To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Edited by
Katherine Warburton, California Department of State Hospitals, University of California, Davis, USA,Stephen M. Stahl, University of California, Riverside, USA
This study explores the effectiveness of antipsychotic medications in restoring competency to stand trial in individuals with severe mental illness, particularly psychotic disorders. While antipsychotic medications are known for reducing symptoms of psychosis, this research focuses on their ability to improve functional outcomes necessary for competency to stand trial (CST). Among over 3,000 patients in California’s forensic state hospital system, 86.5% were successfully restored to competency, with 98.8% discharged on antipsychotic medications. Patients on antipsychotic monotherapy demonstrated higher restoration rates compared to those requiring additional mood stabilizers, suggesting that more complex cases demand more intensive treatment. Delusional disorder, traditionally seen as more resistant to treatment, showed a high restoration rate of 93.8% with antipsychotic use.Our findings emphasize the pivotal role of antipsychotics in not only reducing symptoms but also in restoring critical functional abilities for participation in legal proceedings. The functional improvements they enable extend beyond the courtroom. Incorporation of antipsychotic medication as an integral evidence-based mechanism in facilitating community reintegration for individuals with severe mental illness supports the broader goal of transitioning individuals from the legal system back into society, consistent with the ultimate promise of deinstitutionalization.
Edited by
Katherine Warburton, California Department of State Hospitals, University of California, Davis, USA,Stephen M. Stahl, University of California, Riverside, USA
Throughout its two and a half centuries in existence, US mental health policy has repeatedly failed people living with schizophrenia. The failures are cyclical—the inhumane conditions uncovered in the first 75 years of existence were addressed with the construction of state asylums to deliver moral treatment. One hundred years later, the asylums were themselves revealed to be inhumane. Deinstitutionalization, the response to the failure of asylums starting in the 1960s, now drives outcomes such as homelessness, incarceration, and early death for people living with psychotic illnesses. In all cases, well-intentioned policy reform has failed at the level of implementation, largely due to a lack of accountability. The result has been a consistent failureto adequately treat people living with schizophrenia, which is now understood to be a highly treatable condition. As the country passes into a quarter millennium in existence, reform is once again underway. Unlike other points in history, there is good news. Other countries, such as Italy, have successfully leveraged reform to achieve greatly improved outcomes. Understanding US history and the successful implementation of policy change in other countries is imperative and teaches us that accountability in implementation is necessary to break the cycle of policy failure.
Tax evasion is a significant challenge in many African countries where motivations for tax compliance remain poorly understood. This study investigates whether donations to community goods undermine individuals’ willingness to pay state taxes, particularly where community donations are common and public goods scarce. Using a survey experiment in Kenya, we examine the relationship between community donations and tax compliance attitudes, factoring in access to public goods, government fairness, transparency, and enforcement. Findings indicate that community donations reduce tax compliance attitudes, whereas improved access to public goods enhances positive attitudes toward taxes and trust in government. This suggests that perceptions of a fair exchange with the government can be more important than enforcement.
This forum continues the Journal of Public Policy’s series for debate and discussion of important ideas in the scholarly study of public policy. This exchange is anchored with an essay by Christopher Wlezien entitled, “On Policy Responsiveness: Conditions for Effective Demand and Supply.” Understanding the connection between the public and the officials meant to represent them is fundamental to democratic governance. While there is a voluminous literature from across the political science and policy studies spectrum, Wlezien offers a new framework for examining the “theoretical conditions for effective policy representation.” He develops the concepts of “input” as a function of public demand, and “output” as the result of policy supplied. Wlezien concludes that we observe a surprising amount of congruence between what the public wants and the policy it receives. This conclusion is in stark contrast to more pessimistic views prominent in the recent literature.
Pressing environmental and societal challenges, such as the climate crisis and social inequality, demand policy interventions to steer and accelerate sustainability transitions. This chapter highlights four key intervention areas: providing direction to transitions (directionality), fostering innovation (niche support), phasing out unsustainable practices (regime destabilisation), and coordinating transition processes (coordination). We outline their theoretical rationale in transition studies and offer interdisciplinary insights from policy research. Based on a comprehensive literature review, we present 15 concrete policy interventions to transform production and consumption systems. Evaluating these interventions with empirical findings from leading transition journals, we highlight research opportunities at the intersection of public policy and sustainability transitions. Given the resistance and contestation around transformational policies, we aim to foster interdisciplinary exchange on how to accelerate sustainability transitions.
