Attitudes toward hiring applicants with mental illness and criminal justice involvement: The impact of education and experience

Individuals with mental health diagnoses, as well as those involved in the criminal justice system, experience a number of barriers in the recovery and reintegration progress, including access to stable, prosocial employment opportunities. Employment for these populations is important for establishing financial security, reducing unstructured leisure time, increasing self-worth, and improving interpersonal skills. However, research has demonstrated that individuals with psychiatric and/or criminal backgrounds may experience stigmatizing attitudes from employers that impede their ability to find adequate work. This study aimed to evaluate stigmatizing beliefs toward hypothetical applicants who indicated a mental health history, a criminal history, or both, as well as the effectiveness of psychoeducation in reducing stigma. Participants consisted of 465 individuals recruited from a large university who completed a series of online questions about a given applicant. Results of this study varied somewhat across measures of employability, but were largely consistent with extant research suggesting that mental illness and criminal justice involvement serve as deterrents when making hiring decisions. Overall, psychoeducation appeared to reduce stigma for hiring decisions when the applicant presented with a criminal history. Unfortunately, similar findings were not revealed when applicants presented with a psychiatric or a psychiatric and criminal history. Implications and limitations of these findings are presented, along with suggestions for future research.     

Treating offenders with mental illness: a research synthesis

The purpose of this research synthesis was to examine treatment effects across studies of the service providers to offenders with mental illness. Meta-analytic techniques were applied to 26 empirical studies obtained from a review of 12,154 research documents. Outcomes of interest in this review included measures of both psychiatric and criminal functioning. Although meta-analytic results are based on a small sample of available studies, results suggest interventions with offenders with mental illness effectively reduced symptoms of distress, improving offender's ability to cope with their problems, and resulted in improved behavioral markers including institutional adjustment and behavioral functioning. Furthermore, interventions specifically designed to meet the psychiatric and criminal justice needs of offenders with mental illness have shown to produce significant reductions in psychiatric and criminal recidivism. Finally, this review highlighted admission policies and treatment strategies (e.g., use of homework), which produced the most positive benefits. Results of this research synthesis are directly relevant for service providers in both criminal justice and mental health systems (e.g., psychiatric hospitals) as well as community settings by informing treatment strategies for the first time, which are based on empirical evidence. In addition, the implications of these results to policy makers tasked with the responsibility of designating services for this special needs population are highlighted.     

Dangerous mentally disordered criminals: unresolvable societal fear?

The average person fears dangerous criminals, especially those suffering from mental illness. Existing mental health and criminal justice systems provide social control for some of these dangerous individuals, but may be inadequate to deal with those mentally disordered offenders who were not found not guilty by reason of insanity (NGI). In California, innovative laws have attempted to address this problem. However, putative lack of efficacious treatment of mentally ill criminals, insufficient economic support, and individual liberty concerns loom as limiting factors in solving the criminal and psychiatric recidivism problem posed by non-NGI dangerous mentally disordered offenders.     

Citizenship, mental illness, and the criminal justice system

The concept of citizenship in regard to persons with mental illness has gained increasing attention in recent years, but little empirical research has been conducted on this topic. In addition, little research or conceptual writing has been done on the topic of criminal justice in regard to citizenship for people with mental illness, in spite of the high incidence of criminal charges and incarceration among this group. We review our work on an applied theoretical framework of citizenship, including its origins in mental health outreach work to people who are homeless and in a jail diversion program. We then suggest the contribution the framework can make to the intersecting issues of mental illness, its criminalization in the U.S., and the goal of community integration for people with mental illness.     

Medical school forensic psychiatry units in health care delivery facilities rather than criminal justice institutions: an alternative model

We have presented a model for developing forensic psychiatric treatment and teaching services of a medical school Department of Psychiatry, but where these services are the basic comprehensive health care delivery system for the entire community. These offer consultative and treatment services for adult and family court clinic, psychiatric forensic services, of forensic psychiatry open bed and medium security-type bed, as well as day hospital and outpatient services. All of these are sited in the normal health care delivery system of the university teaching hospitals and its patient treatment, teaching, and research facilities. Consultative services are offered on request to the criminal justice system, but the basic health care delivery system is controlled administratively by the ordinary university teaching hospital authorities and exists as a one of a kind unit at the Royal Ottawa Hospital. The Royal Ottawa Hospital is a private nonprofit hospital, with its own Board of Trustees, and is affiliated with the medical school, as part of a major university network. We believe it important to present this model for an overall forensic psychiatric service, in contradistinction to the more commonly established forensic psychiatric facilities in state mental hospitals, in a special facility for the criminally insane, or in a criminal justice system institution such as a penitentiary. We believe that our model for forensic psychiatric facilities has great advantages for the patient. Here the patient is treated in a specialized facility (as all psychiatric patients with specialized problems should be); but one which is a specialized forensic facility, within the range of specialized psychiatric facilities that are needed by an urban community.(ABSTRACT TRUNCATED AT 250 WORDS)     

