Correctional Policy for Offenders with Mental Illness: Creating a New Paradigm for Recidivism Reduction

Offenders with mental illness have attracted substantial attention over the recent years, given their prevalence and poor outcomes. A number of interventions have been developed for this population (e.g., mental health courts). They share an emphasis on one dimension as the source of the problem: mental illness. Their focus on psychiatric services may poorly match the policy goal of reducing recidivism. In this article, we use research to evaluate (a) the effectiveness of current interventions, and (b) the larger viability of psychiatric, criminological, and social psychological models of the link between mental illness and criminal justice involvement. We integrate theory and research to offer a multidimensional conceptual framework that may guide further research and the development of efficient interventions that meaningfully reduce recidivism. We hypothesize that the effect of mental illness on criminal behavior reflects moderated mediation (i.e., the effect is direct in the case of one subgroup, but fully mediated in another); and that the effect of mental illness on other “recidivism” is partially mediated by system bias and stigma. We use this framework to propose three priorities for advancing research, articulating policy, and improving practice.     

A mixed methods study of the mental health and criminal justice histories of missing persons

Approximately 35,000 people are reported missing each year in Australia; rates elsewhere are even higher, with a recent UK study suggesting that a person goes missing every 2 min. Missing persons place a significant burden on police services; it is interesting, therefore, that very little research attention has been paid to this topic. This mixed methods study aimed to address this significant gap by analysing the mental health and criminal justice histories of a sample of missing persons and comparing them to rates in the general community. The study found that both mental health and criminal justice histories were significantly overrepresented among missing persons compared to those in the general community, and that young people reported missing commonly displayed suicidal behaviour. Results highlight at risk groups and suggest that criminality is much more commonly implicated in missing person incidents than previously thought.     

Schizophrenia: Causes,crime, and implications for criminology and criminal justice

This paper is aimed at criminologists and criminal justicians seeking to understand their role in educating law enforcement and correctional personnel who must deal with the mentally ill. It is motivated by William Johnson's (2011) recent call for rethinking the interface between mental illness, criminal justice, and academia, and his call for advocacy. We concur with his concerns, and insist that this rethinking must necessarily include grounding in the etiology of mental illness (specifically, with schizophrenia) as it is currently understood by researchers in the area. Advocacy must go hand in hand with a thorough knowledge of the condition of the people for whom we are advocating. We first examine major etiological models of schizophrenia, emphasizing the neurodevelopmental model that incorporates genetics, neurological functioning, and immunological factors guided by the assumption that the typical criminologist/criminal justician has minimal acquaintance with such material. We then address the link between schizophrenia and criminal behavior, and conclude with a discussion of the implications for criminology and criminal justice.     

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.     

Forensic psychiatric experiences,stigma, and self-concept: a mixed-methods study

This study used a mixed-methods approach to investigate stigma experiences and self-concepts of individuals with both mental illness and criminal histories. The full sample of participants completed self-report measures of self-concept related to mental illness, race, and criminal history, and a brief qualitative self-concept measure. A subsample of participants completed semi-structured interviews, which were analyzed for content domains. Analyses suggested that several aspects of self-concept related to responses on stigma measures. Participants who identified their own styles of acting, feeling, and thinking tended to exhibit less mental illness self-stigma. Qualitative interview findings suggested that the majority of participants described stigma experiences related to mental illness, race, and criminal history, and these stigmatized identities negatively influenced one another. Conclusions review how stigmatized identities can intersect in powerful ways for individuals with mental illness and histories of criminal offending, and discuss implications for future research and clinical practice.     

Rule-making, rule-breaking? Law breaking by government in the Netherlands and the United Kingdom

This article concerns a relatively novel issue: rule breaking and unlawful conduct by government bodies; to which degree does it occur, what is the nature of this misconduct, what are the underlying motives, and what are the consequences and possible solutions? Rule and law breaking is harmful for the credibility and integrity of a state and its law enforcement system. However, very little empirical research has been carried out into this issue, in comparison to research into state crime. There is little clarity about how public actors deal with criminal and administrative laws and rules in areas like environmental protection, safety regulations and working conditions. Do government bodies set a good example? Is their behaviour better or worse than the public and businesses? An analytical framework for research will be presented and also the results of an extensive research project in the Netherlands; the main themes of which have been benchmarked against data from the United Kingdom. The article will conclude with a summary of the main findings and a number of suggestions for further research and policy development.     

