Geographic Risk Management: A Spatial Study of Mentally Disordered Offenders Discharged from Forensic Psychiatric Care

Abstract

We investigated the impact of neighborhood and community factors on the reintegration of forensic patients leaving custodial care in British Columbia, Canada. Using geographic information systems (GIS) techniques, the residential locations of a sample of forensic patients were tracked over time and mapped in relation to each other. The frequency of a patient's return to hospital was monitored and the reasons for these returns were recorded after each unsuccessful community placement. The analysis of the findings suggested that patients who were released to certain, socially disorganized neighborhoods returned to inpatient care at a higher frequency. These neighborhoods exhibited many destabilizing features that may have significant influence on the long-term success or failure of discharge patients, such as low income, high unemployment, poor educational achievement, and concentrated rental accommodation. Further research is needed in order to explore not only the influence of neighbourhood destabilizers on the length of community placements for forensic mental health patients, but also the underlying rationale for locating patient services in socially disorganized areas.

Keywords:

• Mental disorder
• spatial analysis
• social disorganization
• risk management
• neighbourhood

This research was supported by a grant from the Forensic Psychiatric Services Commission of British Columbia. The views expressed herein are those of the authors and do not necessarily represent those of the Commission.

Notes

¹Routine activities theory outlines which elements are necessarily present for a criminal event to occur. Researchers theorized that in order for crime to occur, three factors must intersect in the same temporal and spatial setting: the presence of a motivated offender, the existence of a suitable target, and the absence of a capable guardian (Felson, 1998). These three fundamental factors create a model or formula for criminal events that combine the social environment along with individuality of offenders and targets.

²Guardianship from a routine activities view is somewhat dissimilar from the surveillance function of panoptic prisons explored by Foucault. For surveillance to succeed in behavior reform, individuals must believe they could be seen by authority at any time. Under this theory, citizens would then internalize the surveillance function and police themselves; whereas routine activities theory insists that watchful guardianship is needed from a separate party to protect against deviant behaviors.

³The concept of a moderating variable is being used here as intended by Baron & Kenny, 1986. In this way, threatening environments may affect the correlations between other variables, such as relationships and social networks.

⁴The 52 patients who did not return to the hospital after their first conditional discharge were not tracked further in this study. If they were not required to return to inpatient care due to a deepening of their illness, a breach of their order, or the commission of a new crime during the study period, the patient's experiences in the community were no longer recorded for this research.

⁵Low income designation is determined by Federal Census regulations, and is reserved for households whose income falls below a standard set by the Federal government.

⁶The authors wish to thank one of the anonymous reviewers for this insight.