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Community-Based Alternatives for Justice-Involved Individuals with Severe Mental Illness: Review of the Relevant Research

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Abstract

Community-based alternatives to conviction and imprisonment for adult offenders with severe mental illness are receiving increasing attention from researchers and policy makers. After discussing the justifications that have been offered in support of community-based alternatives, this article reviews the current empirical evidence relevant to such alternatives. The authors use the sequential intercept model as a guide and summarize the existing research at several points along the criminal justice continuum. They conclude by highlighting the gaps in existing research and discussing the need for further research in several key areas.

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... From here, this paper will discuss applications of FACT across the sequential intercept model (SIM), a criminal justice policy framework rooted in the principles of therapeutic jurisprudence (Munitz & Griffin 2006). The SIM holds that there are six distinct points or "intercepts" within the criminal justice system, where individuals with mental illness can benefit from access to community-based services (DeMatteo et al. 2012). In addition, FACT's research base will be critically examined with respect to three key areas across the SIM: pre-trial diversion, alternative to incarceration, and community reentry. ...
... In recent years, researchers have examined the use of FACT teams for individuals with histories of mental illness and incarceration that do not have current criminal justice mandates, such as through probation Zampella or mental health courts (Heilbrun et al., 2012;Skeem et al., 2015). The reasons for doing so stem from exploring FACT as a method to prevent future arrests and involvement in the justice system for this population (Wilson & Draine 2006). ...
... In particular, the literature at this intercept focuses most prominently on the relationship between police officers and behavioral health service providers, including FACT teams. A recent survey of 41 police departments nationwide also noted that although less than half of the police departments surveyed had active partnerships with local FACT teams and other behavioral health service providers, but among the police departments that did, rates of arrest and use of force among people with mental illness were markedly less than those that did not (Heilbrun et al., 2012). ...
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In the United States, adults with serious mental illness are overrepresented in the criminal justice system. The sequential intercept model is a novel framework that identifies three major stages where interventions for this population can best be utilized: pretrial diversion, post-plea alternative to incarceration (ATI), and community reentry from jail and prison. This paper begins with a review of the literature that supports the application of Forensic Assertive Community Treatment (FACT) across these three stages. This paper will also draw on the influences of therapeutic jurisprudence, which holds that the courts can be used to both advance public safety and enhance access to mental health services for justice involved people with serious mental illness. The literature has suggested that patients receiving FACT services have been found to have lower rates of psychiatric hospitalization and criminal justice recidivism in comparison to those who received traditional mental health services. This paper will touch on cutting edge practices to reduce psychiatric hospitalization and criminal justice recidivism rates among people with mental illness that are currently in use. In particular, programs involving law enforcement integration such as ACT-PI teams, co-response teams, and crisis intervention training will be explored. This paper will focus on applications and limitations of FACT across the various stages of the sequential intercept model, with a particular focus of using FACT as a way to reduce racial and gender disparities within the criminal justice system among people with serious mental illness. In light of the broad support the literature highlights for FACT when applied earlier within the criminal justice system, social work practice efforts should accordingly focus on expansion of early access to FACT services. In particular, criminal justice policy efforts should be expanded with respect to utilization of these services at the pretrial diversion and ATI stages, where they are historically underutilized.
... Studies analyzing the outcomes of CITs often report on three findings: (i) the characteristics and long-term outcomes of individuals served under this model; (ii) the impact of CIT training on officers; and (iii) the outcomes from an officer contact, commonly referred to as a "call disposition" (Heilbrun et al., 2012). Individuals brought to a psychiatric hospital by CIT-trained officers were more likely to have a serious psychiatric impairment (e.g., diagnosis of schizophrenia) and to have been known to the local mental health system compared with individuals brought to the hospital by non-CIT-trained officers (Strauss et al., 2005). ...
... Studies of the impact of CIT training on officers found that they report increased confidence in their approach with individuals who exhibit symptoms of mental illness (Borum, Deane, Steadman, & Morrissey, 1998;Hanafi, Bahora, Demir, & Compton, 2008;Heilbrun et al., 2012) and perceive themselves as more efficacious at serving this population (Borum et al., 1998). Additionally, CIT-trained officers show significant increases in their knowledge of symptoms of mental illness and exhibit a change in attitude toward this population (Compton, Esterberg, McGee, Kotwicki, & Oliva, 2006;Hanafi et al., 2008;Wells & Shafer, 2006). ...
... Interviews with officers revealed that they frequently self-select into CIT training because of prior experience with someone who had mental illness (Cross et al., 2014;Wood & Watson, 2017) or they believed they would benefit from having the enhanced skills as a response to the demand for it in their jurisdiction. Similarly to other studies, officers report that the training gave them an increased sense of confidence when taking crisis calls (Borum et al., 1998;Canada, Angell, & Watson, 2012;Hanafi et al., 2008;Heilbrun et al., 2012). ...
Article
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The crisis intervention team (CIT) is a tool that can be used to foster pre-booking diversion of individuals with mental illness from the criminal justice system and into community treatment services. Although CIT is often implemented solely as the training of law enforcement officers, the model stipulates that CIT is a vehicle for collaboration with community stakeholders who share a similar philosophy, as well as expanded mental health services offering a 24 hour–seven days per week drop-off option for law enforcement officers. This case study presents the countywide implementation of CIT and expands previous findings on the prevalence of officer interaction with persons with mental health issues and CIT training outcomes, including changes in officer perception of individuals with mental health issues. Furthermore, analysis of the disposition of calls for officer assistance coded as mental health or suicide found significant increases in officer drop-offs to the mental health crisis center post-CIT training. Interrupted time series analysis determined that this change has been sustained over time, perhaps owing to the unique communication between county law enforcement and mental health staff. Implications for policy and practice are discussed.
... The SIM particularly highlights opportunities for implementing community-based treatment for justice-involved individuals with mental illness as a means of reducing further penetration into the criminal justice system (Munetz & Griffin, 2006). In addition to being less costly than treatment provided in correctional settings, community-based treatments more appropriately address the needs of individuals with mental health issues (Heilbrun et al., 2012). As community-based alternatives specifically target individuals with mental illness, they can provide more targeted treatment than can the criminal justice system, which handles individuals with a wide variety of needs (Heilbrun et al., 2012). ...
... In addition to being less costly than treatment provided in correctional settings, community-based treatments more appropriately address the needs of individuals with mental health issues (Heilbrun et al., 2012). As community-based alternatives specifically target individuals with mental illness, they can provide more targeted treatment than can the criminal justice system, which handles individuals with a wide variety of needs (Heilbrun et al., 2012). Furthermore, there is a humanitarian value to community-based treatment, particularly for individuals who come into contact with the criminal justice system due to behavior caused by their mental illness (Heilbrun et al., 2012). ...
... As community-based alternatives specifically target individuals with mental illness, they can provide more targeted treatment than can the criminal justice system, which handles individuals with a wide variety of needs (Heilbrun et al., 2012). Furthermore, there is a humanitarian value to community-based treatment, particularly for individuals who come into contact with the criminal justice system due to behavior caused by their mental illness (Heilbrun et al., 2012). These individuals are at relatively low risk of reoffending if their behavioral health issues are addressed, and it is therefore in their best interest, as well as the public's, to provide this group with access to alternative treatments (Heilbrun et al., 2012). ...
... In recent years, there has been a dramatic shift in how the criminal justice system handles offenders with specific needs, including druginvolved offenders and adults with severe mental illness. As it became clearer that standard criminal justice processing was not resulting in meaningful improvement in terms of relapse to drug use, mental health functioning, and criminal recidivism, the criminal justice system responded by developing an array of alternatives to standard prosecution (Heilbrun et al., 2012). These community-based alternatives span the full criminal justice system continuum and represent a significant departure from how the criminal justice system previously handled offenders with specific needs. ...
... As such, offenders with special treatment needs, such as drug use or mental health problems, may not get the types of targeted services that research has shown to be effective in addressing such needs. By contrast, community-based alternatives can provide targeted interventions to a narrower group of offenders, which presumably increases the likelihood that offenders' treatment needs will be appropriately addressed (Heilbrun et al., 2012). ...
... Community-based providers also tend to use more evidence-based practices than institutional providers (Friedmann, Taxman, & Henderson, 2007). Additionally, these interventions appear not to jeopardizeand may even enhancepublic safety in the communities where they are implemented (Heilbrun et al., 2012). ...
... Mental illness can cause individuals to act in ways that officers perceive as non-compliant, which increases the likelihood of arrest (Fisher et al., 2011;Rossler & Terrill, 2017), as well as the likelihood of an officer's use of force (Fuller et al., 2015). Crisis Intervention Team (CIT) trainings were designed to train officers in identifying symptoms of mental illness, and has been found to increase their preparedness for interactions with individuals with SMI (Bonfine et al., 2014;Heilbrun et al., 2012). However, to date, there is insufficient research to determine whether CIT training helps to reduce officers' use of force, especially during interactions with individuals with mental illness. ...
