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.     

The Effectiveness of a Mental Health Court in Reducing Recidivism in Individuals with Severe Mental Illness and Comorbid Substance Use Disorder

The current study examined the efficacy of a specialized mental health court in reducing recidivism for severely mentally ill defendants with comorbid substance use disorders. There is a wealth of research supporting the efficacy of mental health courts in reducing recidivism for those with severe mental illness; however, the benefit of these courts for individuals with severe mental illness and comorbid substance use disorders has received limited empirical attention. Participants were 514 defendants enrolled in either a traditional adversarial court or a specialized mental health court. Recidivism was assessed across different outcome variables, including frequency of reoffending, severity of new offenses, and length of time to reoffend. When compared to participants in the traditional adversarial court, enrollment in mental health court was associated with a greater length of time to rearrest and fewer participants were rearrested in the mental health court than the traditional court. Group differences between those with and without comorbid substance use disorders who were enrolled in the mental health court were not found across recidivism outcome metrics. Results of the current study are particularly promising given that defendants with substance use disorders are at a greater risk for reoffending.     

A configurational analysis of 44 US mass shootings: 1975–2015

This study identifies the conditions under which civilian shooter events in the United States become mass episodes of killing. Hitherto, researchers have examined many individual-level variables associated with mass shootings including personal deprivation, family problems, mental illness, among others. Apart from a handful of quantitative studies, scholars have yet to provide a comparative scope to the multiplicity of factors that are influential in bringing about a mass murder. Adopting fuzzy-set qualitative comparative analysis, this study analyses (n = 44) civilian acts of violence that took place from 1975 to 2015 in which some shootings resulted in few deaths and others turned into mass bouts of killing. Empirical results reveal that no variables on their own are sufficient or necessary in accounting for the outcome of a mass shooting. Rather, configurations of causal conditions provide sufficient pathways and new insight into the particular circumstances under which a mass shooting is apt to take place in. The most salient of configurations tell us that mass shootings are prominently influenced by the combination of severe/multiple mental illnesses, a large number/high-powered guns and weak state gun law legislation. Another pathway reveals that mass shootings are also influenced by the interaction of radical ideology, severe/multiple mental illnesses, and high-state level gun ownership.     

RECOMMENDATIONS OF THE COMMITTEE TO STUDY FAMILY ISSUES IN THE ARIZONA SUPERIOR COURT

Justice 2002, a strategic agenda for the Arizona court system over the next five years, has the goal to build public trust confidence in the Arizona courts. A focus of Justice 2002 is the protection of children, families, and communities. One of the number of projects that have been initiated is the establishment of The Committee to Study Family Issues in the Superior Court (Committee). On October 22, 1997, Chief Justice Thomas A. Zlaket established the Committee and charged the members to: "[E]xamine the manner in which cases involving family issues, including cases involving minor children, presently are processed and determined in the Superior Court,… leading to improvement in the manner in which these cases are resolved in the court system; and report to the Arizona Judicial Council its findings and recommendations…" This article is a summarization of the Final Report presented to the Arizona Judicial Council (AJC) in December, 1998. The reader will find that the report is rather general. The Committee has functioned under the assumption that an implementation committee would be formed to work out the details, should the AJC choose to adopt the recommendation to establish a Family Court in Arizona.     

FAMILY COURT–UNIVERSITY PARTNERSHIP TO BENEFIT DIVORCING FAMILIES: THE EXPERIENCE OF MARICOPA COUNTY (ARIZONA) FAMILY COURT DEPARTMENT AND ARIZONA STATE UNIVERSITY'S PREVENTION RESEARCH CENTER*

Using evidence‐based methods to help divorcing families requires the combined best efforts of legal professionals, courts, judges and administrators, mental health oriented service providers, and university researchers. Collaborative program development, implementation, and evaluation involve a complicated process of negotiation between professionals, yet this process is hardly ever described. The current article describes the processes we underwent in forging an alliance of researchers from Arizona State University's Prevention Research Center with professionals from the Maricopa County (Arizona) Family Court, a collaboration that involved a true dialogue and cooperation from the earliest stages and continuing throughout the project. A Community‐Based Participatory Research model was the underlying basis for our partnership; its lynchpin device was a Joint Planning Committee.     

Dealing with mentally ill domestic violence perpetrators: A therapeutic jurisprudence judicial model

People suffering from mental illness are increasingly referred to the domestic violence court. Yet the typical diversion programs available, including batterer's intervention programs, are inappropriate for those with serious mental illness. As a result, the Miami-Dade Domestic Violence Court has developed a new approach for dealing with this population that applies mental health court techniques in domestic violence court. This article will describe and discuss this pioneering model. It also will situate this model within the context of other problem-solving courts and discuss how the court uses principles and approaches of therapeutic jurisprudence. The paper presents some preliminary data that describe the social and legal characteristics of 20 defendants in the Domestic Violence Mental Health Court followed over a two year period between 2005 and 2007.     