Court outcomes for clients referred to a community mental health court liaison service

Court liaison and diversion services come in a variety of forms, but the similarities and differences between these services are not well characterized. Findings from a six-year audit of the Newcastle (Australia) Mental Health Court Liaison (MHCL) service are reported, including client characteristics, offence and service contact profiles, court outcomes, and interrelationships among these variables. During the audit period, there were 2383 service episodes by 1858 clients (1478 males, 380 females). Drug and alcohol disorders (40.9%) and psychotic disorders (17.0%) were the most prevalent mental health problems, while assault (23.1%), theft (23.1%), offences against justice procedures (15.4%), driving offences (13.4%) and malicious damage to property (8.3%) were the most frequently recorded charges. Among service episodes with a finalized court outcome, 70.0% involved a punishment (bond: 49.5%; jail term: 29.7%). Females were less likely to be punished, but more likely to have their case dismissed under sections of the relevant Act that required further assessment and monitoring. Being married, or having an adjustment or drug and alcohol disorder, were also associated with an increased likelihood of punishment, while clients with a psychotic or bipolar disorder were less likely to be punished. Among clients who were punished, those referred from inpatient mental health services were more likely to receive a non-jail punishment, while unemployed clients were more likely to be jailed. A substantial proportion of clients had court outcomes that required an ongoing involvement with local mental health services. By being part of community mental health services, our MHCL service is able to work efficiently and effectively with the criminal justice system, while facilitating ready access to existing mental health services and continuation of care.     

The social,relational and mental health characteristics of justice-involved men in the south-west England

The aim of this article is to describe the social, relational and mental health characteristics of a sample of offenders serving prison or community sentences in the south-west England. About 100 adult male offenders were screened for anxiety and depressive disorders, post-traumatic stress disorder (PTSD), drug and alcohol dependence, and likely personality disorder using validated instruments. Fifty-eight per cent of the sample reported at least one common mental health problem, of these only 26% reported receiving treatment. Participants exposed to traumatic events and/or participants with past mental health problems were more likely to score positive for current common mental health problems. Our study identified factors that may increase the risk of a first episode or recurrent anxiety and/or depression for offenders. Health and criminal justice services should create partnerships and develop interventions that address the risk factors which lead and/or contribute to offenders' mental health difficulties.     

A Comparison of Defendants with Mental Illness Represented by Public Defenders and Private Attorneys: an Analysis of Court-Ordered Pretrial Psychiatric Evaluations

This study compared the characteristics and court-ordered evaluation questions and responses among 4,430 defendants to determine if differences existed between those represented by public defenders and private attorneys when receiving trial competency or responsibility psychiatric evaluations from a state department of mental health. Defendants represented by public defenders were more likely to be younger, to have less education, to have psychotic disorders, to have a history of inpatient psychiatric treatment, to live in urban or rural counties, and to be jailed at the time of the evaluation. In addition, defendants represented by public defenders were less likely to have a request for a criminal responsibility evaluation and more likely to be evaluated as having a mental illness, to be incompetent to stand trial, and to need hospitalization pending trial. Consideration of whether defendants with public defenders receiving less requests for responsibility evaluations was indicative of a therapeutic jurisprudence approach is discussed. Implications for research on types of legal representation of defendants with mental illness are discussed.     

Perceived criteria used by criminal justice and mental health professionals to predict dangerous behavior of mentally ill persons

A group of 163 Colorado mental health and criminal justice professionals were asked to rate the effectiveness of a set of predictors of violent behavior for mentally ill persons. Violent behavior and the characteristics of the offense were rated highest, followed by mental health and social factors respectively. Little variation existed between mental health and criminal justice groups with respect to which predictors were perceived as important. The rankings of the dangerous behavior predictors by criminal justice and mental health workers were highly correlated, suggesting agreement between the groups. A moderate correlation was found for the rankings of mental illness predictors. These factors were similar to those identified in previous research. Both groups perceived their predictors to be accurate.     