... CIT has been found to have a positive effect on self-reported officer attitudes toward individuals with mental illness, knowledge of mental illness, and readiness to respond to mental health crises (Compton et al., 2008(Compton et al., , 2014a(Compton et al., , 2014b. CIT-trained officers were more likely to report feeling prepared for situations with mental health crises (Heilbrun et al., 2012), were better able to identify and screen for mental illness (Wells & Schafer, 2006), and showed increased knowledge of mental illness, common medications, and triggers (Kubiak et al., 2017). ...
Article
This study examined the level of force used by Crisis Intervention Team (CIT) and non-CIT officers responding to individuals experiencing a mental health crisis (N = 382). Level of force was coded using National Institute of Justice (2009) strategy, least to most lethal. Analyses examined differences in officers’ use of force by CIT-training status and citizen characteristics. Results indicated CIT-trained officers were less likely to use any level of force and more likely to use the lowest level of force, compared to non-CIT-trained officers. CIT-trained officers were significantly less likely to escalate to higher levels of force, utilizing the lowest level of force more often.
... Within the law enforcement, pre-arrest context, 'diversion' occurs when police officers redirect people, for example, with learning disabilities or mental health challenges to assessment and intervention/treatment services, instead of arresting them (Schucan and Shemilt 2019). This is expected to reduce criminal activities, promote public safety, improve access to relevant mental health services for those in need of such, and save money (Kane et al. 2018, Heilbrun et al. 2012). In the public health context, triage occurs when health and social care services identify and prioritise service delivery according to need (Stanfield 2015). ...
... Diversion and triage are an established practice across LEPH that can lead to fewer arrests (Schucan and Shemilt 2019), a reduction in criminal behaviour, and improved access to healthcare services (Heilbrun et al. 2012, Kane et al. 2018. For diversion and triage to succeed, there must first be an inter-professional understanding of whose role is most appropriate at each stage of contact (Bartkowiak-Théron and Asquith 2017, Enang et al. 2019. ...
Article
Assessing vulnerability is an international priority area across law enforcement and public health (LEPH). Most contacts with frontline law enforcement professions now relate to ‘vulnerability’; frontline health responders are experiencing a similar increase in these calls. To the authors’ best knowledge there are no published, peer-reviewed tools which specifically focus on assessing vulnerability, and which are specifically designed to be applicable across the LEPH frontline. This systematic review synthesised 33 eligible LEPH journal articles, retaining 18 articles after quality appraisal to identify assessment guidelines, tools, and approaches used relevant to either law enforcement and/or public health professions. The review identifies elements of effective practice for the assessment of vulnerability, aligned within four areas: prevention, diversion/triage, specific interventions, and training across LEPH. It also provides evidence that inter-professional/integrated working, shared training, and aligned systems are critical to effective vulnerability assessment. This systematic review reports, for the first time, effective practices in vulnerability assessment as reported in peer-reviewed papers and provides evidence to inform better multi-agency policing and health responses to people who may be vulnerable.
... State hospital bed capacity has not kept pace with the increasing rate of court-ordered forensic referrals (Colwell & Gianesini, 2011;Mossman et al., 2007), resulting in waitlists at local jails and decreasing hospital capacity for civil patients. The combination of burgeoning forensic populations, lean state mental health budgets, and successful lawsuits arguing for placements in "least restrictive settings" for forensic patients has led many states to develop community forensic programs as alternatives to correctional confinement and inpatient hospitalization (Bloom, 2012;DeMatteo, LaDuke, Locklair, & Heilbrun, 2013;Heilbrun et al., 2012;Wall, 2013). Examples of innovations that can decrease pressure on jails and state hospitals include pre-and postbooking jail diversion programs (Sirotich, 2009), mental health courts (Burns, Hiday, & Ray, 2013), in-creased services for insanity acquittees (Vitacco, Vauter, Erickson, & Ragatz, 2014), and specialized services for probationers or parolees with mental illness (Eno Louden et al., 2012). ...
... Given the rise in the number of community-based forensic programs nationwide over the last several years, the development of OCRPs is hardly surprising. States are looking for viable alternatives to resource-intensive forensic hospitalizations (Bloom, 2012;DeMatteo, LaDuke, Locklair, & Heilbrun, 2013;Heilbrun et al., 2012). Although the idea for outpatient competency restoration is not new, many states are increasingly forced to explore alternatives to inpatient restoration as hospital resources and state mental health budgets fail to meet the needs of growing populations, and as federal oversight and legal challenges continue to mount. ...
Article
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In response to consistently increasing numbers of individuals found incompetent to stand trial, some states have identified community-based or “outpatient” competency restoration programs (OCRPs) as a viable alternative to inpatient restoration. This study used a multistep approach to capture information about OCRPs nationwide. We reviewed states’ competency statutes to determine which states have provisions that allow for outpatient competency restoration, and we then corroborated this review with a brief preliminary survey that was disseminated to each representative of the Forensic Division of the National Association of State Mental Health Program Directors. We received responses from 48 of 51 U.S. jurisdictions (47 states and the District of Columbia). We conducted in-depth interviews with forensic representatives in those 16 states that identified having operational OCRPS. The current study presents our analysis of state statutes and then compares and contrasts current OCRPs. In summary, OCRPs are a recent but rapidly developing alternative to traditional inpatient restoration. Through a comparison of existing OCRPs, we believe OCRPs show preliminary but promising outcomes in terms of high restoration rates, low program failure rates, and substantial cost savings.
... Published reviews of CIT research suggest that CIT is effective in improving officer attitudes about interactions with persons with mental illness and improving officers' confidence about their ability to appropriately respond to calls regarding persons with mental illness (Compton et al., 2008;, 2011Heilbrun, 2012). Borum et al. (1998) found that when compared with non-CIT law enforcement officers, Memphis officers who had gone through CIT training were more likely to feel prepared for situations involving persons with mental illness, more likely to characterize the local mental health system as 'helpful', and more likely to describe local emergency rooms as 'helpful'. ...
... The degree of force used related strongly to the subjects' potential for violence, and CIT officers used force less often than officers who had not been trained in CIT. Evidence from the work of Compton and associates (2008) and Heilbrun (2012) suggests that CIT increases the connection of persons with mental illness to psychiatric services or diverts them to services instead of jail. ...
Article
The primary intent of this article is to trace the historical context of Crisis Intervention Team (CIT) training and present the various elements of the Memphis CIT model as highlighted throughout the literature. We begin by operationalizing how the literature defines CIT training and the various elements that comprise its foundation. Next, we provide a review of extant literature with focus on evidence that support the impact of CIT across various police agencies in the USA. Then we demonstrate how research is translated into practice by introducing the 10 case of Jefferson Parish Sheriff’s Academy and its use and development of CIT training for law enforcement in the state of Louisiana, USA. A brief summary and conclusion are offered.
... During the past decades, therapeutic jurisprudence has been developed in the criminal justice system (CJS) and is defined as the extent to which legal procedures and decisions can affect therapeutic outcomes in the individuals involved (Lurigio and Snowden, 2009). Since standard prosecution has proven largely unsuccessful in reducing criminal offending and enhancing (drug) abstinence in offenders with specific (treatment) needs, such as substance use or mental health treatment and social services, a problem solving approach was established in the CJS by moving away from standard prosecution to administering community-based judicial alternatives (Dematteo et al., 2013;Heilbrun et al., 2012). Problem solving courts (PSCs) are, next to diversion to treatment by police officers or by public prosecutors, a result of this therapeutic jurisprudence movement (DeMatteo et al., 2013). ...
... Indeed, criminal offending is often a result of societal, social and/or personal factors (Winick, 2003). Main examples of PSCs are mental health courts, community courts and drug treatment courts (DTCs) (Heilbrun et al., 2012). ...
Article
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Purpose – Problem solving courts are a result of the therapeutic jurisprudence movement. Drug treatment courts (DTCs), for instance, aim to divert substance using offenders away from the criminal justice system (CJS) to (drug) treatment services. DTCs are associated with reduced criminal offending and substance use. Psychosocial outcomes of DTCs, such as employment, health and family relations, received only little attention. The paper aims to discuss these issues. Design/methodology/approach – This paper focuses on the outcomes regarding substance use and psychosocial variables of a Belgian DTC situated in the Ghent region, which were investigated by a naturalistic evaluation study with a pre- post-design using judicial files. Findings – The results show that Ghent DTC clients were diverted to drug treatment and financial counselling services. Next the Ghent DTC produced beneficial outcomes regarding employment. Contrary to criminal offending (De Keulenaer and Thomaes, 2013), substance use was not significantly reduced in the Ghent DTC sample. Yet more compliance with opioid maintenance treatment was observed. Information on more client centred outcomes such as health and social relations was lacking, precluding a full outcome measurement of psychosocial variables. Research limitations/implications – Future DTC studies should address more client centreed outcomes by gathering information through DTC clients and treatment services instead of solely relying on judicial data sources. In addition, DTCs should develop a clear and uniform registration system regarding these outcomes. Originality/value – Since the therapeutic jurisprudence movement continues to expand, discussion regarding the roles and tasks of the CJS as well as treatment and counselling services is vital. Each actor should maintain its own role and task, regarding monitoring and substantive work, to insure a “problem solving approach” that is in line with the recovery philosophy.