12-Month Prevalence,Trends, Gender Differences,and the Impact of Mental Health Services on Intimate Partner Violence Perpetration Among Discharged Psychiatric Inpatients

Minimal research has examined partner violence committed by individuals with severe mental illness. This study examined rates of IPV in the first year post-discharge from psychiatric hospitalization, trends over time, gender differences, and the impact of follow-up mental health services. One in five (20.3 %) patients committed at least one act of IPV in the first year. Whereas women were more than twice as likely to perpetrate IPV, men were nearly twice as likely to be violent toward non-family members. Risk of IPV was highest immediately post-discharge and decreased over time, with the sharpest decline after 20 weeks in the community. Mental health treatment was associated with a 40 % decrease and medication non-adherence a 50 % increase in risk for IPV. Partner violence is a prevalent concern among discharged psychiatric patients, and these findings suggest that coordinated risk management efforts should focus on the time immediately following hospital discharge.     

An Interactional Perspective of Intimate Partner Violence: An In-depth Semi-structured Interview of a Representative Sample of Help-seeking Women

This article reports a study of women victimized by intimate partner violence (IPV). We describe three interactional aspects of IPV: (1) responses and conduct before, during, and after IPV episodes, (2) impact of alcohol and drug intoxication, and (3) Predictors of risk for IPV victimization in more than one partnership. A representative sample of 157 help-seeking women, recruited from family counseling offices, the police and shelters, were interviewed about physical, psychological and sexual IPV. The nature and characteristics of the IPV interactions were complex and heterogeneous. There were significant interactional differences between the IPV categories concerning the women’s responses and conduct before, during and after the IPV. The impact of alcohol and drug intoxication was relatively small on the occurrence of IPV. About 75% reported that neither the perpetrator nor the female victim had consumed alcohol or drugs before the index IPV exposure. Only 23% of the women had experienced IPV by previous partners. Women who had been subjected to sexual abuse in their family of origin were at almost 25 times increased risk of IPV victimization in more than one partnership. Childhood exposure to physical IPV between parents increased the risk of IPV victimization in more than one partnership significantly more than if the woman had been subject to childhood physical victimization.     

The Empirical Limits of Forensic Mental Health Assessment

This article introduces a special issue of Law and Human Behavior, including five articles describing the limits of forensic mental health assessments of (a) risk of violence in female adolescents, (b) sexually violent predators, (c) dangerousness in capital murder cases, (d) child sexual abuse, and (e) PTSD litigants. Knowing the limits of forensic mental health assessment methods is essential in order to recognize their strengths, increase the credibility of forensic mental health assessment, and drive research that will enhance the value of assessments for the courts.     

From Rogers to Rivers: the rights of the mentally ill to refuse medication

Many individuals with mental illness wish to avoid psychotropic drugs, a type of treatment that may relieve their symptoms only at the risk of unpleasant, even permanent, side effects. In marked contrast to the widely-held view that most patients may refuse any treatment and that even patients with mental illness may reject other psychoactive interventions such as electroconvulsive therapy and psychosurgery, the courts and legislatures have been slow to recognize any right to refuse psychotropic drugs. This Article demonstrates that many of the justifications offered for forcing patients to take unwanted medications are inadequate and that unless treatment refusals are reviewed outside mental institutions, patients' rights will rarely receive appropriate deference. The author analyzes the federal and state litigation to determine whether the courts have fashioned meaningful relief for the mentally ill. The Article concludes that two recent United States Supreme Court decisions have made it impossible for the federal courts to provide adequate protection. By contrast, several state courts have responded to the needs and rights of patients with mental illness.     

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.     

Beyond Therapy: Problem‐Solving Courts and the Deliberative Democratic State

Problem‐solving courts (drug courts, community courts, domestic violence courts, and mental health courts), unlike traditional courts, attempt to get at the root of the individual and social problems that motivate criminal behavior. Theoretical understandings of problem‐solving courts are mostly Foucauldian; proponents argue that these new institutions employ therapeutic techniques that encourage individuals to self‐engineer in ways that subtly increase state power. The Foucauldian approach captures only some elements of problem‐solving courts and does not fully theorize the revolution in justice that these courts present. Problem‐solving courts, domestic violence courts in particular, orient not just around individual change but also around social change and cultural transformation. Combining the Foucauldian idea of a therapeutic state (as developed by James Nolan) with an understanding of the deliberative democratic mechanisms of larger‐scale structural transformation (found in Habermas and others) leads to a more balanced and empirically open orientation to the actual motivations, goals, and achievements of problem‐solving courts.     

The hundredth volume of the Law Reports of the Commonwealth

This article, written as a foreword to the hundredth volume of the Law Reports of the Commonwealth (LRC), celebrates the growing success of these law reports published since 1985. Generally appearing in four or five volumes each year, the reports collect some of the main cases, mostly from final courts, decided throughout the Commonwealth of Nations. With the demise of the Privy Council as an institutional link, the courts of the Commonwealth remain connected by the English language, a shared doctrinal and historical tradition, common legal taxonomies and a similar professional culture. The author pays special tribute to the excellent Cumulative Indexes from the 1980s to date; the insightful annual Editorial Reviews which draw attention to grand themes and trends throughout the Commonwealth in the LRCs; the outstanding work of the two foundation general editors Professor James Read and Dr. Peter Slinn; and the publishers Butterworths LexisNexis. In the place of imperial rule there is now a free sharing of knowledge in the law, as befits the free association of the Commonwealth of Nations.     

