Stopping the revolving door: a meta-analysis on the effectiveness of interventions for criminally involved individuals with major mental disorders

Faced with high and increasing rates of mental disorder within the criminal justice system (CJS), a range of interventions have been implemented in an effort to prevent continued involvement in criminal activities among this population. A meta-analytic review was undertaken to consider the effectiveness of interventions for criminally involved adults with a mental disorder targeting either improved criminal justice or mental health outcomes. Furthermore, characteristics that were hypothesized to predict better outcomes were examined. Studies that considered sex offender interventions, or focused solely on antisocial personality, intellectual and cognitive, or substance use disorders were excluded. Results assuming a fixed-effects model combining 37 effect sizes from 25 studies (N = 15,678) support the effectiveness of these interventions in terms of reductions in any CJS involvement (d = 0.19 excluding one outlier). Interventions had no significant effect on an aggregate mental health outcome (d = 0.00). However, when considering distinct mental health outcomes, intervention participants had significantly better functioning (d = 0.20) and fewer symptoms (d = 0.12). There were no significant effects of the interventions on mental health service or medication use. Moderator analyses identified seven sample, intervention, and design characteristics that were related to the magnitude of the effect sizes for criminal justice outcomes, and suggest implications for service provision, policy, and research. Results suggested some relationship between intervention effects on mental health and criminal justice reinvolvement, although future research is needed in this area, especially given the absence of mental health outcome data in many studies.     

A quasi-experimental test of the effects of criminal justice involvement on later mental health

Objectives

While many criminological theories posit causal hypotheses, many studies fail to use methods that adequately address the three criteria of causality. This is particularly important when assessing the impact of criminal justice involvement on later outcomes. Due to practical and ethical concerns, it is challenging to randomize criminal sanctions, so quasi-experimental methods such as propensity score matching are often used to approximate a randomized design. Based on longitudinal data from the Cambridge Study in Delinquent Development, the current study used propensity score matching to investigate the extent to which convictions and/or incarcerations in the first two decades of life were related to adverse mental health during middle adulthood.

Methods

Propensity scores were utilized to match those with and without criminal justice involvement on a wide range of risk factors for offending.

Results

The results indicated that there were no significant differences in mental health between those involved in the criminal justice system and those without such involvement.

Conclusions

The results did not detect a relationship between justice system involvement and later mental health suggesting that the consequences of criminal justice involvement may only be limited to certain domains.

     

Race,the Economic Maturity Gap,and Criminal Offending in Young Adulthood

While research has documented that racial and ethnic groups are differentially involved in juvenile and adult crime, little research has examined whether economic and employment well‐being can explain Black and White adolescents' persistence in criminal activity into young adulthood. One potential explanation emerges from Moffitt, who posits an economic maturity gap to explain Blacks' greater persistence in offending in young adulthood. To evaluate this hypothesis, we draw on three waves of data available in the National Longitudinal Survey of Adolescent Health to examine whether economic and employment well‐being in young adulthood can account for the racial gap, and persistence in offending. Findings are consistent with Moffitt's hypothesis and indicate that economic and employment well‐being in young adulthood explain Blacks' greater involvement in criminal and violent offending in young adulthood. In addition, results indicate that the greater tendency of Blacks, compared to Whites, to persist in violent offending is also driven by the reduced economic and employment well‐being that Blacks face in young adulthood.     

Envisioning the next generation of behavioral health and criminal justice interventions

The purpose of this paper is to cast a vision for the next generation of behavioral health and criminal justice interventions for persons with serious mental illnesses in the criminal justice system. The limitations of first generation interventions, including their primary focus on mental health treatment connection, are discussed. A person–place framework for understanding the complex factors that contribute to criminal justice involvement for this population is presented. We discuss practice and research recommendations for building more effective interventions to address both criminal justice and mental health outcomes.     

Designing Programming and Interventions for Women in the Criminal Justice System

Women are the fastest growing segment of the criminal justice population, yet the majority of research on criminal justice populations has been focused on men. Programming and interventions that reduce women’s involvement in the criminal justice system and ameliorate the negative consequences associated with criminal justice involvement are urgently needed. The overall aim of this paper is to provide a comprehensive framework for developing evidence-based, gender-specific programming and interventions to reduce criminal justice involvement and its associated consequences among women in the criminal justice system. The first section of the paper offers a conceptually guided review of the three primary factors that facilitate and complicate women’s involvement in the criminal justice system: victimization; mental disorders; and substance use. In the second section of the paper, findings from focus groups conducted with women on probation or parole identify strategies to engage this population in psychosocial interventions. The third and final section of the paper provides comprehensive recommendations for designing programming and interventions for women in the criminal justice system.     