Mentally ill offenders eligible for diversion at local court in New South Wales (NSW), Australia: factors associated with initially successful diversion

Diversion away from the criminal justice system and into mental health treatment services is a key strategy for addressing the well-established burden of mental illness suffered by those presenting to court. While mental health courts, court liaison and court diversion services have been developed in many jurisdictions internationally, there is limited research evidence to support their effectiveness in identifying those with mental health need and achieving successful diversion. The Statewide Community and Court Liaison Service in New South Wales, Australia, identifies mentally ill offenders likely to meet legal eligibility criteria for diversion at the busiest local courts across the state. Utilising data collected by mental health clinicians working in the service, 8317 individuals were identified as being eligible for court diversion on at least one occasion during the study period (1 July 2008 and the 30 June 2015) and 57.3% were subsequently diverted by Magistrates. Successful diversion at this first step was associated with being female, older, of non-Aboriginal and/or Torres Strait Islander background, and having a serious mental illness, replicated when stratified by sex and by Aboriginal and/or Torres Strait Islander background. There may be barriers to mental health diversion at court for individuals with particular socio-demographic characteristics which future service developments may need to take into account.     

Demographic and clinical characteristics of 1092 consecutive police custody mental health referrals

The 43 police forces in England and Wales have made over 13 million arrests in the last decade. Yet, despite this high volume criminal justice system activity, and evidence of substantial health morbidity across the criminal justice pathway, mental health services in police custody have only been patchily developed, and the literature in this area is limited. Referrals (n = 1092) to a pilot mental health service operating across two police stations in a London borough were examined over an 18-month period in 2012/2013. The referred group had high levels of mental health and substance misuse problems (including acute mental illness, intoxication and withdrawal), self-harm, suicide risk and vulnerability (including intellectual disability), with some important gender differences. Although this work has limitations, the findings are broadly consistent with the small existing literature and they confirm the need for services that are sufficiently resourced to meet the presenting needs.     

Gender differences in violent offending: results from a multicentre comparison study in Dutch forensic psychiatry

ABSTRACT

The past two decades, a disproportionate growth of females entering the criminal justice system and forensic mental health services has been observed worldwide. However, there is a lack of knowledge on the background of women who are convicted for violent offenses. What is their criminal history, what are their motives for offending and in which way do they differ from men convicted for violent offenses? In this study, criminal histories and the offenses for which they were admitted to forensic care were analyzed of 218 women and 218 men who have been treated between 1984 and 2014 with a mandatory treatment order in one of four Dutch forensic psychiatric settings admitting both men and women. It is concluded that there are important differences in violent offending between male and female patients. Most importantly, female violence was more often directed towards their close environment, like their children, and driven by relational frustration. Furthermore, female patients received lower punishments compared to male patients and were more often considered to be diminished accountable for their offenses due to a mental illness.     

Incarcerated male and female offenders' perceptions of their experiences in the criminal justice system

This study compared the experiences of males and females who have been convicted of criminal offenses and institutionalized. The inmates were asked about their arrests, trials, sentencings, and incarcerations, their impressions of the criminal justice system and court personnel they encountered, and their feelings about justice in America as it applied to them.It was found that substantial percentages of both the males and females in the sample were minority group members, poorly educated, products of disorganized family life, and individuals who had experienced repeated contacts with the criminal justice system. Males were more likely than females to have had contacts with the criminal justice system from their early teens, to view the police as unnecessarily harsh and harassing, not to have been released on bail, and to have entered guilty pleas without going to trial. The females as a group received swifter dispositions of their cases than did the males.The vast majority of both males and females felt that the sentences they received were too harsh and they were dissatisfied with their lawyers' services. Most felt that a poor man cannot get a fair trial in America.     

Juvenile Mental Health Court: Rationale and Protocols

Under the sponsorship of the judiciary, the Santa Clara County, California Juvenile Court, in partnership with the Juvenile Mental Health Department and a technical assistance agency (SOLOMON), has pioneered a Juvenile Mental Health Court for seriously mentally ill children who have become involved in the criminal justice system. The judiciary, probation department, district attorney, public defender, county counsel, and service providers have collectively embarked upon the implementation of a modern approach to mental health diagnosis, triage, and treatment services for youth and families who come in contact with the justice system as a result of the combination of serious mental illness and juvenile delinquency. This article presents the court's rationale and protocols.     

A prospective comparative evaluation of a Criminal Justice Liaison and Diversion Service in Belfast

There is continued interest in the planning, development and implementation of services designed to identify detainees with mental illness and connect them to health and social services. However, currently, little is known about how best to configure, organise and deliver these services. The study employed a prospective follow-up design with a comparator group to describe and evaluate a police mental health liaison service based in Belfast. Participants were recruited from two neighbouring police stations, only one of which provided a mental health liaison service. Outcomes including mental health status, drug and alcohol misuse, risk-related behaviour and ‘administrative’ outcomes were assessed at the time of arrest and six months later. The service was successful in identifying and assessing detainees, though there appeared to be similar between-group levels of mental health problems over time. Results highlight a need to develop firmer linkages and pathways between criminal justice liaison/diversion services and routine health and social services.     

