Anne Crocker | Université de Montréal (original) (raw)
Papers by Anne Crocker
The First Wave of COVID-19 in Forensic Psychiatry: A Rapid Review Series
Victims & offenders, Dec 28, 2022
What Happens after Discharge from a Forensic Psychiatric Hospital?: An Analysis of Causally Complex Patterns of Recovery among People Found Non-criminally Responsible on Account of Mental Disorder
International Journal of Forensic Mental Health, Oct 7, 2022
Exploring the nature and prevalence of targeted violence perpetrated by persons found not criminally responsible on account of mental disorder
Behavioral Sciences & The Law, May 3, 2023
Although mental illness has a demonstrated link with violence, the prevalence of targeted (planne... more Although mental illness has a demonstrated link with violence, the prevalence of targeted (planned and goal‐directed) violence perpetrated by individuals with mental illness and its association with psychiatric symptoms is relatively unexplored. File information was compared for all 293 individuals found not criminally responsible due to mental illness in British Columbia between 2001 and 2005, of whom 19% had committed targeted violence. Most individuals with targeted offenses displayed at least one warning behavior before their offense (93%); all displayed delusions and approximately one third exhibited hallucinations. Compared to individuals who perpetrated non‐targeted offenses, the individuals with targeted offenses displayed greater proportions of threats/criminal harassment, had female victims, displayed a psychotic disorder and/or personality disorder, and displayed delusions during the offense. This implies that severe psychiatric disorders do not preclude the perpetration of planned violence and suggests that exploring symptoms of mental illness that may be proximally indicative of targeted violence is important in preventing future acts.
Attitudes of health care professionals toward people with intellectual disability: a comparison with the general population
Journal of Intellectual Disability Research, Jul 2, 2018
BackgroundFew studies have examined attitudes that may promote the social inclusion of persons wi... more BackgroundFew studies have examined attitudes that may promote the social inclusion of persons with an intellectual disability (ID) among health care providers (HCPs). Yet these attitudes could impact the accessibility and quality of services provided to this population, as well as the general attitudes of HCPs. The objectives of this study were to (1) examine HCPs' pro‐inclusion attitudes toward people with ID, (2) compare these to the general population's attitudes and (3) examine how HCPs' attitudes vary as a function of their socio‐demographic characteristics.MethodThe Attitudes Toward Intellectual Disability Questionnaire was administered to 367 HCPs and a representative sample of the Québec population (N = 1605).ResultsResults indicated that at least half of HCPs displayed positive attitudes, that is, attitudes that are compatible with notions of social inclusion and equal rights, toward individuals with ID. Positive attitudes were less frequently observed for the Interaction and the Sensitivity or tenderness factors measured by the Attitudes Toward Intellectual Disability Questionnaire. In comparison with the general population, HCPs exhibited more positive attitudes on the Knowledge of causes and Sensitivity or tenderness factors and less positive attitudes on the Interaction factor. HCPs who regarded themselves as more knowledgeable about ID and those who reported higher quality contacts or interactions with persons with ID expressed attitudes that were more favourable toward social inclusion.ConclusionsIn addition to providing general knowledge about ID and the specific health care needs of individuals with ID, training programmes should also promote interactions with this population. Further studies are needed to document HCPs' pro‐inclusion attitudes toward people with ID and to assess the impact of interventions on these attitudes.
Traumatismes complexes et services psycholégaux : vers des pratiques sensibles au trauma
Santé mentale au Québec, 2022
Violence Prevention Climate in Civil and Forensic Mental Health Settings: Common Goal, Different Views?