... Over the last several years, the rate of adjudicative competence evaluations has been steadily rising, alongside decreases in the base rate of competence, which has contributed, in part, to what many have termed a nationwide "competency crisis" (Gowensmith, 2019;Gowensmith & Murrie, 2022). Indeed, many states are facing lawsuits related to excessive wait times to be evaluated and/or admitted for competence restoration treatment, for which nationwide efforts have been made to develop alternative models of treatment (e.g., jail-and community-based restoration), unique models of service delivery, and/or diversion (Callahan & Pinals, 2020;Gowensmith et al., 2016;Heilbrun et al., 2012Heilbrun et al., , 2019Murrie et al., 2023; Substance Abuse and Mental Health Services Administration [SAMHSA], 2022). ...
Article
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Research has indicated that individuals with intellectual disability represent a relatively small but meaningful subset of defendants referred for adjudicative competence evaluations. While scholars have consistently argued that this population is unique and requires special consideration in terms of the competency assessment and treatment process, little is known about this population overall and/or the relative effectiveness of the uniquely tailored interventions recommended in the literature. The current study, an archival analysis of 117 court-ordered adjudicative competence evaluations, aimed to address this gap by focusing exclusively on a known group of defendants with intellectual disability. The results revealed a significantly lower base rate of opined competence (18.8%) relative to the larger population of defendants referred for competency evaluations (i.e., historically between 70% and 80%). Nearly one-quarter of the sample was opined unrestorable, which was associated with significantly lower measured intelligence (d = 0.61 and 0.91) and adaptive behavior scores (d = 1.04) than their counterparts. These results add to a very limited body of research on this subset of defendants. Implications are discussed in terms of systemic considerations, with a particular emphasis on the need for appropriate services for this subset of defendants, as well as a commitment to research on the efficacy of these interventions.
... Since the adoption of the SIM by the Substance Abuse and Mental Health Services Administration (SAMHSA) in 2010, this model has been one of the first to inform criminal justice policy with respect to people living with mental illness (Costigan, Woodin, Duerksen, & Ferguson, 2021;Rohrer, 2021). In terms of specific interventions for people with serious mental illness, Assertive Community Treatment (ACT) has been widely considered a superior treatment model associated with reductions in psychiatric hospitalization rates (Heilbrun et al., 2012). This study represents an examination of ACT used within the pretrial intercepts of the SIM. ...
... Officers trained in the CIT model are more likely to report verbal de-escalation or negotiation as their highest level of force utilization in response to mental health crises. CITtrained officers are less likely to arrest people with mental illness (74,75) and more likely to transport individuals to psychiatric services rather than jail (76,77). Yet, three decades in, activists and scholars critique CITs as another carceral mechanism propagating harm against youth of color. ...
Article
Suicide rates among ethnoracially minoritized youth (i.e., youth of color) peak before the age of 30, and striking disparities in access to mental health services have been identified in this age group. However, suicide prevention strategies have yet to fully address structural racism as a mechanism in producing disparities in risk, protective factors, and access to quality effective intervention for youth of color. Such an approach is critical to provide more culturally responsive mental health care. Through an adapted socio-ecological model, the authors propose the Structural Racism and Suicide Prevention Systems Framework and illustrate pathways through which structural racism impacts suicide prevention and intervention for youth of color in the United States. The authors contextualize the impact of structural racism in three key settings where youth suicide prevention occurs: mental health services, schools, and the interface between crisis care and law enforcement. The authors posit that critical attention must be paid to the intersection of mutually reinforcing, interdependent systems rather than to systems in isolation. The authors then propose recommendations to address structural racism in suicide prevention, including macro-level interventions to improve societal conditions, research strategies to inform structural solutions, training approaches to address institutional racism, and clinical approaches to address the impact of racism and racial trauma on youths and families.
... mental health services) to which the person is diverted. The appeal of diversion programmes is their potential to reduce the prevalence of mental health disorders in prisons, increase access to appropriate J o u r n a l P r e -p r o o f services for people with mental health conditions, reduce recidivism in the long-term and increase public safety, all with the potential for cost savings [22][23][24]. ...
Article
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Purpose Women in prisons are known to suffer with more mental health difficulties and many experience challenges prior to incarceration. Diversion programmes are initiatives designed to divert people with pre-existing mental illness from the criminal justice system into mental health services. The variability of effectiveness of interventions makes realist approaches particularly appropriate for diversion programmes, and this paper presents the first realist review to be undertaken across the breadth of this topic. This realist review aimed to explain the successes, failures and partial successes of these programmes as an intervention to improve the outcomes of women offenders with mental health issues. Methods We conducted a realist review of published literature explaining the impact of diversion programmes on participants with mental health issues. Consultations with six specialists in the field were conducted to validate the principles and hypotheses about key dynamics for effective programmes. Results The review included 69 articles. We identified four essential principles, developed through thematic groupings of context-mechanism-outcome configurations, to articulate key drivers of the effectiveness of diversion programmes: coordination between services; development and maintenance of relationships; addressing major risk factors; and stabilisation through diversion programmes. Conclusions The behaviour of women offenders is driven by need, and the complex needs of this group require individualised plans that incorporate relationships as vehicles for support and change. Although there is a role for gender-specific interventions, it is not fully understood and further research is required. Implications for future interventions are discussed.
... Defining characteristics of mental health courts, in particular, include a specialized docket devoted to defendants with mental illness; incorporating a less adversarial approach, which encourages collaboration between the judge, prosecutor, and defense counsel; agreement from the defendant to adhere to a treatment plan; regular court appearances for judicial monitoring of the defendant's compliance; and reduction or dismissal of charges on successful completion of the program (Moore & Hiday, 2006). Although the research on problem-solving courts is mixed and riddled with methodological shortcomings, studies have found that drug courts and mental health courts can yield positive results, in terms of both criminal justice outcomes (e.g., fewer jail days, lower rearrest rates) and clinical outcomes (e.g., reduced drug abuse, greater engagement with mental health treatment; DeMatteo et al., 2013;Heilbrun et al., 2012). ...
Article
The social justice uprisings that have stemmed from several recent highly publicized murders of Black people by police have shed increasing light on the systems of oppression, inequity, and white supremacy that have been the backbone of the United States' policing and criminal justice systems since their inception. The American Psychological Association, along with many professional organizations across the subfields of psychology, has released its statement outlining how psychology must contribute to the eradication of systemic racism and white supremacy. In this article, we address the need for psychology and its subfields to acknowledge our complicity in certain systems of oppression, such as our ties to law enforcement and the police, our support of mental health reforms that merely increase the scope of a punitive criminal justice system, and our complicity in the harm done by our current immigration policies. We argue that the best way, in fact the only way, for the profession to move toward an antiracist psychological practice is to embrace an abolitionist framework so that we may reimagine our relationships with historically oppressive institutions and rebuild our clinical practices to promote life-affirming interventions and liberation for individuals and communities.
... The second point of diversion occurs at the initial detention and hearing, and consists of screening, assessment, and negotiation with diversion staff and criminal justice personnel to provide a treatment plan or reduce/ drop the charges (Broner et al., 2004). Individuals diverted at this stage of the model tend to spend more time in the community, participate in more treatment programs, and are seemingly less likely to be rearrested than individuals who have not been diverted (Heilbrun et al., 2012). ...
Article
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Recent research has suggested nationwide increases in the rates of referral for competence to stand trial (CST) evaluations across the United States. Many of these evaluations are for defendants charged only with misdemeanor offenses and for whom diversion programs are most appropriate. The present study was designed to analyze the characteristics of, and re-arrest outcomes for, defendants charged with misdemeanors ordered to undergo CST evaluations in a large metropolitan area. Overall, there was a high base rate of incompetent to stand trial (IST) opinions (over 70% of defendants) in this sample, with the greatest impairments in rational understanding and ability to assist counsel. Defendants opined IST were more likely to have a psychotic disorder, a history of psychiatric hospitalization, and greater abnormalities in thought content relative to their competent counterparts. Of concern, defendants opined IST, and especially those referred for crisis evaluations upon dismissal of the charges, were significantly more likely to be re-arrested than their counterparts. These data support the criminalization hypothesis, suggesting that criminal justice involvement for this subset of defendants inappropriately reflects psychiatric instability, supporting the need for more options for inpatient and outpatient treatment to effectively intervene in this process. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... With growing recognition that a robust community-based behavioral health system will prevent justice involvement, Intercept 0: Hospital, Crisis, Respite, Peer and Community Services was added and refined (Abreu, Parker, Noether, Steadman, & Case, 2017). Grounded in the principle that community-based treatment is more effective and cost efficient, the goal is to divert individuals from further penetration into the justice system by providing community-based treatment alternatives (Heilbrun et al., 2012). As such, SIM Intercepts correspond to criminal justice decision junctures and are available intervention points to prevent further entrenchment in the justice system. ...