Recognition and understanding of goals and roles: The key internal features of mental health court teams

The increasing involvement of people with mental illness in the criminal justice system has led to the formation of specialty programs such as mental health courts (hereafter MHCs). We discuss MHCs and the teams serving these courts. Specifically, we examine team members' perceptions of MHC goals and their own and others' roles on the MHC team. Using a semi-structured interview instrument, we conducted 59 face-to-face interviews with criminal justice and mental health treatment personnel representing 11 Ohio MHCs. Findings from our qualitative data analyses reveal that MHC personnel understand individuals' roles within the teams, recognize and appreciate the importance of different roles, and share common goals. MHCs could foster this level of understanding and agreement by working to recruit and retain individuals with experience in or willingness to learn about both the criminal justice and mental health systems. Future research should explore the impact of MHC team functioning on client outcomes.     

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.     

Criminal and civil community-based "detention": some parallels

Over the last 20 years, governments in Australia and elsewhere have increasingly embraced the notion of community-based treatment of the mentally ill in preference to detention in a mental health facility. At the same time, governments have also embraced the notion of community-based treatment and punishment of criminal offenders in preference to detention in a custodial facility. This article examines the use of Community Treatment Orders (CTOs) within the Victorian mental health regime, and the use of Intensive Correction Orders (ICOs) within the Victorian criminal justice regime. It is argued that a number of striking similarities can be found in the respective legislative schemes and policy considerations.     

Intimate Partner Violence Among Hispanic Females

Abstract

Intimate partner violence poses a major public health and social problem with serious criminal justice, health and social-related consequences. However, little is known about the etiology of intimate partner violence among young people, especially minority youth. Using the Hispanic Stress Inventory, we examine intimate partner violence among Hispanics, particularly Mexican American adolescent females. Understanding and identifying issues related to intimate partner violence is crucial for developing and implementing effective policies and programs encompassing both public health and criminal justice approaches specific to this rapidly growing population of young people.     

Psychiatric symptoms and mental health court engagement

People with mental illnesses are overrepresented in the criminal justice system. Many interventions have been implemented to treat the underlying causes of criminal justice involvement and prevent people with mental illnesses from recidivating. Mental health courts (MHC) are one of these programs. This analysis examines the relationship between psychiatric symptoms and MHC engagement. Eighty MHC participants from two Midwestern MHCs were interviewed. Symptom severity was assessed at baseline using the Brief Psychiatric Rating Scale. MHC engagement was estimated by treatment adherence, substance use, days spent in jail, probation violations, and MHC retention during a six-month follow-up period. Using nonparametric statistical tests and logistic regression, results indicate symptoms of depression, anxiety, and guilt are more severe at baseline for those people who are incarcerated during the follow-up period. Symptoms of anxiety are more severe for people who are terminated or went missing during the follow-up period. Further research is needed to determine the directionality and causality of these relationships. MHCs professionals should be aware of the relationship between symptom severity and MHC engagement and attempt to connect participants with treatment and services as early as possible and individualize treatment plans based on current symptoms and need.     

The enduring racial divide in death penalty support

One of the more enduring observations in the study of death penalty support within the United States is the strong divide between Whites and Blacks. Whites show significantly higher levels of support for capital punishment than Blacks. This divide between Whites and Blacks appeared in all surveys, over time, and across a variety of methodological designs. Using data from three separate studies (two local surveys of venirepersons and the NORC-General Social Surveys), this study attempted to understand the basis for this divide. It examined racial differences in socioeconomic status, religion/religiosity, political ideology, positions on right-to-life and other social issues, fear of crime and victimization experience, experience with the criminal justice system, philosophies of punishment, and attribution styles. The findings revealed that the effect of race/ethnicity on capital punishment support continued to hold while controlling for the effects of nearly all of these “explanations.”     

Childhood Violence Exposure: Cumulative and Specific Effects on Adult Mental Health

Childhood exposure to violence and victimization is a significant public health problem, with potentially long-lasting, deleterious effects on adult mental health. Using a longitudinal study design, 123 young adults—identified in adolescence as at-risk for high school dropout—were examined for the effects of multi-domain childhood victimization on emotional distress and suicide risk, net of adolescent risk and protective factors, including family dysfunction. The hypothesis that higher levels of cumulative childhood victimization would be significantly associated with mental health maladjustment in young adulthood was confirmed by the analysis. However, the victimization predictors of adult emotional distress were different than the predictors of adult suicide risk. These findings indicate the need for prevention and intervention approaches that include thorough assessment, and focus on the childhood and adolescent problem areas that are most consequential for long-term psychological well-being.     