International Journal of Forensic Mental Health
How Do Persons Found NCRMD and Identified as Indigenous Differ from Other Persons Found NCRMD: Profiles, Trajectories, and Outcomes
International Journal of Forensic Mental Health
Community treatment orders: A qualitative study of stakeholder perspectives
International Journal of Law and Psychiatry
Survol de l’organisation des services de santé mentale forensique à travers le monde : vers un modèle hiérarchisé-équilibré
Santé mentale au Québec, 2022
[Complex Trauma and Forensic Mental Health Services: Towards Trauma-informed Care]
Santé mentale au Québec, 2022
Objectives Exposure to repeated traumatic events during childhood and adolescence is associated w... more Objectives Exposure to repeated traumatic events during childhood and adolescence is associated with high prevalences of mental illness, addictions, physical health conditions, and psychosocial difficulties (Felitti et al., 2019). The most common consequence of exposure to trauma is violence towards self and others (Hughes et al., 2017). The very high prevalence of complex trauma among forensic mental health service users challenges these settings to modify their practices, training approaches, policies, and service delivery approaches. The objective of this article is to contribute to such a transformation of forensic mental health services by clarifying the impacts of complex trauma on the trajectories and experiences of forensic mental health services users, as well as practices responding to complex trauma. Methods We reviewed the published and grey literature on complex trauma among forensic mental health service users. After synthesizing the findings, they were contrasted with our experiences as clinicians and researchers in the field of forensic mental health care through the development of a case vignette. Results We first identify the role of complex trauma and victimization in the development and maintenance of violent behaviours. We describe the negative experiences of services and care settings reported by individuals with complex trauma in the absence of recognition and understanding of traumatic experiences and their impacts. We highlight the fundamental principles of trauma-informed care (trust and transparency; safety; peer support; collaboration and reciprocity; empowerment and choice; sensitivity to gender, cultural and historical differences), as well as the clinical and organizational approaches emerging from those principles. Next, we describe the approaches developed internationally to apply and implement trauma-informed care in forensic mental health setting, and the opportunities and challenges associated with their implementation in the Québec context. Conclusion To date, few studies have documented and evaluated the implementation of trauma-informed care in forensic mental health settings. The literature reviewed in this paper indicates that an in-depth understanding of complex trauma among forensic mental health service users should be at the core of contemporary forensic research, policies and practices.
[Beyond Housing: The Heterogenous Effect of Housing First on Criminal Justice Outcomes Among Homeless People With Mental Illness]
Santé mentale au Québec, 2022
Background Housing First does not, on average, reduce criminal justice involvement. This analysis... more Background Housing First does not, on average, reduce criminal justice involvement. This analysis aims to test whether the overall absence of an impact is due to intervention effect heterogeneity as a function of the pattern of lifetime criminal justice involvement, identified through latent class analysis conducted through earlier work. Methods This analysis relied on data from the Montréal, Toronto and Vancouver sites of the Canadian At Home/Chez Soi randomized controlled trial, merged with administrative records of lifetime criminal charges (N = 1,321). Negative binomial models with interaction terms were used to estimate the impact of Housing First, in comparison to treatment as usual, on violent charges, acquisitive charges (e.g., theft, sex work), and administration of justice charges (e.g., breach of probation), for each pre-identified profile. Results Participants with past criminal justice involvement associated with a chronic history of homelessness or with criminalized substance use experienced a decrease in violent charges as a result of Housing First, whereas those with no or little past criminal justice involvement experienced a marginal increase. Housing First did not affect acquisitive or administration of justice charges, regardless of profile. Conclusions Findings suggest that integrating criminological or forensic mental health tools, knowledge and approaches into the multidisciplinary teams that support Housing First service users may be an effective solution, so that all aspects of their recovery, including potential criminogenic needs, are addressed. Future research should focus on the feasibility and effectiveness of such adjunct interventions.
Les méthodes et enjeux relatifs à l’évaluation du risque de la violence hétérodirigée
Santé mentale au Québec
Effectiveness of Forensic Assertive Community Treatment on Forensic and Health Outcomes: A Systematic Review and Meta-Analysis
Criminal Justice and Behavior
Given the increasing literature on forensic assertive community treatment (FACT), we conducted a ... more Given the increasing literature on forensic assertive community treatment (FACT), we conducted a systematic review and meta-analysis to explore the effectiveness of FACT among justice-involved individuals with severe mental illness. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Sixteen studies were included in the systematic review, six of which were included in the meta-analyses for a total of 1,246 participants. Mixed results regarding health-related outcomes were found. The pre-post FACT analysis and comparison with control groups did not yield significant results other than increased outpatient service use. Results on forensic outcomes were more compelling. Both the narrative review and the meta-analysis highlighted that FACT programs may improve justice outcomes such as the number of days spent in jail. More high quality and multisite randomized controlled trials are needed to consolidate findings. Further research is ...