Jack Kemp’s ascent from cast-off professional football player to conservative national figure requires understanding how the phases of his athletic career, which he filtered through his on-field experiences, shaped his unorthodox hybridity. He was in many ways a standard small-government conservative advocating the tenets of the technocratic Sunbelt New Right, but one who took surprisingly progressive stands on issues of labor and race very much at odds with developing Republican orthodoxy.
Vaccine hesitancy was a major concern during the Covid-19 pandemic, and a significant percentage of healthcare workers (HCWs) proved to be hesitant too. Various governments, including that of Greece, reacted aggressively, imposing mandates stipulating dismission of HCWs from work unless vaccinated. Hesitancy was understood as a case of moral failing and against the principle of ‘do no harm’. In this article, we deploy hermeneutics policy analysis based on interviews and analysis of texts to challenge this view. On the basis of qualitative analysis of transcripts of press conferences organized by the Greek Ministry of Health and 74 interviews with hesitant HCWs, we show that government’s and HCWs’ understanding of the risk of infection and the associated threat posed to the public health system were starkly different. For HCWs, hesitancy was linked to distrust toward political institutions, which should be treated in a different manner from a case of moral failing of HCWs. We argue that, rather than mandates, persuasion is a better strategy, since hesitancy raises the question of trust toward the politicoscientific establishment. Therefore, reforming science advice institutions so that they make use of local expertise and engage civil society is key. We focus on Greece, as we consider it to be an interesting case of a newly established science advice system with a distinctive character that we term the ‘look from inside’, based on the model of ‘ethical chief scientist,’ which makes it a brilliant case study for others considering building or reforming their systems.
Around the start of the 21st century, countries began to experience a unique demographic transition. After generations of declining dependency and expanding labor forces, increasing longevity and persistently low fertility have reversed dependency trajectories. This paper examines the political consequences of rapid demographic aging and retirement reforms. An empirical assessment of 41 countries from 1980 to 2020 suggests that efforts to postpone retirement are politically destabilizing. In particular, increases in average retirement age and labor force participation among older cohorts may increase political instability. Demographic forecasts for rich and middle-income countries indicate a massive growing demand for age-related public services, alongside a rapid decline in the relative size of economically active populations. Policy reform is therefore urgently needed to sustain pension systems, maintain economic growth, and mitigate political instability. The paper concludes that governments must consider country-specific demographic, political, and economic conditions when designing alternatives to potentially destabilizing retirement reforms.
Christian Nationalism has been an increasing focus of scholars as it has seemingly come to dominate much of the Republican Party and its voters. Existing research, however, has focused almost exclusively on individual attitudes. In this article, I examine a key piece of the Christian Nationalist agenda, policy change at the state level, seeking to change individuals’ perception of the religious foundations of the United States through symbolic legislation. I focus on Project Blitz, an organization that creates model bills for state legislators to introduce all over the country. Project Blitz is an explicitly Christian Nationalist effort, and its origins and supporters help demonstrate a key missing piece of the scholarly and popular conversation about Christian Nationalism: the current power and influence of Christian Nationalist attitudes and activities is based on the historical influence of the Christian Right social movement.
Advocating more repressive law and order policies along the slogan ‘tough on crime, tough on the causes of crime’ in their election manifesto, Tony Blair in the United Kingdom and Gerhard Schröder in Germany were elected in the late 1990s. Once in power, however, only New Labour substantially toughened law and order policies, whereas the German Social Democrats did not change the legal status quo, to a similar extent, during their mandate. This article tackles this puzzle, arguing that the preferences of the ministers and the formal and informal rules shaping the balance of power in government are crucial to understanding why two governments that initially advocated similar policies adopted a rather different policy stance. The results are based on meticulous process tracing and a series of elite interviews concerning two major topics in the realm of law and order during the 1990s: policies directed at sexual offenders, and policies responding to the terrorist attacks of 9/11.
In this paper we leverage a sudden shift in refugee settlement policy to study the electoral consequences of refugee settlements. After the 2013 Norwegian parliamentary election, the newly elected right‐wing government made a concerted effort to spread newly arrived immigrants across the country, with the consequence that some municipalities with limited experience in settling refugees accepted to do so. We propose that such policy changes have political consequences, increasing the salience of immigration issues and shifting voters’ preferences to the right. We further propose that successful refugee integration can move (parts of) the electorate to the left, with stronger political polarization as a possible effect of the policy change. Applying difference‐in‐differences techniques, we find no evidence of unidirectional shifts in voter sentiments, but support for the hypothesis of stronger political polarization.