Article
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Justice-involved youth experience high rates of adverse childhood experiences (ACEs), placing them in great need of behavioral health treatment and risk for continued justice involvement. Policymakers, government agencies, and professionals working with justice-involved youth have called for trauma-informed juvenile justice reform. Yet, there is currently no available review of the literature on ACEs and their impact on justice-involved youths' psychological, legal, and related (e.g., academic) outcomes to rigorously guide such reform efforts. The current systematic scoping review synthesizes existing literature related to the impact of ACEs on justice-involved youth and offers recommendations for data-driven intervention along the Sequential Intercept Model, which describes five different points of justice system contact (i.e., first arrest, court diversion, detention, and community supervision) in which there is opportunity to intervene and improve youth behavioral health, legal, and associated outcomes. Eight unique studies were included in 40 articles examining ACEs among justice-involved youth; 38% were longitudinal or prospective analyses and none were intervention studies. Studies included delinquency (e.g., recidivism; n = 5), psychiatric (n = 4), substance use (n = 3), and other (n = 2; e.g., academic, pregnancy) outcomes, documenting high prevalence of ACEs and significant associations between ACEs and a variety of outcomes. Implications for clinical services (e.g., targeting youth dysregulation and aggression), agency context (e.g., training police officers in trauma-responsive practices), and system-level changes (e.g., intervening at the time of first ACE documentation such as parent's arrest) are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Some experts suggested that alternative models within corrections systems could be developed for rapid case management to ensure that brief touch points can still be used; the ability to have quick, established options within the corrections setting would allow greater coverage for those for whom limited confinement times preclude extended assessment. Collectively, the demands on the criminal justice system often might cost more than providing housing alone (Heilbrun et al., 2012), although other panel members suggested that this point should be further studied by conducting benefit-cost evaluations to show the value of housing approaches relative to criminal justice intervention. ...
... Research has demonstrated that community-based services have greater rehabilitative effectiveness than those provided in correctional facilities, for reasons including greater access to targeted interventions, greater use of evidence-based practices, and the ability to provide individualized or focused care (e.g., Friedmann, Taxman, & Henderson, 2007;Gendreau, French, & Gionet, 2004;Heilbrun et al., 2012). Although there are mixed findings regarding the impact of reentry programs as captured by statistical significance and effect size, reentry services have been associated with reduced recidivism (e.g., Berghuis, 2018;Lutze, Rosky, & Hamilton, 2014); increased engagement in rehabilitative opportunities, including employment, vocational training, and SUD treatment services (Morani et al., 2011); and improved outcomes related to housing, substance use, and employment (Lattimore & Visher, 2013). ...
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The emergence and rapid growth of the coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the U.S. criminal justice system as federal and state governments consider allowing the early release of select currently incarcerated individuals to mitigate the pandemic’s spread. As a result, the number of incarcerated individuals released into the community is likely to increase abruptly. COVID-19 has drastically altered the communities to which reentering individuals are returning, and the needs of reentry populations are changing accordingly. This article reviews the existing and anticipated criminogenic needs of previously incarcerated individuals as they transition to the community during a pandemic. It also provides recommended adaptations to reentry services in order to promote successful reentry during the COVID-19 pandemic.
... Crisis intervention is specifically designated as a critical training need, and mental health response training is often mandated (The President's Task Force on 21st Century Policing, 2015). The Memphis model of crisis intervention team (CIT) training is perhaps the most successful use of psychologists and other mental health workers in law enforcement officer's training (Compton, Bahora, Watson, & Oliva, 2008, Heilbrun et al., 2012. In the 40-hour training sequences for CIT, officers partner with local mental health and substance abuse treatment personnel in the local community to simulate situations in which officers respond to a call when a mental health crisis is occurring. ...
Article
True justice is equitable. Counseling psychologists, through their skills, knowledge, and values, can be a powerful force in reforming a system that oppresses marginalized groups to one that is just. In this paper, we focus on three major aspects of the justice system: laws and the courts, law enforcement, and detention and corrections, and we further describe injustice in these three areas. We then use critical race theory and counseling psychology perspectives to develop a framework to provide counseling psychologists with practical strategies to transform inequities. Such strategies include advocating to change unjust laws, filling the research gap for effective and humane practices, developing evidence-based programs, and providing leadership and training.
... Appropriateness of diversion is likely to be based on the seriousness of the offence, the safety of the individual and the public (DeMatteo, LaDuke, Locklair, & Heilbrun, 2013). The appeal of prearrest diversion lies in its promise for reducing criminal recidivism in the longer term, enhancing public safety, saving money, and improving access to the appropriate services for people with mental health problems (Heilbrun et al., 2012;Kane, Evans, & Shokraneh, 2018). There has, however, been no systematic evaluation of research to date which has assessed such outcomes, so prearrest diversion is still not deemed to be evidence-based (Watson, Compton, & Draine, 2017). ...
Article
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Background Prearrest diversion strategies are being adopted across the Western world, enabling the police to identify and divert people suspected of having mental disorder towards health and community services rather than the criminal justice system. Aims To quantify longer‐term criminal justice and mental health outcomes after prearrest diversion of people with suspected mental disorder and consider economic correlates. Methods A systematic review of published literature on longer term outcomes after prearrest diversion. Results Only two quasi‐experimental studies, with four independent samples, could be included. Findings for criminal and mental health outcomes were inconclusive, but potential for adverse outcomes was identified. Ten studies with cost data suggested that prearrest diversion can lead to overall cost savings. Conclusions There is still inadequate evidence on which to base prearrest diversion programmes. Although some benefits have been identified by the review, so have possible harms. Future research and funding strategies must build in high‐quality, systematic evaluation of outcomes before implementing a theoretically attractive strategy more widely.
... In recent decades, there has been sustained focus on police responses to persons experiencing mental health crises and the need to improve safety in these encounters (Cochran, Deane, & Borum, 2000;Steadman & Morrissette, 2016). Additionally, there is wide acknowledgment of the over-representation of persons with mental illnesses in jails and prisons, and the need to divert them from the criminal justice system at the earliest point possible, ideally at the initial point of contact with the police (Heilbrun et al., 2012;Munetz & Griffin, 2006). ...
Article
In recent decades, there has been sustained focus on police responses to persons experiencing mental health crises. The Crisis Intervention Team (CIT) model has been a seminal effort to improve safety, reduce arrests and enhance the use of emergency psychiatric assessment. With CIT well established, new discussions have emerged around how to further enhance the police–public health interface, including diversion from hospital emergency departments. In this context, this article takes stock of current police practices, utilizing descriptive data on 428 mental health-related calls addressed by Chicago Police over 3 years triangulated with insights from 21 in-depth officer interviews. During these calls, hospital transports were conducted more often than arrests. Moreover, informal interventions – without any legal action or hospitalization – were used most often, speaking to the “gray zone” nature of mental health-related encounters. Taken together, the data reveal the need for non-crisis diversion options that address chronic vulnerabilities.
... Following arrest, diversion procedures at Intercept 2 may be employed at the initial court hearing or jail detention, and are meant to inform the court about the possible presence of mental illness and options for treatment (Munetz & Griffin, 2006). Individuals at this stage may receive some form of specialty probation (Heilbrun et al., 2012). Diversion at Intercept 3 often involves problem-solving courts (e.g., drug court, mental health court, veterans court). ...
Article
Society and the criminal justice system prioritize the reduction of reoffending risk as part of any criminal justice intervention. The Sequential Intercept Model identifies five points of interception at which justice-involved individuals can be diverted into a more rehabilitative alternative: (1) law enforcement/emergency services; (2) booking/initial court hearings; (3) jails/courts; (4) re-entry; and (5) community corrections/community support. The present article focuses on diversion as part of Intercept 5 - re-entry planning and specialized services in the community. We describe the challenges associated with diversion at this stage, and review the relevant research. Next, we describe a "criminogenic cognitive behavioral therapy" project that has been developed and implemented as part of a federal re-entry court. Finally, we discuss the implications of the challenges of intervention at this stage, and the recently developed "Re-entry Project," for research, policy, and practice.
... Research suggests that new ways of working (e.g. specialty caseloads) may contribute to improving compliance with community orders and reducing re-offending (Heilbrun et al., 2012;Skeem and Eno Louden, 2006;Ministry of Justice, 2014). Thus there is increasing focus on addressing offenders' welfare needs as a means of reducing re-offending rather than simply as an end in itself. ...
Article
Purpose The purpose of this paper is to examine how the role in offender mental health for the probation service described in policy translates into practice through exploring staff and offenders’ perceptions of this role in one probation trust. In particular, to examine barriers to staff performing their role and ways of overcoming them. Design/methodology/approach Qualitative secondary analysis of data from semi-structured interviews with a purposive sample of 11 probation staff and nine offenders using the constant comparative method. Findings Both staff and offenders defined probation’s role as identifying and monitoring mental illness amongst offenders, facilitating access to and monitoring offenders’ engagement with health services, and managing risk. Barriers to fulfilling this role included limited training, a lack of formal referral procedures/pathways between probation and health agencies, difficulties in obtaining and administering mental health treatment requirements, problems with inter-agency communication, and gaps in service provision for those with dual diagnosis and personality disorder. Strategies for improvement include improved training, developing a specialist role in probation and formalising partnership arrangements. Research limitations/implications Further research is required to explore the transferability of these findings, particularly in the light of the recent probation reforms. Originality/value This is the first paper to explore how staff and offenders perceive probation’s role in offender mental health in comparison with the role set out in policy.
