Treatment Satisfaction in a Civil Commitment Facility for Sexually Violent Persons

Evaluating patient satisfaction in therapeutic settings is consistent with a Risk–Needs–Responsivity (RNR) model. This study provides results from a program improvement initiative in a sexually violent person (SVP) civil commitment facility that queried patients and treatment providers about their satisfaction with therapeutic processes and assessment methods. Overall, patients reported high levels of satisfaction with treatment at the facility, with the highest levels of satisfaction on items about being treated with kindness and respect and staff acting professionally. Providers rated current assessment methods such as the Penile Plethysmography (PPG) assessment, polygraph testing, and neuropsychological testing as most helpful for patients in treatment progress; however, patients rated PPG assessment and polygraph testing as the least helpful of the assessments conducted. Soliciting patient feedback periodically could be important for maintaining treatment engagement and discovering opportunities to enhance patient satisfaction to treatment in a SVP civil commitment setting.

Civil commitment for opioid misuse: do short-term benefits outweigh long-term harms?

In response to a sharp rise in opioid-involved overdose deaths in the USA, states have deployed increasingly aggressive strategies to limit the loss of life, including civil commitment—the forcible detention of individuals whose opioid use presents a clear and convincing danger to themselves or others. While civil commitment often succeeds in providing short-term protection from overdose, emerging evidence suggests that it may be associated with long-term harms, including heightened risk of severe withdrawal, relapse and opioid-involved mortality. To better assess and mitigate these harms, states should collect more robust data on long-term health outcomes, decriminalise proceedings and stays, provide access to medications for opioid use disorder and strengthen post-release coordination of community-based treatment.

Mandatory treatment for methamphetamine use in Australia

Background In 2016, following a flurry of government inquiries and taskforces including calls for mandatory treatment regimes, the Australian community nominated methamphetamine as the drug most likely to be associated as a problem substance. Mandatory treatment for alcohol and other drug problems in Australia consists of broadly two mechanisms compelling a person into treatment: involuntary treatment or civil commitment regimes; and coercive treatment regimes, usually associated with the criminal justice system. This paper aims to provide a review of the evidence for mandatory treatment regimes for people who use methamphetamines. Methods Using a narrative review methodology, a comprehensive literature and citation search was conducted. Five hundred two search results were obtained resulting in 41 papers that had cited works of interest. Results Small, but robust results were found with coercive treatment programs in the criminal justice system. The evidence of these programs specifically with methamphetamine use disorders is even less promising. Systematic reviews of mandatory drug treatment regimes have consistently demonstrated limited, if any, benefit for civil commitment programs. Despite the growing popular enthusiasm for mandatory drug treatment programs, significant clinical and ethical challenges arise including determining decision making capacity in people with substance use disorders, the impact of self determination and motivation in drug treatment, current treatment effectiveness, cost effectiveness and unintended treatment harms associated with mandatory programs. Conclusion The challenge for legislators, service providers and clinicians when considering mandatory treatment for methamphetamines is to proportionately balance the issue of human rights with effectiveness, safety, range and accessibility of both existing and novel mandatory treatment approaches.

Humanistic design, and beyond

The pandemic is consequence of our mistaken relationship with nature is correct. It’s crucial to learn from past mistakes and it’s necessary to create a sustainable horizon of meaning for our thought and our action, centred on the health of the planet, with man as an integral part of nature. The design can contribute: a Humanistic design, based on a civil commitment, that works with the territories, in in a cosmopolitan spirit, with an inclusive project; but also a design which, however, goes beyond Humanism, which takes away the central role of man – an anthropocentrism that through the ages has created numerous problems... -, in the name of a new accord, in harmony with nature as a whole. The Francesco Faccini, Maurizio Montalti, Gionata Gatto, Giovanni Innella and Formafantasma’s designs can be a possible example of this new idea.