Long-term recidivism of mental health court defendants

The first MHC was established in 1997 and now, over 15 years later, there are over 300 mental health courts in the United States. In a relatively short time these courts have become an established criminal justice intervention for persons with a mental illness. However, few studies have looked at the long-term outcomes of MHCs on criminal recidivism. Of the studies evaluating the impact of MHCs on criminal recidivism, most follow defendants after entry into the court during their participation, and only a few have followed defendants after court exit for periods of one or two years. This study follows MHC defendants for a minimum of five years to examine recidivism post-exit with particular attention to MHC completion's effect. Findings show that 53.9% of all MHC defendants were rearrested in the follow-up and averaged 15 months to rearrest. Defendants who completed MHC were significantly less likely to be rearrested (39.6% vs. 74.8%), and went longer before recidivating (17.15 months vs. 12.27 months) than those who did not complete. This study suggests that MHCs can reduce criminal recidivism among offenders with mental illness and that this effect is sustained for several years after defendants are no longer under the court's supervision.     

Criminal Justice Education and Training in North Carolina: History and Development from 1920 to 1980

This paper examines and analyzes primary and secondary data relative to the history and development of criminal justice education and training in North Carolina for six decades. Emphasis is focused on the early attempts to provide education and training for criminal justice personnel from 1920 to 1940, the expansion and improvement in criminal justice education and training from 1940 to 1960, and the establishment of criminal justice education and training programs in two-year community colleges and technical institutes and four-year senior public and private postsecondary education institutions from 1960 to 1980. In addition to discussing the similarities and differences in the methods utilized by institutions to establish criminal justice education and training programs, this paper discusses the curricula, course offerings, and characteristics of the faculties, as well as internal and external conditions, forces, and factors that influenced the history and development of education and training programs for criminal justice personnel. As a result of the impact of these and various influences from within police departments and individual institutions, educational and governmental state agencies, and from demands and needs of criminal justice personnel and society for better protection and safety, criminal justice education and training programs were in force at 15 two-year community colleges, 30 two-year technical institutes, 10 four-year senior, public institutions, and eight four-year, senior, private institutions in North Carolina in 1978.     

The feasibility of a brief evaluation of mental state at the time of the offense

If psychological evaluations of criminal defendants could be performed in the community on an outpatient basis rather than in a distant state hospital on an inpatient basis, substantial savings could result and defendants' rights to speedy trial, bail, and the least restrictive alternative would more likely be respected. The authors thus developed a protocol, the mental state at the time of the offense screening evaluation (MSE), designed to enable outpatient evaluatiors to “screen out,” in the course of a brief interview, those defendants whose alleged criminal conduct clearly was not caused by “significant mental abnormality.” They tested the validity of the MSE by having pairs of mental health professionals use the MSE to evaluate 36 criminal defendants. The professionals' conclusions were then compared with the conclusions of state hospital professionals who performed a comprehensive evaluation of each defendant. They were also compared to court adjudications of the defendant's criminal charges. They found that the MSE screened out a large proportion of defendants (sufficient to suggest an improvement in cost-efficiency) without prejudice to those defendants who might have a valid legal defense.     

Mental health issues and the Canadian criminal justice system**

The critics assert that a significant proportion of incarcerated individuals suffers from mental health issues, i.e. ‘the criminalization hypothesis.’ The current paper reviews the scholarly literature to address five interrelated questions: (1) What are the risks of those classified as mentally ill for committing crimes and, in particular, violent crimes? (2) As the gatekeepers to the criminal justice system, what happens during ‘first encounters’ between the police with those who have mental illnesses? (3) What community-based services are available for effective diversions as an alternative to incarceration for those with mental illnesses? (4) What are the impacts of treatment options upon those experiencing mental illnesses while incarcerated, including the impact upon recidivism? (5) What types of pre-release planning and community responses have the most positive effects to help reduce recidivism and assist offenders in coping with mental health issues in the Canadian context? After summarizing key evidence pertaining to these questions, the paper presents case studies as exemplars of ‘best practices’ to illustrate promising directions conducive to integrated, holistic, and effective responses at the intersection of the criminal justice and mental health systems.     

Detention under the Mental Health Act: balancing rights,risks and needs for services

Mental health law has to balance considerations of both justice, and health and welfare. In the political climate of the 1990s mental health services have become targeted on those with serious mental illness, to address the objectives of containing risks and limiting service expenditure. This paper identifies that increasing rates of detention under the Mental Health Act through the 1990s in a particular region, disproportionately involve longer-term detentions (under section 3), men, and people with serious mental illnesses. Those detained are likely to experience social difficulties. Changes in legislation are imminent, and the paper concludes that thought should be given to the amount of statutory intervention in the lives of seriously mentally ill people, and to the principle of reciprocity in relation to those coerced for lesser periods. Services should seek to address the issues of social exclusion which are reflected in the circumstances of those detained.