... 112 Recent estimates conclude that over 400 such programs are now in operation nationwide, with models adapted to meet local contexts and resources. [113][114][115][116] However, there is also the opportunity to prevent people presenting with symptoms of mental illness coming into contact with police custody, especially where it might be used as a place of safety rather than where a person is suspected of having committed an offence. ...
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This paper is a scoping review of the available evidence regarding health care issues in police custody. It describes the types and prevalence of health disorders encountered in custody and provides an overview of current practice and recent innovations in police custody health care. In contrast to the health of prisoners, the health of police custody detainees has, until recently, received little academic or clinical attention. Studies on health care in police custody identified for this review are limited to a few geographical jurisdictions, including the UK, continental Europe, North America, and Australia. There are significant health concerns among police detainees including acute injury, chronic physical health problems, mental and cognitive disorders, and the risks associated with drug and alcohol intoxication or withdrawal. There is some evidence that deaths in police custody have reduced where attention has been paid to the latter issue. Police personnel continue to experience difficulties identifying detainees with health issues relevant to their safe detention, but research shows that the use of evidence-based screening tools improves detection of such morbidities. Innovations in police custody health care mainly relate to detainees with mental disorders, including improved identification of illness, timely access to mental health services, the protection of the rights of mentally disordered detainees, and the diversion of mentally disordered persons from the criminal justice system into appropriate health and social care interventions. There is a lack of rigorous research relating to interventions for physical health problems, protecting those at risk of substance withdrawal, and detainees with preexisting or peri-arrest injures. Research to improve the health of police custody detainees requires greater priority, focusing on case identification and service redesign to address high levels of morbidity and to facilitate health promotion and prevention activities.
... When released from prison or compulsory inpatient forensic psychiatric care into the community, offenders with mental health problems and substance use problems face many difficulties and are likely to have remaining problems [3,5]. Community interventions provide a realistic context in which it is possible to practice new skills, and have been highlighted as important for this, as well as other offender populations, in order to reduce problems and crime relapse rates [3,20,21]. Exploring the participation in community interventions and crime outcomes among offenders with combined mental health and substance use problems could add useful knowledge in order to facilitate treatment provision for this population. Treatment may be associated with reductions in criminal behavior which in turn may lead to an increased well-being and safety for citizens in society. ...
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Substance abuse is related to offending and substance abuse treatment has been associated with reductions in criminal behavior. This cohort study aimed to explore the relationship between participation in substance abuse interventions and general criminal recidivism among offenders with a combination of mental health problems and substance use problems. In total, 150 Swedish offenders with self-reported mental health and substance use problems were followed for approximately three years with regard to participation in substance abuse interventions and criminal recidivism. Participants with at least three planned visits to specialized outpatient substance abuse clinics had a substantially reduced risk of reoffending as compared to those with fewer than three such visits (HR = 0.47, 95% CI 0.29-0.77). For those with at least three planned visits, general criminal recidivism was reduced by 75% during periods of participation in outpatient visits, as compared to periods of non-participation (HR = 0.25, 95% CI 0.11-0.60). For offenders with mental health problems and substance use problems, outpatient substance abuse interventions could be regarded as important from a clinical risk management perspective, and be encouraged.
... Programs of particular promise include community-based diversion programs (ie, programs that utilize alternatives to incarceration). 23,50 Examples of such programs include mental health or drug courts, specialized probation teams and officers, and outpatient mental health and criminal treatment programs where the individual resides in the community. Although the empirical support for community-based programs for PMI is mixed, with some showing success [51][52][53][54] and others failing to significantly impact CJ or mental health outcomes, 55 one issue of continued concern is housing. ...
Article
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The relationship between mental illness, violence, and criminal behavior is complex, and involves a multifaceted interaction of biological, psychological, and social processes. In this article, we review the emerging research that examines the neurobiological and psychological factors that distinguish between persons with mental illness who do and who do not engage in crime and violence. Additionally, a novel model for understanding the interaction between mental illness and criminalness is proposed. (As defined by Morgan and colleagues, criminalness is defined as behavior that breaks laws and social conventions and/or violates the rights and wellbeing of others.) Stemming from this model and outlined research, we argue that management and treatment approaches should target the co-occurring domains of mental illness and criminalness to improve criminal and psychiatric outcomes. Specifically, we discuss and propose effective housing (management) and biopsychosocial intervention strategies for improving outcomes.
... Engaging female street sex workers by community-based outreach was an important component of the Coalition project and proved a desirable alternative to reaching only female sex workers in the criminal justice system. The SIM was selected as the overarching model based on the literature supporting its successful use in similar programs (Heilbrun, DeMatteo, Yasuhara, Brooks-Holliday, Shah, King, et al., 2012;Kelsey, 2004;NIMH SBIR, 2005;OMHSAS, 2002). Delaware had also used the SIM previously in the design of their mental health court (DE Supreme Court, 2010). ...
Article
Women involved in sex work experience myriad challenges, such as poverty, illiteracy, low social status and gender inequity, as they struggle to access healthcare. These challenges place them at high risk for poor health outcomes. The purpose of this article is to describe the formation of a strong cross-system Coalition representing both the criminal justice and healthcare systems to address the health needs of sex workers in Delaware. The Delaware Coalition for Health and Justice implemented a Coalition-building strategy to design interventions and streamline systems to promote health and reduce criminal justice contact for sex workers. The sequential intercept model was utilized to organize Coalition membership and build consensus among varied stakeholders. The model assisted the Coalition in understanding differing primary objectives for key system programs, recognizing the limitations and barriers of each stakeholder group, sharing findings and discovering opportunities for partnership, and engaging stakeholders in designing and providing a comprehensive "systems" approach. This work suggests that aligning the criminal justice, healthcare, and community social services in a systemic process to build consensus can result in the implementation of effective systems change initiatives that address gender disparities and promote the health of justice-involved women. Copyright © 2014 Elsevier Ltd. All rights reserved.
... The person thus avoids or spends a significantly reduced time in jail and/or lockups on the current charge or on violations of probation resulting from previous charges. Diverting certain individuals from jail to community-based mental health treatment has been heralded for its potential benefits to the criminal justice system, the community, and the diverted individual (Case, Steadman, Dupuis, & Morris, 2009;Steadman & Naples, 2005; also see Heilbrun et al., 2012, for a comprehensive recent review of the research on community-based alternatives for justiceinvolved individuals with SMI). ...
Article
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Study attrition is a problem in all community-based intervention studies using longitudinal research designs, but is compounded with hard to reach populations. High attrition poses threats to internal and external validity and may result in an inadequate sample size. The purpose of our study was to determine the characteristics associated with attrition. The study employed data from a cross-site evaluation of jail diversion programs. A self-report interview was conducted at baseline for 1,289 individuals. A 33% and 52% attrition rate was observed at the 6-month and 12-month follow-up interviews, respectively. The characteristics associated with loss to follow-up were male gender, part-time or full-time employment, drug offenses, jail days, baseline interview location, community supervision, and community geography. Knowing which individuals are more likely to attrit allows evaluators to develop targeted sampling strategies and participant engagement strategies.
... In recognition of the unique challenges faced by offenders with SMI, an array of specialized interventions has been developed for this population in the past two decades (Epperson et al., 2011), most of which entail a community-based diversion component as an alternative to incarceration (Heilbrun et al., 2012). Two types of specialty programs have been developed for persons with SMI on probation: specialized mental health probation and mental health court. ...
Article
Specialized probation programs were developed to more effectively address the unique needs of probationers with serious mental illnesses. Probation officers are tasked with serving both law enforcement and rehabilitative functions, and officers play an important gatekeeper function in helping probationers with serious mental illnesses avoid long incarceration sentences. The purpose of this paper was to explore specialized and standard probation officers' work in supervising probationers with serious mental illnesses. Twenty-one probation officers (11 specialized and 10 standard) participated in semi-structured interviews. Qualitative analyses examined: 1 — beliefs on the relationship between mental illness and crime; 2 — purpose of specialized and standard probation units; and 3 — approaches to supervising probationers with serious mental illnesses. Implications for developing more effective probation supervision programs are discussed.
... Moreover, some studies are methodologically weak, primarily because of small samples (9,10), lack of a comparison group (11,12), or research design features that are less rigorous than desired (particularly regarding uncontrolled selection effects). Comprehensive reviews of CIT research are available (13,14). ...