Journal of Sexual Aggression, 2018
Using data from the National Trajectory Project, we compared 50 individuals found Not Criminally ... more Using data from the National Trajectory Project, we compared 50 individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD) for sexual offences with 50 age-and gender-matched individuals found NCRMD for nonsexually violent offences. We also described the concurrent offenses, the symptoms at the time of the offense and the characteristics of the victims of offenders found NCRMD for sexual offences. Persons found NCRMD for sexual offences were less likely to be employed and were significantly younger at time of first psychiatric contact, but did not differ in other sociodemographic characteristics, other aspects of their psychiatric histories or in criminal history. Despite no differences in recidivism and no differences in behaviours between Review Board hearings when adjusting for unequal time at risk, persons found NCRMD for sexual offences had longer tenures under a Review Board mandate than persons found NCRMD for nonsexually violent offences. Given the many similarities between the two groups, this finding suggests that Review Boards may be unnecessarily conservative in how they manage sexual offenders.
Predicting housing trajectories of forensic patients
Persons with ID facing the criminal justice system
Quality of Life Research, 2015
for depression and anxiety Por: Obbarius, A (Obbarius, Alexander)[ 1 ] ; Clark, D (Clark, David)[... more for depression and anxiety Por: Obbarius, A (Obbarius, Alexander)[ 1 ] ; Clark, D (Clark, David)[ 2 ] ; Crocker, AG (Crocker, Anne G.)[ 3 ] ; Emmelkamp, P(Emmelkamp, Paul)[ 4 ] ; Furukawa, TA (Furukawa, Toshi A.)[ 5 ] ; Hedman, E (Hedman, Erik)[ 6 ] ; Kangas, M (Kangas, Maria)[ 7 ] ;Lesage, A (Lesage, Alain)[ 8,9 ] ; Mwesigire, DM (Mwesigire, Doris M.)[ 10 ] ; Nolte, S (Nolte, Sandra)[ 1 ] ...Más Ver ResearcherID y ORCID QUALITY OF LIFE RESEARCH Volumen: 24 Páginas: 110-111 Suplemento: 1 Abstract de reunión: 1088 Fecha de publicación: OCT 2015 Ver información de revista
Social Psychiatry and Psychiatric Epidemiology, 2018
Purpose To quantify the demand for forensic psychiatric services in Ontario over the past 25 year... more Purpose To quantify the demand for forensic psychiatric services in Ontario over the past 25 years and investigate whether the sociodemographic, clinical and offense-based characteristics of forensic patients have changed over time. Methods We investigated all forensic admissions from 1987 to 2012 resulting in a disposition of Not Criminally Responsible on account of Mental Disorder (N = 2533). We present annual proportions of patients with specified sociodemographic, clinical and offense characteristics, and investigate whether the duration of forensic system tenure varies as a function of admission year, psychiatric diagnosis, or index offense. Results There has been a steady increase in forensic admissions over this time period, particularly individuals with comorbid substance use disorders and individuals of non-Caucasian ethno-racial background. The proportion of persons committing severe violence has remained low and has decreased over time. Having a comorbid personality, neurological, or substance use disorder significantly increased forensic system tenure, as did committing a violent offense. Individuals who came into the system in earlier years had slower rates of discharge compared to more recent admissions. Conclusions Defining the trends characterizing the growth of the forensic population has important policy implications, as forensic services are costly and involve a significant loss of liberty. The current results indicate that young, substance abusing individuals of diverse ethno-racial backgrounds and who commit relatively low-level violence comprise an increasing proportion of Ontario's forensic population, and suggest that treatment must be optimized to best serve the needs of these individuals.
