Publication Type: Conference Paper/Unpublished Manuscript
Review Method: Peer Reviewed
Abstract: Criminological researchers, have focused on persistence and desistence from offending, but not considered the issue in mental health populations. This research identifies age-related patterns of offending over a 10 year period in a developmental framework, and analyzes temporal patterns of criminal involvement among a statewide cohort of Massachusetts Department of Mental Health clients. Persons with two or more arrests during that period were analyzed using the zero-inflated Poisson trajectory analysis yielding five “trajectories” of arrest. This presentation offers an overview of cohort characteristics, and discusses charges associated with arrests in the cohort and the charge categories used in the analysis.

Publication Type: Conference Paper/Unpublished Manuscript
Abstract: My goal is to better conceptualize mental health, mental illness and distress by introducing the concept of alienation. I first review the literature on mental illness and mental health attempting to clarify these concepts. Based upon the efforts of positive psychology, I then examine the distinctions between mental health and mental illness and the possibility that these are distinct phenomena. I will argue that alienation and distress provide the mechanisms for facilitating this move. To be more specific, my analysis suggests mental health and alienation constitute one continuum while mental illness and distress constitute a separate yet related continuum. I then move to an empirical test, using data from the National Survey of Midlife Development in the Unites States (MIDUS) and confirmatory factor analysis (CFA) to assess the model fit.

Publication Type: Conference Paper/Unpublished Manuscript
Abstract: Improving the experiences of victims and witnesses is a key priority for the UK Ministry of Justice that is reflected in The Court Experience of Vulnerable People Research Programme. The programme includes systematic reviews and original empirical research. This paper reports on research into the Court Experience of Vulnerable People in the Criminal and Civil systems. Overall the research aims to determine how the courts system supports the complex and specific needs of adults with mental health problems, learning disabilities and mental capacity. The research is being conducted in two phases and phase 1 of the research aims to:

• Identify a comprehensive list of policies, services and practices available to support parties, victims and witnesses with mental health problems, learning disabilities and limited mental capacity;
• Explore how these vary across England and Wales and how this affects the quality of local service provision; and
• Assess the aims of different service models, explore how different agencies operate and explore any early examples of potential good practice.

The paper reports on the overall research design, methodology, methods and preliminary findings from Phase 1.

Publication Type: Invited Paper
Abstract: To date, more than 182,000 women have been deployed to Iraq, Afghanistan and surrounding countries. Many of these women are mothers.
In this paper, using case studies drawn from fifty oral history interviews with women combat vets from all branches of the armed service, I will explore the ways that female Marines, soldiers, sailors and airmen negotiate the complexities of juggling deployments and motherhood�and the way that stories about deploying mothers shape public opinion about women in combat. While technically women are barred from combat, these women are often being mortared on their Forward Operating Bases, doing house-to-house searches, conducting I.E.D. sweeps, and serving as gunners on convoys.

As one pregnant marine told me, �If the Marine Corps had wanted us to have babies, they would have issued them.� However, the reality is that more and more mothers are deploying to a war zone�and that with the U.S. military stretched to the limit of its resources, many mothers are experiencing repeat deployments. Their stories range from that of Marine Corporal Jocelyn Proano, who bitterly regretted leaving her one-year old daughter to deploy to Iraq�and who then ended up extending her deployment for six months so she wouldn�t have to leave her unit, to Army Sergeant Connica McFadden, who deployed with her husband when she was breast-feeding her six-month old daughter, and who returned to find that the child did not recognize her parents, and cried when left alone with them: it was two months before her baby would consent to go home with her. Many women I have interviewed joined the military in order to get health insurance for children with major health problems.

Many of these combat vets are single mothers, which throws issues of child care into sharper relief. As well, however, many of them embrace the martial values which have traditionally been seen as masculine. As Corporal Proano told me, �You want to be a Marine, and you can�t be a mom all the time. I feel bad for wanting to go out again, but I don�t want to live my life in the Marine Corps thinking, �man, I should�ve deployed again � I should�ve done this.�� Many female soldiers have talked to me about wanting to deploy again, in order to experience the singleness of purpose, the camaraderie, and even, in some cases, the adrenaline rush of facing danger. These comments challenge commonly held perceptions about the overriding nature of the �maternal impulse,� and suggest the way that some women are rethinking the ways that they can raise their children while maintaining a military career. But at the same time, the issues faced by deploying mothers, ranging from loss of custody to altered relationships with their children, may force the public to consider the implications of the current administrations Global War on Terror�a war which, by its very definition, has no end in sight.

Publication Type: Abstract
Abstract: Background: Research has shown that how mental health services are financed affects the types and amounts of services provided. Most of these studies have considered differences between fee-for-service (FFS) providers and capitated provider groups. To our knowledge, no published study has examined the characteristics of contractual relationships typical of county-based public mental health systems in California.

Objectives: To analyze the relationship between financing and service delivery in a large community public mental health system among three provider types: county providers, county-contracted providers, and FFS providers.

Research Design: We examined outpatient services, hospitalizations and use of emergency services, and costs for persons treated for schizophrenia, bipolar disorder, or major depression in San Diego County in fiscal years 2002-2003 and 2003-2004 (N=20,562). We assigned clients to one of the three provider types based on where they received the majority of their medication management services. Costs were determined by detailed examination of contracts and cost reports, and were linked to individual level encounter data. Multivariate models were used to adjust for a number of socio-demographic and clinical characteristics expected to affect service use.

Results: Outpatient service use was greatest, and total costs lowest, among clients of county-contracted providers. Clients of FFS providers were more likely than clients of county or county-contracted providers to be admitted to an acute psychiatric facility.

Conclusions: Mental health services use and costs in this population are related to provider type.