Article
The popularity of crisis intervention teams (CITs) for law enforcement agencies has grown dramatically over the past decade. Law enforcement agencies and advocates for individuals with mental illness view the model as a clear improvement in the way the criminal justice system handles individuals with mental illness. There is, however, only limited empirical support for the perceived effectiveness of CITs. This Open Forum analyzes research needs in this area and offers recommendations. Two major gaps in CIT research are identified: verifying that changes in officers' attitudes and skills translate into behavioral change and determining how criminal justice-mental health partnerships affect officers' behavior. Research addressing these gaps could help set benchmarks of success and identify evidence-based practices for CIT, substantially increasing the empirical base of support for CIT.
... When released from prison or compulsory inpatient forensic psychiatric care into the community, offenders with mental health problems and substance use problems face many difficulties and are likely to have remaining problems [3,5]. Community interventions provide a realistic context in which it is possible to practice new skills, and have been highlighted as important for this, as well as other offender populations, in order to reduce problems and crime relapse rates [3,20,21] . Exploring the participation in community interventions and crime outcomes among offenders with combined mental health and substance use problems could add useful knowledge in order to facilitate treatment provision for this population. ...
Article
Introduction Substance abuse is associated with criminal recidivism. Substance abuse treatment has been found to correlate negatively with re-offending among treatment utilizers. However, for offenders with mental health problems and substance abuse, research on how substance abuse treatment affects re-offending is sparse. Objectives The study aimed to examine the relationship between self-reported outpatient-based substance abuse treatment and self-reported a) re-offending, b) substance use and c) psychiatric problems among offenders with mental health and substance use problems. Methods Data were gathered from a naturalistic follow-up study with 208 participants, subjected to a court-ordered psychiatric assessment. This analysis covers 91 individuals who were followed-up after an average study period of 17 months. Among these, 68% had been sentenced to institutional imprisonment or forensic psychiatric care. Results Offences, substance use and psychiatric problems declined between baseline and follow-up. However, the reduction was not associated with self-reported treatment utilization. Among participants who were sentenced to non-institutional corrections, more individuals had utilized outpatient-based treatment compared to individuals who were sentenced to imprisonment or forensic psychiatric care. Conclusions A definitive conclusion about the effect of treatment is difficult to draw. For instance, self-reported data may not reflect actual treatment consumption. However, one interpretation is that participants naturally recovered over time. Institutional correction might also have resulted in positive outcomes equivalent to outpatient-based treatment.
... When released from prison or compulsory inpatient forensic psychiatric care into the community, offenders with mental health problems and substance use problems face many difficulties and are likely to have remaining problems [3,5]. Community interventions provide a realistic context in which it is possible to practice new skills, and have been highlighted as important for this, as well as other offender populations, in order to reduce problems and crime relapse rates [3,20,21] . Exploring the participation in community interventions and crime outcomes among offenders with combined mental health and substance use problems could add useful knowledge in order to facilitate treatment provision for this population. ...
Article
Background Substance abuse is clearly associated with criminal recidivism among offenders with and without mental disorder. Treatment for substance abuse correlates with lower rates of re-offending among participants in outpatient-based as well as institution-based substance abuse treatment programs. However, for offenders with mental disorder, research on the possible preventive effect of substance abuse treatment on criminal recidivism is sparse. This paper reports from on an ongoing naturalistic and prospective interview study on the relationship between post-release outpatient substance abuse treatment and re-offending. Methods The Stockholm county sample comprises 246 offenders of both genders subjected to a forensic psychiatric assessment, who screened positive for substance abuse problems. Eighty-five percent ( n =210) agreed to participate in the study. Baseline data and follow-up interview data, collected immediately on release from incarceration (prison/forensic hospital) and 6 and 12 months later, include self-reported substance abuse, treatment involvement and criminality. By February 2010, data will be available from the first follow-up for 150 participants, from the second follow-up for 80 individuals and from the third follow-up for 10 subjects. Results and conclusions The focus of the presentation will be recidivism comparisons between substance abuse treatment utilizers and those who decline treatment. Data on ongoing levels of substance abuse, mental health problems and offending will serve as dependent variables. Additional analyses will present perceived benefit from and reasons for accepting or rejecting treatment.
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Apstrakt: Alternativne krivične sankcije predstavljaju temu koja godinama unazad izaziva posebnu pažnju naučne i stručne javnosti. Ostvarivanje opšte svrhe krivičnog prava, alo-kacija ekonomskih resursa i najzad, prenatrpanost zatvora (kazneno popravnih zavoda), najčešće se navode kao razlozi za postojanje i primenu alternativnih krivičnih sankcija. U radu su analizirane kazna rada u javnom interesu i mera upozorenja uslovna osuda sa zaštit-nim nadzorom. Nakon uvodnog (teorijskog) i zakonodavnog okvira, u radu je predstavljen deo istraživanja koje je u toku 2017. godine sproveo Institut za kriminološka i sociološka istraživanja, u saradnji sa Misijom OEBS, na temu povrata u Republici Srbiji. Istraživanje je sprovedeno na uzorku od 502 ispitanika, prema kojima je u toku 2012. i 2013. godine izvršena neka od navedene dve alternativne krivične sankcije, pri čemu je osnovni cilj bio da se sagleda uspešnost njihove primene u smislu specijalne prevencije, te da se uz pomoć multivarijantne analize sagledaju faktori koji imaju najveću značajnost u razumevanju kri-minalnog povrata. Ključne reči: alternativne krivične sankcije, rad u javnom interesu, uslovna osuda sa zaštit-nim nadzorom, povrat, Srbija. UVOD Krivične sankcije predstavljaju sredstvo za ostvarivanje zaštitne funkcije krivič-nog prava, koja je osnovni cilj i svrha postojanja krivičnog prava u celini. 1 Pitanje si-stema krivičnih sankcija, svakako je jedno od pitanja koje je vekovima unazad pred-stavljalo jedno od centralnih pitanja, ali i sporenja u krivičnim naukama, pri čemu * viši naučni saradnik i direktor Instituta,
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The new Sentencing Council Guideline on sentencing offenders with mental disorders, effective from 1 October 2020, is essential reading for all psychiatrists who give evidence in the criminal courts, revealing something of required judicial thinking, our common ground on public safety concerns but differences in focus on culpability and punishment.
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This article explains how jail diversion introduced in one Midwestern county changed its focus over time from persons with serious mental illness (PSMI) to persons with opioid use disorder (POUD). Applying the theory of institutional isomorphism, the authors use both qualitative interview and quantitative program data to explore the isomorphic pressures that caused programming change resulting from an opioid addiction crisis at the expense of arrested PSMI not appropriate for treatment with Vivitrol ® .
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The Crisis Intervention Team (CIT) model was developed as a specialized police-based program in which officers are trained to safely interact with individuals with mental illnesses. In 2011, the Minnesota Department of Corrections adapted this program for corrections. This study compares prison incidents involving CIT officers to a comparison sample of non-CIT incidents on a number of outcomes, including gaining compliance from people in custody (either immediately or as an incident unfolds), making mental health referrals, and using force against people in custody. We conducted a content analysis of reports describing 500 incidents in an all-male, maximum security prison and estimated multivariate binary logistic models to control for characteristics of situations, incarcerated people, and employees. The findings provide some support for implementing CIT training in a correctional setting, but some less encouraging results show that improvements to the program are still needed.
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The Crisis Intervention Team (CIT) model is an established training program used to improve police response to encounters involving persons with mental illness (PwMI). Diversion of PwMI from the criminal justice system to appropriate treatment providers in the community is one of the primary goals of CIT. The present study examines characteristics and outcomes of encounters between citizens experiencing mental health-related crises and CIT-trained patrol officers. Findings of this study indicate encounters involving PwMI and CIT-trained officers often result in diversion to mental health services. Implications for policy and future research are discussed.
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Individuals with mental illnesses are disproportionately involved with the criminal justice system and are now being diverted from jails to community-based supervision. This study examines secondary data from a state hospital, mental health diversion program. Logistic regression was used to examine risk factors that best predicted successful program completion. Results indicate that non-whites are more likely to complete. Participants in supervised housing, ever been re-hospitalized, diagnosed with a depressive or psychotic disorder or who had their probation revoked were less likely to complete. Findings indicate practitioners should provide a holistic and individually oriented treatment approach for success.
Chapter
Now that the professional development foundation, mastery of the external, and professional development have been covered, we can now look into the future. Of all the chapters in this publication, this is the chapter we are most excited about. The goal of this chapter is to provide an overview of some new developments in psychology and to review different disciplines in psychology and their trajectories. In this chapter, we will review the status of prescriptive authority for psychologists, the relationship between psychology and interrogation, the relationship between psychology and coaching, and review the definition of evidence-based practice and psychology as a science. The chapter will conclude with a review of 13 different disciplines in psychology; in this section we outline the discipline and some developments in an effort to understand the trajectory of each discipline. It is a very exciting time to be a psychologist and we hope that this information is helpful!
Chapter
Diversion is a general term for all community-based alternatives to standard prosecution that occur before a criminal offender has entered a plea or gone to trial. The goal of diversion is to balance society's interest in punishing offenders with the criminal justice system's interest in reducing recidivism in a cost-effective manner. Diversion seeks to accomplish these objectives by addressing the underlying treatment needs of subsets of criminal offenders, including those who are drug involved and/or mentally ill. Various community-based alternatives to incarceration have been designed to provide treatment, social services, and supervision to diverted offenders, and different forms of diversion are implemented along various “intercepts” or stages in the criminal justice process. These include a number of prebooking initiatives such as crisis intervention teams and co-responder models, and postbooking initiatives such as mental health courts and drug courts.