The First Wave of COVID-19 in Forensic Psychiatry: A Rapid Review Series
Victims & offenders, Dec 28, 2022
What Happens after Discharge from a Forensic Psychiatric Hospital?: An Analysis of Causally Complex Patterns of Recovery among People Found Non-criminally Responsible on Account of Mental Disorder
International Journal of Forensic Mental Health, Oct 7, 2022
Exploring the nature and prevalence of targeted violence perpetrated by persons found not criminally responsible on account of mental disorder
Behavioral Sciences & The Law, May 3, 2023
Although mental illness has a demonstrated link with violence, the prevalence of targeted (planne... more Although mental illness has a demonstrated link with violence, the prevalence of targeted (planned and goal‐directed) violence perpetrated by individuals with mental illness and its association with psychiatric symptoms is relatively unexplored. File information was compared for all 293 individuals found not criminally responsible due to mental illness in British Columbia between 2001 and 2005, of whom 19% had committed targeted violence. Most individuals with targeted offenses displayed at least one warning behavior before their offense (93%); all displayed delusions and approximately one third exhibited hallucinations. Compared to individuals who perpetrated non‐targeted offenses, the individuals with targeted offenses displayed greater proportions of threats/criminal harassment, had female victims, displayed a psychotic disorder and/or personality disorder, and displayed delusions during the offense. This implies that severe psychiatric disorders do not preclude the perpetration of planned violence and suggests that exploring symptoms of mental illness that may be proximally indicative of targeted violence is important in preventing future acts.
Attitudes of health care professionals toward people with intellectual disability: a comparison with the general population
Journal of Intellectual Disability Research, Jul 2, 2018
BackgroundFew studies have examined attitudes that may promote the social inclusion of persons wi... more BackgroundFew studies have examined attitudes that may promote the social inclusion of persons with an intellectual disability (ID) among health care providers (HCPs). Yet these attitudes could impact the accessibility and quality of services provided to this population, as well as the general attitudes of HCPs. The objectives of this study were to (1) examine HCPs' pro‐inclusion attitudes toward people with ID, (2) compare these to the general population's attitudes and (3) examine how HCPs' attitudes vary as a function of their socio‐demographic characteristics.MethodThe Attitudes Toward Intellectual Disability Questionnaire was administered to 367 HCPs and a representative sample of the Québec population (N = 1605).ResultsResults indicated that at least half of HCPs displayed positive attitudes, that is, attitudes that are compatible with notions of social inclusion and equal rights, toward individuals with ID. Positive attitudes were less frequently observed for the Interaction and the Sensitivity or tenderness factors measured by the Attitudes Toward Intellectual Disability Questionnaire. In comparison with the general population, HCPs exhibited more positive attitudes on the Knowledge of causes and Sensitivity or tenderness factors and less positive attitudes on the Interaction factor. HCPs who regarded themselves as more knowledgeable about ID and those who reported higher quality contacts or interactions with persons with ID expressed attitudes that were more favourable toward social inclusion.ConclusionsIn addition to providing general knowledge about ID and the specific health care needs of individuals with ID, training programmes should also promote interactions with this population. Further studies are needed to document HCPs' pro‐inclusion attitudes toward people with ID and to assess the impact of interventions on these attitudes.
Traumatismes complexes et services psycholégaux : vers des pratiques sensibles au trauma
Santé mentale au Québec, 2022
Violence Prevention Climate in Civil and Forensic Mental Health Settings: Common Goal, Different Views?