Young people with cognitive disabilities and overrepresentation in the criminal justice system: service provider perspectives on policing

Young people with cognitive disabilities (YPWCD) are overrepresented as offenders in the criminal justice system. However, most existing research on this topic examines overrepresentation in courts and corrections rather than at the police gatekeeping stage of the criminal justice process. Furthermore, while the views of other groups have been documented, the perspectives of service providers – who often bear witness to YPWCD’s interactions with police – have yet to be examined. This research addresses this gap by analysing qualitative interviews with service providers from Queensland, Australia, using the three most common theoretical explanations for the overrepresentation of PWCD (the susceptibility, differential treatment and psychosocial disadvantage theses) as an analytic framework. A number of implications emerged from the study. There is a need to take a critical and intersectional lens to YPWCD’s experiences, as well as to equip police to work with YPWCD to de-escalate interactions with this group.     

Legal narratives as significant news sources about mental illness and violent crime

Media coverage about people affected by mental illness is an area of research that is extensively examined. Many scholars argue that the media depicts people with mental illness as inherently violent and dangerous within sensational narratives. These depictions are criticized for reinforcing the social stigma and disadvantages many of the mentally ill face. The media does, however, require news sources and, in the context of crime and mental illness, the courts are a significant source. Through qualitative content analysis of Australian newspaper articles, this research examines an under-researched and incompletely theorized area. In doing so, it demonstrates that media depictions of some mentally ill offenders reflect and heavily draw upon legal narratives and what is argued in court about these offenders in the context of criminal responsibility and legal insanity.     

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.     

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.     

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.     

Can General Strain Theory Help Us Understand Violent Behaviors Among People with Mental Illnesses?

Recent work suggests that violence among people with mental illnesses is not simply due to the symptoms and comorbidities that define mental illness. We further this work by examining the extent to which strains or stressors explain the link between mental illness and violence. Specifically, we apply general strain theory (GST) to a longitudinal sample of adults with mental illnesses to investigate the lagged effects on violence of several strain measures, while controlling for mental illness symptoms, substance abuse, past violence, and other key variables. Parental drug abuse from childhood and stressful life events across the life course predict violence in adulthood. In a prospective model, relationship strain from an earlier time period significantly predicts changes in later self-reported violence. The results shed light on the ability of criminological frameworks to explain violence among people with mental illnesses.     

Civil commitment and the criminal insanity plea in Israeli law

In Israeli jurisprudence there is a substantial difference towards mentally ill patients between the civil and penal law systems that goes well beyond differences required by their separate objectives. Mentally ill people dangerous to others due to their illness belong in the hospital, not in the community or in jail. The data gathered especially for this paper make it hard to escape the conclusion that contemporary practice in Israel does not accord with this objective. On the civil front, inaccuracy in predicting who is dangerous may lead to involuntary commitment of people who are not dangerous. On the criminal side, too few people are sent to the hospital in Israel and correspondingly too many to jail. Comparison with US data and practice shows that on the civil side prediction has been improved by using actuarial methods, while on the penal side more up to date definitions of mental illness have been adopted. Whatever the appropriate solution for Israel, surely the first requirement is recognition of the problem.     

Crimes Against Minds: On Mental Manipulations, Harms and a Human Right to Mental Self-Determination

The neurosciences not only challenge assumptions about the mind’s place in the natural world but also urge us to reconsider its role in the normative world. Based on mind-brain dualism, the law affords only one-sided protection: it systematically protects bodies and brains, but only fragmentarily minds and mental states. The fundamental question, in what ways people may legitimately change mental states of others, is largely unexplored in legal thinking. With novel technologies to both intervene into minds and detect mental activity, the law should, we suggest, introduce stand alone protection for the inner sphere of persons. We shall address some metaphysical questions concerning physical and mental harm and demonstrate gaps in current doctrines, especially in regard to manipulative interferences with decision-making processes. We then outline some reasons for the law to recognize a human right to mental liberty and propose elements of a novel criminal offence proscribing severe interventions into other minds.     