Chapter
Diversion services have been in place since the late 1940s, when an increased focus on rehabilitation made its way into criminal justice policy. The introduction of treatment in lieu of incarceration has helped build models meant to engage potential offenders in the community. As a result, historical perspectives associated with diversion services drive current policies and funding allocation. This entry discusses diversion services in the criminal justice system, paying close attention to sources of referral, points of entry, and policies and practices currently in place.
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Like the Republic of South Africa, the United States faces serious challenges regarding fitness to stand trial evaluations, including long waitlists for individuals awaiting such evaluations. Some similarities exist between the RSA and US evaluation systems, including an increasing number of referrals for fitness to stand trial evaluations, limited evaluator resources, and concerns about the significant restrictions on civil liberties for those awaiting evaluation. Recently, the United States has implemented several different solutions to address these issues. These have included broadening the eligibility requirements for fitness to stand trial evaluators, utilizing localized and short-term settings for fitness to stand trial evaluations, and a host of other ideas. This article examines these different solutions, discusses their relevance and potential effectiveness for the RSA evaluation system, and makes recommendations for consideration by policy makers and mental health professionals.
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There is relatively little research in the literature on insanity acquittees as compared with the large number of studies focused on the supervision and treatment of probationers and parolees with mental illness. Ideally, the latter literature could be successfully applied to insanity acquittees discharged from an inpatient hospital on "conditional release." This article describes the challenges faced by persons on conditional release as well as the gaps in extant conditional release literature. Then, five evidence-based models for the supervision and/or treatment of probationers and parolees with mental illness are applied to a theoretical conditionally released population (mental health courts, forensic assertive community treatment teams, the risk-need-responsivity model, informed supervision practices, and HOPE probation). Benefits and limitations are noted, and recommendations for such crossover are given. Copyright © 2016 John Wiley & Sons, Ltd.
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Although many probation agencies have instituted specialty mental health caseloads, little is known about the policies and practices of these caseloads. The authors surveyed supervisors of 54 specialty and 20 traditional probation agencies. The survey yielded three key findings. First, most agencies lack formal policies on officers' supervision of probationers with mental illness (PMIs). Second, relative to traditional officers, specialty officers are more involved in supervising PMIs, meeting with PMIs more often, functioning as part of a treatment team, and using problem solving strategies. Third, although both agency types use graduated sanctions, traditional officers generally respond to PMIs' noncompliance with more punitive strategies than specialty officers. Implications for developing and evaluating these caseloads are discussed.
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The authors studied175 mentally ill, substance-using adult jail detainees assessed at baseline, 3, and 12 months through a quasi-experimental comparison design. The study examines the effect of diversion, treatment, and individual characteristics on criminal justice, mental health, substance use, and life satisfaction outcomes. The intervention group included nonmandated and mandated diversion tracks. The com- parison participants met diversion acceptance criteria but underwent standard crim- inal justice processes. Main findings included that mandated diversion clients were less likely to spend as much time in prison and more likely to spend time in the commu- nity, have been linked to residential and outpatient treatment, have received more treatment, and decrease drug use. However, those who did not perceive themselves coerced and had insight into their mental illness received more treatment regardless of diversion condition. Although mandated diversion was found effective for some outcomes, individual characteristics, treatment, and diversion in general signifi- cantly contributed.
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A large number of probationers with mental illness (PMIs) are under supervision in the United States. In this national survey, we compared the supervision approaches of a matched sample of 66 specialty mental health and 25 traditional probation agencies. The prototypic specialty agency has five key features that distinguish it from the traditional model: (a) exclusive mental health caseloads, (b) meaningfully reduced caseloads, (c) sustained officer training, (d) active integration of internal and external resources to meet PMIs’ needs, and (e) problem-solving strategies as the chief means for addressing treatment noncompliance. Probation supervisors perceived these specialty features as “very useful” and perceived specialty agencies as more effective than traditional ones for PMIs. However, the most important feature of the prototypic specialty agency may also be the most endangered: reduced caseloads. Implications for research and practice are presented.
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Mental health courts (MHCs) generally began to appear in 1997. Today, more than 80 courts exist in the United States. In the present article, the authors argue that the 2nd generation of MHCs has arrived. The authors compare 8 previously described courts (P. A. Griffin, H. J. Steadman, & J. Petrila, 2002) with 7 newer courts that have not been previously described in the psycholegal literature. The authors identify 4 dimensions distinguishing 1st- from 2nd-generation courts: (a) the acceptance of felony versus misdemeanant defendants, (b) pre- versus postadjudication models, (c) the use of jail as a sanction, and (c) the type of court supervision. The 4 dimensions are interdependent in that the acceptance of more felony cases contributes to the rise in processing cases postadjudication, using jail as a sanction and more intensive supervision. Potential reasons for the evolution of a 2nd generation are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Forensic assertive community treatment (FACT) is an adaptation of the assertive community treatment model designed to prevent criminal recidivism through criminal justice collaborations. A national survey was conducted to examine FACT collaborations with probation departments. Members of the National Association of County Behavioral Health and Developmental Disability Directors were surveyed to identify FACT programs. Programs reporting collaborations with probation departments were contacted to provide details. Fifty-six percent of FACT programs (15 of 27) reported collaborating with probation departments. Probation officers were assigned an average of 29±16 hours weekly, and 80% of programs (12 of 15) reported a favorable impact of collaboration on risk of patient rearrest. Only two programs reported using standard tools to formally assess recidivism risk. The most common barrier to collaboration was differences in philosophy between FACT team clinicians and probation officers. FACT collaborations involving probation departments are common and are viewed by most program leaders as helpful in reducing criminal recidivism.
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Mental health courts are growing in popularity as a form of jail diversion for justice system-involved people with serious mental illness. This is the first prospective multisite study on mental health courts with treatment and control groups. To determine if participation in a mental health court is associated with more favorable criminal justice outcomes than processing through the regular criminal court system and to identify defendants for whom mental health courts produce the most favorable criminal justice outcomes. Longitudinal study. Four mental health courts in San Francisco County, CA, Santa Clara County, CA, Hennepin County (Minneapolis), MN, and Marion County (Indianapolis), IN. A total 447 persons in the mental health court (MHC) and 600 treatment-as-usual (TAU) controls. Eighteen months of pre-entry and postentry data for 4 jurisdictions. All subjects were interviewed at baseline, and 70% were interviewed at 6 months. Objective outcome data were obtained on all subjects from Federal Bureau of Investigation arrest records, jails, prisons, and community treatment providers. Annualized rearrest rates, number of rearrests, and postentry incarceration days. The MHC and TAU samples are similar on the major outcome measures in the pre-entry 18-month period. In the 18 months following treatment, defined as entry into mental health court, the MHC group has a lower annualized rearrest rate, fewer post-18-month arrests, and fewer post-18-month incarceration days than the TAU group. The MHC graduates had lower rearrest rates than participants whose participation was terminated both during MHC supervision and after supervision ended. Factors associated with better outcomes among the MHC participants include lower pre-18-month arrests and incarceration days, treatment at baseline, not using illegal substances, and a diagnosis of bipolar disorder rather than schizophrenia or depression. Mental health courts meet the public safety objectives of lowering posttreatment arrest rates and days of incarceration. Both clinical and criminal justice factors are associated with better public safety outcomes for MHC participants.
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Relatively few studies have evaluated whether mental health courts reduce criminal recidivism. This study evaluated an established court and followed for two years defendants who exited the program in the court's fifth year of operation. Court administrative data and state arrest records for 99 defendants who exited a mental health court in 2005 were used to determine whether the proportion arrested and number of arrests were lower in the two years after court exit than in the two years before court entry and whether the reduction was greater for those who completed the court process. Logistic regression was used to examine completion's effect on recidivism with controls for other predictors. Survival analysis was used to discern how long court effects were sustained after exit. Defendants had significantly reduced recidivism from precourt entry to postcourt exit. Completers (N=60) and those ejected from the program (N=31) had fewer rearrests, but completers were much less likely to be rearrested (odds ratio=.12), even with confounds controlled for, and they had a much longer period before rearrest. This study adds to the evidence that mental health courts can reduce criminal recidivism among offenders with mental illness and shows that this effect was sustained for two years, even though defendants were no longer being monitored by the court or receiving court-mandated treatment. The results show that the mental health court program studied had a greater impact on defendants who completed the program than on defendants who did not.