International Journal of Forensic Mental Health
How Do Persons Found NCRMD and Identified as Indigenous Differ from Other Persons Found NCRMD: Profiles, Trajectories, and Outcomes
International Journal of Forensic Mental Health
Community treatment orders: A qualitative study of stakeholder perspectives
International Journal of Law and Psychiatry
Survol de l’organisation des services de santé mentale forensique à travers le monde : vers un modèle hiérarchisé-équilibré
Santé mentale au Québec, 2022
[Complex Trauma and Forensic Mental Health Services: Towards Trauma-informed Care]
Santé mentale au Québec, 2022
Objectives Exposure to repeated traumatic events during childhood and adolescence is associated w... more Objectives Exposure to repeated traumatic events during childhood and adolescence is associated with high prevalences of mental illness, addictions, physical health conditions, and psychosocial difficulties (Felitti et al., 2019). The most common consequence of exposure to trauma is violence towards self and others (Hughes et al., 2017). The very high prevalence of complex trauma among forensic mental health service users challenges these settings to modify their practices, training approaches, policies, and service delivery approaches. The objective of this article is to contribute to such a transformation of forensic mental health services by clarifying the impacts of complex trauma on the trajectories and experiences of forensic mental health services users, as well as practices responding to complex trauma. Methods We reviewed the published and grey literature on complex trauma among forensic mental health service users. After synthesizing the findings, they were contrasted with our experiences as clinicians and researchers in the field of forensic mental health care through the development of a case vignette. Results We first identify the role of complex trauma and victimization in the development and maintenance of violent behaviours. We describe the negative experiences of services and care settings reported by individuals with complex trauma in the absence of recognition and understanding of traumatic experiences and their impacts. We highlight the fundamental principles of trauma-informed care (trust and transparency; safety; peer support; collaboration and reciprocity; empowerment and choice; sensitivity to gender, cultural and historical differences), as well as the clinical and organizational approaches emerging from those principles. Next, we describe the approaches developed internationally to apply and implement trauma-informed care in forensic mental health setting, and the opportunities and challenges associated with their implementation in the Québec context. Conclusion To date, few studies have documented and evaluated the implementation of trauma-informed care in forensic mental health settings. The literature reviewed in this paper indicates that an in-depth understanding of complex trauma among forensic mental health service users should be at the core of contemporary forensic research, policies and practices.
[Beyond Housing: The Heterogenous Effect of Housing First on Criminal Justice Outcomes Among Homeless People With Mental Illness]
Santé mentale au Québec, 2022
Background Housing First does not, on average, reduce criminal justice involvement. This analysis... more Background Housing First does not, on average, reduce criminal justice involvement. This analysis aims to test whether the overall absence of an impact is due to intervention effect heterogeneity as a function of the pattern of lifetime criminal justice involvement, identified through latent class analysis conducted through earlier work. Methods This analysis relied on data from the Montréal, Toronto and Vancouver sites of the Canadian At Home/Chez Soi randomized controlled trial, merged with administrative records of lifetime criminal charges (N = 1,321). Negative binomial models with interaction terms were used to estimate the impact of Housing First, in comparison to treatment as usual, on violent charges, acquisitive charges (e.g., theft, sex work), and administration of justice charges (e.g., breach of probation), for each pre-identified profile. Results Participants with past criminal justice involvement associated with a chronic history of homelessness or with criminalized substance use experienced a decrease in violent charges as a result of Housing First, whereas those with no or little past criminal justice involvement experienced a marginal increase. Housing First did not affect acquisitive or administration of justice charges, regardless of profile. Conclusions Findings suggest that integrating criminological or forensic mental health tools, knowledge and approaches into the multidisciplinary teams that support Housing First service users may be an effective solution, so that all aspects of their recovery, including potential criminogenic needs, are addressed. Future research should focus on the feasibility and effectiveness of such adjunct interventions.
Les méthodes et enjeux relatifs à l’évaluation du risque de la violence hétérodirigée
Santé mentale au Québec
Effectiveness of Forensic Assertive Community Treatment on Forensic and Health Outcomes: A Systematic Review and Meta-Analysis
Criminal Justice and Behavior
Given the increasing literature on forensic assertive community treatment (FACT), we conducted a ... more Given the increasing literature on forensic assertive community treatment (FACT), we conducted a systematic review and meta-analysis to explore the effectiveness of FACT among justice-involved individuals with severe mental illness. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Sixteen studies were included in the systematic review, six of which were included in the meta-analyses for a total of 1,246 participants. Mixed results regarding health-related outcomes were found. The pre-post FACT analysis and comparison with control groups did not yield significant results other than increased outpatient service use. Results on forensic outcomes were more compelling. Both the narrative review and the meta-analysis highlighted that FACT programs may improve justice outcomes such as the number of days spent in jail. More high quality and multisite randomized controlled trials are needed to consolidate findings. Further research is ...
