly described and insufficiently evaluated. Recent strategic initiatives by both the Ministry of Justice and the Department of Health, as well as the commissioning changes that have followed the Health and Social Care Act 2012, provide a basis for reconsideration and a further paradigm shift. Suggestions for a reinvigorated model of gender-sensitive provision are made, relying on principles of resilience and autonomy. / Secure provision for women in both the Criminal Justice System and the Health Service has evolved in the last decade, in line with emerging gender-specific policy. Notable gains have been the approach to self-harm in prison and a reduction in the inappropriately high levels of secure hospital care. Although treatment pilots in UK settings are in progress, much practice remains poorly described and insufficiently evaluated. Recent strategic initiatives by both the Ministry of Justice and the Department of Health, as well as the commissioning changes that have followed the Health and Social Care Act 2012, provide a basis for reconsideration and a further paradigm shift. Suggestions for a reinvigorated model of gender-sensitive provision are made, relying on principles of resilience and autonomy.

Psychological assessment of mentally disordered offenders requires a systematic consideration of response styles, including malingering and defensiveness. Important components of these evaluations are standardized diagnostic interviews. However, the ability of offenders to feign mental disorders on such measures to achieve such external incentives as treatment, placement on safer units, or possible release from jail remains uninvestigated. With a known-groups comparison with the data from the Structured Interview of Reported Symptoms as a criterion, 24 suspected malingerers were compared to 64 genuine patients on the Schedule of Affective Disorders and Schizophrenia (SADS), the abbreviated SADS-C, the Suicide Probability Scale, and the Referral Decision Scale.

When assessing the risk of violence, increasing interest has been shown in bringing science and practice closer together. Moving from clinical intuition in the first generation of risk assessment via actuarial scales in the second generation to the structured professional judgments where risk assessments are today produces better, more valid results when assessing the risk of violence. One of the best predictors of violence is gender. Approximately 10% of the violent criminality can be attributed to women; even so, it is increasing, especially among young women. It is therefore important to examine risk assessments from a gender perspective. Another important factor when assessing the risk of violence is psychopathy and there are indications that there might be gender differences in this diagnosis. Thus, a special interest has been focused on psychopathy in this thesis. The purpose with this work is to explore the similarities and differences in assessing risk for violence in male and female mentally disordered offenders, while the overall aim is to validate the violence risk assessment instrument HCR-20 for Swedish offender populations. The risk assessments for all six studies in this thesis were made by trained personnel using the HCR-20 instrument, where psychopathy was diagnosed with the screening version of the Psychopathy Checklist (PCL:SV). The study populations were both male and female mentally disordered offenders in either the correctional or the forensic setting. The findings show that both the validity and the reliability of the HCR-20 and the PCL:SV were good and the clinical and risk management subscales were found to have better predictive validity than the historical scale. Another finding was that there were more similarities than differences between genders in the HCR-20, while the opposite applied to the PCL:SV, where the antisocial behavior was performed in a different manner. Moreover, it was found that the gender of the assessor might be a factor to take into account when assessing the risk of violence in women, where the recommendation was that at least one assessor should be female. The conclusions were that the HCR-20 and the PCL:SV can be used In Swedish offender populations with valid results. For female offenders, there are differences in the antisocial behavior that is assessed in order to diagnose psychopathy and these differences tend to underestimate psychopathy among female offenders. Furthermore, the gender of the assessor might be of greater importance than has previously been realized. The overall conclusion was that this thesis supports the structural professional judgment method of making risk assessments in order to prevent violence in the community.

When assessing the risk of violence, increasing interest has been shown in bringing science and practice closer together. Moving from clinical intuition in the first generation of risk assessment via actuarial scales in the second generation to the structured professional judgments where risk assessments are today produces better, more valid results when assessing the risk of violence. One of the best predictors of violence is gender. Approximately 10% of the violent criminality can be attributed to women; even so, it is increasing, especially among young women. It is therefore important to examine risk assessments from a gender perspective. Another important factor when assessing the risk of violence is psychopathy and there are indications that there might be gender differences in this diagnosis. Thus, a special interest has been focused on psychopathy in this thesis. The purpose with this work is to explore the similarities and differences in assessing risk for violence in male and female mentally disordered offenders, while the overall aim is to validate the violence risk assessment instrument HCR-20 for Swedish offender populations. The risk assessments for all six studies in this thesis were made by trained personnel using the HCR-20 instrument, where psychopathy was diagnosed with the screening version of the Psychopathy Checklist (PCL:SV). The study populations were both male and female mentally disordered offenders in either the correctional or the forensic setting. The findings show that both the validity and the reliability of the HCR-20 and the PCL:SV were good and the clinical and risk management subscales were found to have better predictive validity than the historical scale. Another finding was that there were more similarities than differences between genders in the HCR-20, while the opposite applied to the PCL:SV, where the antisocial behavior was performed in a different manner. Moreover, it was found that the gender of the assessor might be a factor to take into account when assessing the risk of violence in women, where the recommendation was that at least one assessor should be female. The conclusions were that the HCR-20 and the PCL:SV can be used In Swedish offender populations with valid results. For female offenders, there are differences in the antisocial behavior that is assessed in order to diagnose psychopathy and these differences tend to underestimate psychopathy among female offenders. Furthermore, the gender of the assessor might be of greater importance than has previously been realized. The overall conclusion was that this thesis supports the structural professional judgment method of making risk assessments in order to prevent violence in the community.

