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In its narrowest sense, "mentally disordered offender" refers to
the approximately twenty thousand persons per year in the United
States who are institutionalized as not guilty by reason of
insanity, incompetent to stand trial, and mentally disordered sex
offenders, as well as those prisoners transferred to mental
hospitals. The real importance of mentally disordered offenders,
however, may not lie in this figure. Rather, it may reside in the
symbolic role that mentally disordered offenders play for the rest
of the legal system. The 3,140 persons residing in state
institutions on an average day in 1978 as not guilty by reason of
insanity (see Chapter 4), for example, are surely worthy of concern
in their own right. But they represent only 1% of the 307,276
persons residing in state and federal prisons in the same period
(U. S. Dept. of Justice, 1981). From a purely numeric point of
view, the insanity defense truly is "much ado about little"
(Pasewark & Pasewark, 1982). The central importance of
understanding these persons, however, is that they serve a symbolic
function in justifying the imprisonment of the other 99%. The
insanity defense, as Stone (1975) has noted, is "the exception that
proves the rule. " By exculpating a relatively few people from
being criminally responsible for their behavior, the law inculpates
all other law violators as liable for social sanction.
In its narrowest sense, "mentally disordered offender" refers to
the approximately twenty thousand persons per year in the United
States who are institutionalized as not guilty by reason of
insanity, incompetent to stand trial, and mentally disordered sex
offenders, as well as those prisoners transferred to mental
hospitals. The real importance of mentally disordered offenders,
however, may not lie in this figure. Rather, it may reside in the
symbolic role that mentally disordered offenders play for the rest
of the legal system. The 3,140 persons residing in state
institutions on an average day in 1978 as not guilty by reason of
insanity (see Chapter 4), for example, are surely worthy of concern
in their own right. But they represent only 1% of the 307,276
persons residing in state and federal prisons in the same period
(U. S. Dept. of Justice, 1981). From a purely numeric point of
view, the insanity defense truly is "much ado about little"
(Pasewark & Pasewark, 1982). The central importance of
understanding these persons, however, is that they serve a symbolic
function in justifying the imprisonment of the other 99%. The
insanity defense, as Stone (1975) has noted, is "the exception that
proves the rule. " By exculpating a relatively few people from
being criminally responsible for their behavior, the law inculpates
all other law violators as liable for social sanction.
In courts across the country, judges depend on mental health
experts to determine whether mentally disordered people are
dangerous. But experts' ability to predict violence is severely
limited, and they are wrong as often as they are right. This study
reviews two decades of research on mental disorder and offers new
empirical and theoretical work that will pave the way for more
accurate predictions of violent behavior. Essential for all those
who are interested in the study of risk assessment of violence. It
is particularly important for the researcher in this area. . . .
For the clinician who must make violence assessments it is
important reading as well.--Stewart Levine, Bulletin of the
American Academy of Psychiatry and the Law
Rethinking Risk Assessment tells the story of a pioneering investigation that challenges preconceptions about the frequency and nature of violence among persons with mental disorders, and suggests an innovative approach to predicting its occurrence.
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