Firearms regulation,violence and the mentally ill: A contemporary Antipodean appraisal

As recent cases of mass murder at Utoya Island in Norway, and in the United States (US) at Virginia Tech, Virginia; Tucson, Arizona; Aurora, Colorado; and Newtown, Connecticut all illustrate, acts of extreme violence involving high powered weapons and committed by persons with a presumed or confirmed mental illness tend to arouse intense public and political debates about the efficacy of firearm regulation and control. Following these tragedies, in the US at least, various law reform measures have been proposed and in some cases implemented designed principally to make it more difficult for mentally ill persons to gain access to firearms. In this article it is contended that measures like these are at best tinkering with the margins of gun control and also have the tendency to reinforce the stigma and discrimination experienced by persons with a mental illness, while perpetuating stereotypes of them as dangerous to themselves and others. Despite these limitations, and while firearm regulation policies and practices vary widely across the globe, most nations still seek in some way to limit access to guns by persons with a mental illness. This article explores in more detail how such policies and practices have been applied in the Australian State of New South Wales and the lessons to be learned elsewhere from this experience.     

Enrollment in Mental Health Courts: Voluntariness,Knowingness, and Adjudicative Competence

Mental health courts (MHCs) are rapidly expanding as a form of diversion from jails and prisons for persons with mental illness charged with crimes. Although intended to be voluntary, little is known about this aspect of the courts. We examined perceptions of voluntariness, and levels of knowingness and legal competence among 200 newly enrolled clients of MHCs at two courts. Although most clients claimed to have chosen to enroll, at the same time, most claimed not to have been told the court was voluntary or told of the requirements prior to entering. The majority knew the “basics” of the courts, but fewer knew more nuanced information. A minority also were found to have impairments in legal competence. Implications are discussed.     

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.     

Physical and Emotional Well‐Being: Court Performance Measures for Children and Youth in Foster Care

Given that courts have the responsibility to ensure the state is providing proper care to children in its custody, courts need to consider whether those children over whom they have jurisdiction are receiving a quality education and are physically and emotionally healthy. Court well‐being measures were not developed when the safety, permanency, timeliness, and due process measures were established. However, there have been recent efforts to address this void. This article describes the newly developed set of well‐being measures for courts to track success in improving well‐being outcomes in the areas of physical health, mental health, maintaining permanent relationships, transition to adulthood, and enhanced family capacity to provide for their children's needs.     

Does Level of Intimate Partner Violence and Abuse Predict the Content of Family Mediation Agreements?

This study investigated whether reported levels of intimate partner violence (IPV) and/or abuse (IPV/A) victimization are related to reaching agreement and to the content of mediation agreements of parties seeking to resolve family‐ and child‐related issues. Whether or not parties reached agreement was analyzed for 105 cases at a law school mediation clinic. Agreement content was coded for the 71 cases that reached agreement. Levels of IPV and IPV/A were determined separately for males and females, using a standardized measure. Regression models were utilized to examine reports of IPV or IPV/A as predictors. Results indicated that mediation may help families with a reported history of IPV and IPV/A address a variety of concerns; levels of partner violence/abuse predicted numerous issues in mediation agreements, including arrangements regarding legal custody, parenting time, holidays, child exchanges, interparental communication, safety restrictions, counseling referrals, child support, financial arrangements, and other miscellaneous topics (e.g., relocation). However, some findings were consistent with concerns raised about the use of mediation with parties reporting IPV and IPV/A; for example, increasing levels of male‐perpetrated IPV/A predicted increased likelihood of making an agreement to share legal custody. Further research is needed to resolve the longstanding debate of whether divorce mediation is an effective and safe process for parties demonstrating IPV/A.

Key Points for the Family Court Community
• This study adds to the debate of whether divorce mediation is an effective and safe process for parties demonstrating IPV/A.
• It examines whether reported levels of IPV and IPV/A victimization are related to reaching agreement and to the content of mediation agreements of parties seeking to resolve family‐ and child‐related issues.
• Results provide some evidence that mediation may help families with a reported history of IPV and IPV/A address a variety of concerns.
• However, some findings are consistent with concerns raised about the use of mediation with parties reporting IPV and IPV/A.
• Findings have implications for the practice of family mediation with parties reporting a history of IPV or IPV/A.

     

Recidivism Outcomes for Suburban Mental Health Court Defendants

Mental health courts have recently emerged as one means to reduce the number of persons with mental illness in the criminal justice system. Using a post-test only comparison group design, this study examined rearrest rates for 1 year post discharge among three groups meeting admission criteria for a municipal mental health court. The rearrest rate of defendants who successfully completed the program (N = 351) was 14.5%, compared to 38% among defendants negatively terminated from the program (N = 137), and 25.8% among defendants who chose not to participate (N = 89). This positive result held even when controlling for a range of variables in a Cox regression survival analysis. Factors associated with rearrest are identified for each of the three groups.