Conditional Release Placements of Insanity Acquittees in Oregon: 2012–2014

Abstract

Between January 1, 2012 and December 31, 2014, there was a large population (N = 200) of insanity acquittees placed on conditional release (CR) in the state of Oregon. This article looks at the demographic and system characteristics of this large group of individuals. The authors then focus on the initial housing placement and what happens to individuals after their release in relation to their housing placement. In Oregon, insanity acquittees are either conditionally released directly by the court or placed in the hospital prior to potential CR by a supervising board. In general, once CR occurs, individuals tend to stay in their initial placement without moving to less structured levels of care, raising concerns about transinstitutionalization. This is especially true for individuals released to the most structured living arrangement (secure residential treatment facility). Those individuals who are conditionally released to less structured settings have a higher rate of revocation back to the hospital. Those individuals who do move to less structured levels of care usually have longer hospital stays and start off in more structured levels of care to start their CR. Copyright © 2016 John Wiley & Sons, Ltd.

Risk assessment and provisional discharge: Predictive utility of the HCR-20.

“…Overall, the rate of return to the hospital in the current sample (22%) was comparable to recent trends nationally (Novosad et al, 2016; Vitacco et al, 2014). Those who ultimately returned to the hospital were able to maintain community status for an average of nearly three years, indicating a period of successful transition before problems arose.…”

“…Second, the current study is limited in that data regarding placement setting (e.g., group home, independent housing, family) were not available for those provisionally discharged to the community. Such factors could be controlled in subsequent research as there is some indication that placement type may be predictive of returns from conditional release (Marshall et al, 2014; Novosad et al, 2016) and, overall, more research is warranted on the impact of placement type on successful community reintegration. While risk communication was not the primary focus of the study, the data available in narrative-format reports was limited due to unscored items and inconsistent reporting of summary risk judgments and relevance ratings, which highlights the importance of clear, comprehensive report writing (Storey et al, 2015).…”

Hospital treatment of persons found not guilty by reason of insanity

“…Supportive housing plays a particularly important role in maintaining the success of insanity acquittees in the community. Novosad, Banfe, Britton, and Bloom (2016) studied insanity acquittees released to different types of housing (e.g., independent apartments, secure residential facilities, family's homes), finding that individuals who are conditionally released to less structured settings have a higher rate of revocation back to the hospital. Salem et al (2015) found that individuals placed in independent housing following conditional release from the hospital were 2.5 times more likely to commit a new offense, nearly three times more likely to commit an offense against a person, and 1.4 times more likely to be readmitted for psychiatric treatment compared with individuals residing in supportive housing.…”