Mental health, gender, and drug court completion

Drug-involved offenders report high rates of mental health problems that can negatively impact criminal justice outcomes. Yet, relatively little attention has been given to the mental health issues of drug court offenders. Therefore, this study examined 449 participants in a Delaware drug court and investigated relationships between mental health, gender, and program completion. Bivariate results indicated that gender was related to both mental health status and completion status. Multivariate findings revealed that two indicators of mental health, depression and being prescribed drugs for a psychological or emotional problem, were significant predictors of drug court completion. Policy implications include assessing the mental health status of all drug court participants at program entry so that services can be provided which aim to improve offender health and increase the likelihood of successful program outcomes. Drug courts must better meet the needs of participants with co-occurring disorders if they are to remain an effective and viable criminal justice intervention. This research was supported by grant RO1 DA12424 “Drug Court Offenders in Outpatient Treatment,” by the National Institute on Drug Abuse.     

证明责任与强制鉴定：“精神病”的鉴定问题研究

精神病的刑事责任问题在英美法国家经历由非此即彼的有无向中间环节的妥协,诞生了限制刑事责任;同时精神病证明责任的分配也由控方绝对责任向相对责任缓冲,并逐渐演变为辩方承担证明责任和控方承担说服责任配置方式。我国应当在借鉴精神病证明责任合理分配的基础上,构建强制鉴定制度,以此来促进精神病证明责任的合理配置流向,保证精神病证明责任的程序正当。     

Violence and personality in forensic patients: is there a forensic patient-specific personality profile?

Concerning the discussion about the connection of personality traits, personality disorders, and mental illness, this study focused on the personality profiles of male forensic patients, prison inmates, and young men without criminal reports. The main topic centered on group-specific personality profiles and identifying personality facets corresponding with mental illness. The authors therefore used the Rasch model-based Trier Integrated Personality Inventory. They individually tested 141 German forensic patients with different crime backgrounds, 122 prison inmates, and 111 soldiers of the German army. Within group differences they found that the individuals with mental retardation differ from patients with a personality disorder or psychosis. Patients with mental retardation displayed higher neurotic and/or paranoid personality accents and tended to be low organized and self-confident.     

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.     

Police use of TASER devices in mental health emergencies: A review

The proliferation of TASER devices among police forces internationally has been accompanied by concerns about injuries and health effects, and about the use of TASER devices on vulnerable populations such as people with mental illness. TASER devices have generated a flood of research studies, although there remain unanswered questions about some of the key issues. This paper outlines the introduction of TASER devices to policing and their subsequent widespread adoption. The paper considers the role of police in mental health emergencies with a particular focus on use of TASER devices. Some factors contribute to the special vulnerability of people with mental illness to the effects of TASER devices. The paper also reviews research into use of TASER devices and raises issues about conflict of interest in research into TASER devices. We conclude that TASER devices look set to play a significant role in policing in the future. We make suggestions for a future research programme, and suggest guidelines for publication of papers in which there may be a conflict of interest.     

The Courts in a Fragmented Criminal Justice System

The U.S. President's Commission on Law Enforcement and Administration of Justice under President Johnson in 1967 outlined a central role for courts in the criminal justice system. That role, however, has been somewhat diminished by the dominance of plea bargaining and the legislative enactment of mandatory minimum sentences that limit judges’ discretion. At the same time, judges have become more involved in specialized courts dealing in cases involving drugs and mental illness. A major topic of concern is the lower courts, which in many areas have changed little since the 1960s Commission. In those places, the traditional adversary process is not operating well, with many defendants pleading guilty unnecessarily in a system that may be designed primarily to collect fees. In violent crime cases, the imposition of capital punishment remains a controversial issue for states that is not likely to be resolved by a new national commission. The central court functions of sentencing and overseeing plea bargains are discussed elsewhere in this volume.