The impact of race on criminal justice ideology: An examination of high school students

Research suggests that differences exist in the criminal justice ideology of Black and White Americans. For example, adult African Americans are more likely than their White counterparts to support criminal justice measures that address the root causes of crime. There has, however, been limited interest in exploring the criminal justice ideology of juveniles. Using survey data collected from 1,398 rural and suburban public high school students, the present study examined the influence of race on the criminal justice ideology of juveniles. The findings suggested that while Black teenagers are significantly more likely to hold a liberal crime control ideology and White teenagers are significantly more likely to hold a conservative ideology, confidence in the justice system to be fair strongly influences the beliefs of both groups.     

Race and treating other people's children as adults

Juvenile offenders are sometimes transferred to a criminal court where they may stand trial as adults. The rationale for this current trend cannot be justified based on evidence from developmental psychology, the evidence of consistent positive effects for particular intervention strategies, and ethical arguments for justification of punishment. The rationale in actuality reflects the selective manipulation of the alternative conceptions of young people as dependent and vulnerable or as autonomous and responsible to continue to justify policies that entail cultural and racial discrimination. Discretionary decisions at various stages of the justice process amplify racial disparities as minority youths proceed through the system and result in more severe dispositions than for comparable White youths.     

Is Violence Bad for Your Health? An Assessment of Chronic Disease Outcomes in a Nationally Representative Sample

Longitudinal offending research has grown substantially in the last two decades. Despite this increased scholarly attention, longitudinal investigations of the effects of offending on physical health have not kept pace. Acknowledging the intersections of criminology, criminal justice, and public health, this study examines the relationship between violent offending and chronic diseases among a nationally representative longitudinal sample of young adults. Results suggest that variation across offender typologies (i.e. adolescence-limited, adult-onset, and consistent violence during youth and young adulthood) significantly predicts experiencing chronic disease in early adulthood, with the risk being the most pronounced among those individuals, who demonstrate violence continuity. Study limitations and policy implications are discussed.     

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.     

Self-Control Theory,Race, and Delinquency

Abstract

The size of the Hispanic population in the United States has grown to the point that they now comprise the largest minority group. While much research has been conducted to explore the effects of race and ethnicity on various aspects of the criminal justice system, most of these studies focus on African Americans. The purpose of this study is to assess the representation of Hispanics in criminal justice literature and to summarize the findings. The results suggest that while many studies contained Hispanic subjects, few articles focused specifically on His-panics and fewer articles focused on Hispanic women. When analyzed separately, Hispanics were found to be statistically different from other groups. Much of the Hispanic-focused research centered on drug use, gang involvement, and violence. Given the size and growth of this important group, criminologists must consciously recognize and proactively seek to include the views and experiences of Hispanics in their research.     

Getting Caught and Getting Hitched: An Assessment of the Relationship Between Police Intervention,Life Chances,and Romantic Unions

Little research has assessed the link between formal police intervention, financial hardship, and the formation and quality of romantic relationships. Using data from the Rochester Youth Development Study, we contribute to this literature by examining effects of police intervention at two time points on marriage stability and romantic relationship quality. We find that police intervention during adolescence is associated with increases in financial hardship during young adulthood, which, in turn, decreases the odds of entering into a stable marriage by age 31 and the extent to which those who have a romantic relationship feel their partner is supportive. Early police intervention also is indirectly associated with a reduction in partner satisfaction and an increase in partner violence via young adult arrest. We conclude that even minimally invasive contact with the criminal justice system during adolescence has long-lasting collateral consequences in the family arena.     

The impact of race on perceptions of criminal injustice

Based on a stratified sample of 239 residents of Cincinnati, Ohio, the present study explored whether African Americans and Whites differ in their perceptions of racial injustice in the criminal justice system. The data revealed a cleavage in the extent to which the races believed that Black citizens would be differentially stopped by the police, given a speeding ticket, jailed, and sentenced to death. The effect of race remained strong even when controls were introduced for sociodemographic characteristics, experience with the criminal justice system, experience with crime, neighborhood disorder, and political and crime related ideology. Perceptions of injustice, moreover, were strongest among the least affluent African Americans. The possibility that the racial divide in perceived criminal injustice both reflects and contributes to a larger racial chasm in how Black and White citizens understand and experience their lives in American society is explored.