Throughout Latin America, the relationship between government and civil society organizations (CSOs) has been characterized by opposition, substitution, and submission; and, the incipient path to cooperation is barely noticeable. For their part, participatory public policies make sense within a theory of democratic governance. Democratic governance seeks two propositions: (a) participation from other social actors will give rise to more efficient government action; and (b) citizen support will emerge from the said government action. This paper criticizes the current relationships between the governments and CSOs in this region. In addition, it explores the potential strategies that could be adopted were there a cooperation between these two entities. The paper is supported by theoretical literature as well as by a revision of some cases of participatory public policies that are currently active in the region. The paper proposes that the strategies of opposition to government and government substitution have to be abandoned in this region. The paper focuses on civil organizations (CSOs). It is true that they do not constitute the entirety of civil society; however, they are frequently the most organized compared with other civic actors, such as social movements, families, and individual initiatives. CSOs form only a part of the diversity known as civil society; however, they significantly contribute to the discussion about the public good, and very often they participate in providing such goods. The future of participatory democracy in Latin America is related to our ability to achieve a more complete participation of CSOs in the entire process of participatory public policies—from the formation of public agendas to their design, implementation, and evaluation.
Governments face the challenge of fostering the social economy in a context of economic crisis and austerity policies. Despite the high levels of institutional recognition for the considerable social and economic value added by the social economy (SE), government policies following this approach have been scarce during the latest economic recession. This article analyses the case of Spain, a country that has endured deep austerity policies and has a strong SE sector. Building on the SE approach that combines quantitative and qualitative data, this study examines the policies that promoted the SE during two periods: before and during the economic crisis. As a novel contribution, the study compares the political discourse with the policies implemented. The findings highlight a gap between the discourse and the policies implemented during the crisis, showing that the SE has not been prioritized by policymakers, and link that gap with the recent EU economic policy.
Nonprofit and voluntary associations have a long history of defending the rights of their members, clients, and the public. Despite a burgeoning literature on advocacy by nonprofit organizations, few studies attempt to answer a central question: what factors influence nonprofit success in achieving the changes they aim to affect? Using original data from nearly 400 US nonprofits, we examine the extent to which they were involved in changing public policy, the nature of this engagement, and advocacy activities, organizational characteristics and relationships with others associated with reported policy change. More than three quarters of respondents reported having enacted, stopped, or modified policy. Nonprofits more often reported proactively changing policy when working in partnership and reactively stopping or modifying policy when facing opposition groups. Providing expertise and attending meetings was associated with reported policy change, whereas placing opinion ads was not.
The article argues that closer attention to how solidarity is understood and expressed in different European contexts can shed light on the conditions for establishing a social and solidarity economy. Drawing on data collected within the H2020 SOLIDUS project, which explores current expressions of European solidarity, the comparative analysis covers three social economy initiatives, each representing a country with different political and economic context. The analysis focuses on solidarity as reciprocity and, in particular, how it is affected by such factors as actor motivations, internal participatory functioning, resource mix and political legitimacy. While further empirical work is needed, the findings suggest that solidarity as reciprocity produced by social and solidarity economy organisations thrives where political institutions are both supportive and trusted, where public funding is accessible, and where partnerships with relatively autonomous social and solidarity economy organisations are genuinely collaborative.
This article seeks to explore democratic theory by focusing on the example of agonistic democracy, in which contest between citizens is valued for its potential to render politics more inclusive, more engaging, and more virtuous. Using Connolly and Tully's inclusivism, Chantal Mouffe's adversarialism, and David Owen's perfectionism, the article discusses democratic theory as a critique, a series of normative proposals, and a potential bridge between political theory and public policy. It is this bridge that enables democratic theory to pull together critical and normative discussions with those surrounding public policy and institutional design.
This article begins by describing the major characteristics and the origins of multi-level governance (MLG). It then discusses the alleged novelty of MLG practices, whether MLG achieves its goals in terms of policy efficiency and acceptance, and the possible consequences of governance networks for the democratic quality of political decisions. In relation to these matters, it concludes that there is a gap between the intensity of theoretical debate and a lack of systematic empirical research. It thus seeks to provide some indications about promising avenues for ‘second generation’ research that would allow us to give more substantial answers to controversial questions concerning MLG.
There is growing concern among democracy scholars that participatory innovations pose a depoliticizing threat to democracy. This article tackles this concern by providing a more nuanced understanding of how politicization and depoliticization take shape in participatory initiatives. Based on ethnographic research on participatory projects with marginalized people who are invited to act as experiential experts, the article examines how actors limit and open up possibilities to participate. By focusing on struggles concerning the definition of expertise, the article identifies a threefold character of politicization as a practice within participatory innovations. It involves (1) illuminating the boundaries that define the actors’ possibilities; (2) making a connection between these boundaries and specific value bases; and (3) imagining an alternative normative basis for participation.