Journal of Sexual Aggression, 2018
Using data from the National Trajectory Project, we compared 50 individuals found Not Criminally ... more Using data from the National Trajectory Project, we compared 50 individuals found Not Criminally Responsible on account of Mental Disorder (NCRMD) for sexual offences with 50 age-and gender-matched individuals found NCRMD for nonsexually violent offences. We also described the concurrent offenses, the symptoms at the time of the offense and the characteristics of the victims of offenders found NCRMD for sexual offences. Persons found NCRMD for sexual offences were less likely to be employed and were significantly younger at time of first psychiatric contact, but did not differ in other sociodemographic characteristics, other aspects of their psychiatric histories or in criminal history. Despite no differences in recidivism and no differences in behaviours between Review Board hearings when adjusting for unequal time at risk, persons found NCRMD for sexual offences had longer tenures under a Review Board mandate than persons found NCRMD for nonsexually violent offences. Given the many similarities between the two groups, this finding suggests that Review Boards may be unnecessarily conservative in how they manage sexual offenders.
Predicting housing trajectories of forensic patients
Persons with ID facing the criminal justice system
Quality of Life Research, 2015
for depression and anxiety Por: Obbarius, A (Obbarius, Alexander)[ 1 ] ; Clark, D (Clark, David)[... more for depression and anxiety Por: Obbarius, A (Obbarius, Alexander)[ 1 ] ; Clark, D (Clark, David)[ 2 ] ; Crocker, AG (Crocker, Anne G.)[ 3 ] ; Emmelkamp, P(Emmelkamp, Paul)[ 4 ] ; Furukawa, TA (Furukawa, Toshi A.)[ 5 ] ; Hedman, E (Hedman, Erik)[ 6 ] ; Kangas, M (Kangas, Maria)[ 7 ] ;Lesage, A (Lesage, Alain)[ 8,9 ] ; Mwesigire, DM (Mwesigire, Doris M.)[ 10 ] ; Nolte, S (Nolte, Sandra)[ 1 ] ...Más Ver ResearcherID y ORCID QUALITY OF LIFE RESEARCH Volumen: 24 Páginas: 110-111 Suplemento: 1 Abstract de reunión: 1088 Fecha de publicación: OCT 2015 Ver información de revista
Social Psychiatry and Psychiatric Epidemiology, 2018
Purpose To quantify the demand for forensic psychiatric services in Ontario over the past 25 year... more Purpose To quantify the demand for forensic psychiatric services in Ontario over the past 25 years and investigate whether the sociodemographic, clinical and offense-based characteristics of forensic patients have changed over time. Methods We investigated all forensic admissions from 1987 to 2012 resulting in a disposition of Not Criminally Responsible on account of Mental Disorder (N = 2533). We present annual proportions of patients with specified sociodemographic, clinical and offense characteristics, and investigate whether the duration of forensic system tenure varies as a function of admission year, psychiatric diagnosis, or index offense. Results There has been a steady increase in forensic admissions over this time period, particularly individuals with comorbid substance use disorders and individuals of non-Caucasian ethno-racial background. The proportion of persons committing severe violence has remained low and has decreased over time. Having a comorbid personality, neurological, or substance use disorder significantly increased forensic system tenure, as did committing a violent offense. Individuals who came into the system in earlier years had slower rates of discharge compared to more recent admissions. Conclusions Defining the trends characterizing the growth of the forensic population has important policy implications, as forensic services are costly and involve a significant loss of liberty. The current results indicate that young, substance abusing individuals of diverse ethno-racial backgrounds and who commit relatively low-level violence comprise an increasing proportion of Ontario's forensic population, and suggest that treatment must be optimized to best serve the needs of these individuals.