Police officers are allowed considerable discretion within the criminal justice system in addressing illegal behaviors and interpersonal conflicts. Broadly, such resolutions fall into two categories: formal (e.g., arrest) and informal outcomes. Many of these interventions involve persons who have historically faced stigmatization, such as those who have mental disorders, criminal histories, or both (i.e., mentally disordered offenders). On this point, stigma generally includes discriminatory behavior toward the stigmatized person or group and can be substantially influenced by internal and external attributions. In addition, researchers have suggested that internal attributions lead to punishing behaviors and external attributions lead to helping behaviors. The current study examined attributions about offender behavior made by police officers in an effort to evaluate the effectiveness of Corrigan’s model. Specifically, this study investigated the effects of officer attributions on their immediate decisions in addressing intentionally ambiguous and minor offenses. Officers provided one of two vignettes of a hypothetical offender who was either mentally disordered or intoxicated and provided their anticipated resolution of the situation. Encouragingly, disposition decision differed by offender condition, with a substantially higher rate of arrests for the intoxicated offender (i.e., the external condition). Corrigan’s model was initially successful for both offender conditions, but was overall more successful for the mentally disordered condition. Results are discussed within the broader context of police policy, such as crisis intervention training, and identification of officers who could benefit from additional mental health trainings.

[pt] A presente tese tem por objetivo analisar como o direito penal brasileiro, enquanto discurso, contribui para legitimar as formas peculiares de operacionalidade violenta do sistema penal sobre adolescentes e portadores de sofrimento psíquico autores de infrações penais. Imbricados a esse problema empírico estão os problemas normativos e dogmáticos das inconsistências e fragilidades da imputabilidade e da sua negativa, razão pela qual a tese também busca verificar se é possível repensar a teoria do delito em função da garantia de direitos humanos e fundamentais desses sujeitos; e, em caso positivo, em que termos. Os referenciais teóricos adotados são o realismo jurídico-penal marginal, o funcionalismo teleológico-redutor, a antipsiquiatria e os movimentos de reforma psiquiátrica em geral, e a criminologia crítica latino-americana. Assim, primeiro, investiga-se o desenvolvimento histórico das construções discursivas da inimputabilidade por idade e por sofrimento psíquico no Brasil, bem como da edificação dos seus respectivos sistemas tutelares de medidas correcionais e terapêuticas desde o Império até os dias atuais. Na sequência, analisam-se as principais alternativas e inovações formuladas na teoria do delito, em especial, no âmbito da imputabilidade. Ao final, conclui-se pela defesa da imputabilidade enquanto elemento autônomo da estrutura analítica do delito, dotada de fundamentos materiais, conceituação e posição sistemática próprias, o que implica em alterações na teoria do delito e no sistema de penas e medidas. / [en] This thesis aims to analyse how Brazilian Criminal Law, taken as a discourse, contributes to legitimate the peculiar forms of violent operability of its penal system upon adolescents and mentally disordered offenders. The normative and dogmatic problems of inconsistency and fragilities over the capacity of culpability (imputability) and its negative are related to this empirical problem, and that is why the thesis also aims to verify if it is possible to rethink the theory of crime regarding the guarantee of those subjects human and fundamental rights; and, if so, in what terms. The theoretical references adopted are the marginal realism, the teleological-reductive functionalism, antipsychiatry and psychiatric reform movements in general, and the latin-american critical criminology. Therefore, firstly, the thesis investigates the historical development of the discoursive constructions about the absence of culpability by reasons of age and mental disorders in Brazil, as well as the making of its respective tutelary systems of correctional and therapeutical measures since the Empire to this day. In sequel, the main alternatives and inovations formulated within theory of crime are analysed, specially concerning the capacity of culpability. In conclusion, the thesis states that capacity of culpability – imputability, in fact – is an autonomous element within the analytical structure of crime, gifted with its own material basis, conceptualization and systematic position, which implicates changes in theory of crime and the system of punishments and correctional measures.