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This study presents the long-term outcomes of a continuum of care program for co-occurring psychiatric disabilities and chemical dependency that has been recognized as a best practice model by the American Psychological Association's Committee for the Advancement of Professional Practice's Task Force on Serious Mental Illness and Severe Emotional Disturbance (APA/CAPP, 2007). Since publication of the initial positive outcomes for 18 men in 2002, this innovative recovery program continued to successfully reintegrate a total of 91 men and women with severe co-occurring disabilities who had been acquitted of violent crimes by reason of insanity (NGRI). This follow-up study showed continued positive outcomes for an additional 73 program graduates in terms of non-reoffending, psychiatric stability, substance abuse abstinence, stable housing and meaningful activity. In contrast to other studies that have applied Assertive Community Treatment and Intensive Case Management to populations with forensic issues and failed to reduce criminal recidivism, this continuum of care recovery model had strong results in preventing criminal recidivism in addition to achieving improved mental health, abstinence and quality of life.
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Diversion programs are initiatives in which persons with serious mental illness who are involved with the criminal justice system are redirected from traditional criminal justice pathways to the mental health and substance abuse treatment systems. This article is a review of the research literature conducted to determine whether the current evidence supports the use of diversion initiatives to reduce recidivism and to reduce incarceration among adults with serious mental illness with justice involvement. A structured literature search identified 21 publications or research papers for review that examined the criminal justice outcomes of various diversion models. The review revealed little evidence of the effectiveness of jail diversion in reducing recidivism among persons with serious mental illness. However, evidence was found that jail diversion initiatives can reduce the amount of jail time that persons with mental illness serve. Implications for practice and research are discussed.
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Background: Few studies have examined police officers' use of force toward individuals with schizophrenia, despite the widely disseminated Crisis Intervention Team (CIT) model of partnership between mental health and law enforcement that seeks to reduce use of force and enhance safety of officers and individuals with mental illnesses. This study tested the hypotheses that CIT-trained officers would select a lower level of force, identify nonphysical actions as more effective, and perceive physical force as less effective in an escalating psychiatric crisis, compared with non-CIT-trained officers. Methods: Police officers (n = 135)-48 CIT trained and 87 non-CIT trained-completed a survey containing 3 scenario-based vignettes depicting an escalating situation involving a subject with psychosis. Data were analyzed using repeated-measures analyses of variance. Results: Officers escalated their preferred actions across the scenarios. A significant scenario by group interaction indicated that CIT-trained officers chose less escalation (ie, opting for less force at the third scenario) than non-CIT-trained officers. Officers reported decreasing perceived effectiveness of nonphysical action across the 3 scenarios. A significant scenario by group interaction indicated that CIT-trained officers reported a lesser decline in perceived effectiveness of nonphysical actions at the third scenario. CIT-trained officers consistently endorsed lower perceived effectiveness of physical force. Conclusions: Efforts are needed to reduce use of force toward individuals with psychotic disorders. These findings suggest that CIT may be an effective approach. In addition to clinical and programmatic implications, such findings demonstrate a role for clinicians, advocates, and schizophrenia researchers in promoting social justice through partnerships with diverse social sectors.
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This study examined whether knowledge scores of Crisis Intervention Team (CIT) officers would decline in the months following CIT training and whether shorter time since training would be a significant predictor of mental health knowledge retention. This study also examined whether sociodemographic and work-related characteristics would predict knowledge retention. Eighty-eight CIT officers trained within the past three years completed an online survey containing sociodemographic and work-related questions and 17 of the 40 items used on the knowledge test that is administered at the end of training. Officers' posttraining and follow-up exam scores were matched. As expected, knowledge scores decreased significantly in the months after CIT training. Less experienced officers had lower follow-up scores. However, time elapsed since training did not predict knowledge retention. The findings indicate that CIT officers would benefit from continuing education about mental illnesses and that more seasoned officers may be better candidates for CIT training, at least in terms of knowledge retention.
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The study tested the hypothesis that case management provided to mentally ill offenders both in jail and after release from jail would reduce their recidivism. A total of 261 inmates of the Lucas County (Toledo, Ohio) jail who were diagnosed with a mental disorder were tracked for three years after their release. The relationships between recidivism and diagnostic, demographic, and case management variables were examined through event history analysis. Recidivism was associated with age, employment, previous arrests, and receipt of community-based case management. Receipt of jail-based case management, although not directly related to recidivism, significantly increased the probability of receiving community-based case management. Receipt of community case management was significantly associated with a lower probability of rearrest and a longer period before rearrest. This study found hopeful signs that expanding access to case management, both inside and outside jail, will help mentally ill people live in their communities and stay out of jail.
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The study compared three models of police responses to incidents involving people thought to have mental illnesses to determine how often specialized professionals responded and how often they were able to resolve cases without arrest. Three study sites representing distinct approaches to police handling of incidents involving persons with mental illness were examined-Birmingham, Alabama; and Knoxville and Memphis, Tennessee. At each site, records were examined for approximately 100 police dispatch calls for "emotionally disturbed persons" to examine the extent to which the specially trained professionals responded. To determine differences in case dispositions, records were also examined for 100 incidents at each site that involved a specialized response. Large differences were found across sites in the proportion of calls that resulted in a specialized response-28 percent for Birmingham, 40 percent for Knoxville, and 95 percent for Memphis. One reason for the differences was the availability in Memphis of a crisis drop-off center for persons with mental illness that had a no-refusal policy for police cases. All three programs had relatively low arrest rates when a specialized response was made, 13 percent for Birmingham, 5 percent for Knoxville, and 2 percent for Memphis. Birmingham's program was most likely to resolve an incident on the scene, whereas Knoxville's program predominantly referred individuals to mental health specialists. Our data strongly suggest that collaborations between the criminal justice system, the mental health system, and the advocacy community plus essential services reduce the inappropriate use of U.S. jails to house persons with acute symptoms of mental illness.
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Jails and prisons have become a final destination for persons with severe mental illness in America. Addiction, homelessness, and fragmentation of services have contributed to the problem, and have underscored the need for new models of service delivery. Project Link is a university-led consortium of five community agencies in Monroe County, New York that spans healthcare, social service and criminal justice systems. The program features a mobile treatment team with a forensic psychiatrist, a dual diagnosis treatment residence, and culturally competent staff. This paper discusses the importance of service integration in preventing jail and hospital recidivism, and describes steps that Project Link has taken towards integrating healthcare, criminal justice, and social services. Results from a preliminary evaluation suggest that Project Link may be effective in reducing recidivism and in improving community adjustment among severely mentally ill patients with histories of arrest and incarceration.
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Persons with mental illnesses who are released from jail or prison are at high risk of psychiatric decompensation and re-arrest. This paper describes an ACT jail linkage program for this population that won an American Psychiatric Association Gold Award (2001). Based on interviews with its first 24 participants, we illustrate how they experience factors that contribute to recidivism and decompensation. Pre- and post-data are examined to explore program outcomes. Results suggest that it is possible to identify, engage, and retain people in treatment who struggle with many risk factors. We conclude that this program should be expanded and replicated.
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Persons with severe mental disorders are overrepresented in our nation's jails and prisons. Factors including cooccurring substance use disorders, homelessness, and lack of access to community services have contributed to this problem, as have gaps between criminal justice, healthcare, and community support systems. In order to address these issues, Project Link was developed by the University of Rochester Department of Psychiatry in collaboration with five local community agencies. Project Link is designed to prevent involvement of individuals with severe mental illness from entering the criminal justice system. While many models of diversion programs exist, they are all dependent on access to appropriate community-based services. This paper will describe the steps that Project Link has taken towards integrating criminal justice, healthcare, and community support services for individuals with severe mental disorders involved in the criminal justice system.
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Persons with severe mental illness are overrepresented in jails and prisons in the United States. A national survey was conducted to identify assertive community treatment programs that have been modified to prevent arrest and incarceration of adults with severe mental illness who have been involved with the criminal justice system. Members of the National Association of County Behavioral Health Directors (NACBHD) were surveyed to identify assertive community treatment programs serving persons with criminal justice histories and working closely with criminal justice agencies. Programs were identified that met three study criteria: all enrollees had a history of involvement with the criminal justice system, a criminal justice agency was the primary referral source, and a close partnership existed with a criminal justice agency to perform jail diversion. Senior representatives of each program were subsequently contacted, and a telephone survey was administered to gather information about the design and operation of the programs. A total of 291 of 314 NACBHD members (93 percent) responded to the survey. Sixteen programs that met the study criteria were identified in nine states. The primary referral sources for 13 of these programs (81 percent) were local jails. Eleven programs (69 percent) incorporated probation officers as members of their assertive community treatment teams. Eight programs (50 percent) had a supervised residential component, with five providing residentially based addiction treatment. Eleven of the 16 programs have begun operating since 1999. Only three programs have published outcome data on program effectiveness. Forensic assertive community treatment is an emerging model for preventing arrest and incarceration of adults with severe mental illness who have substantial histories of involvement with the criminal justice system. Further research is needed to establish the structure, function, and effectiveness of this developing model of service delivery.
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The number of mental health courts in the United States is rapidly increasing, from one in 1997 to nearly 100 in 2004. However, to date there is comparatively little research regarding these specialty courts. The present study reports data on the referral and disposition decision-making processes of seven mental health courts. Information on all referrals to the seven courts over a three-month period was gathered. Results show that, in comparison with individuals involved in the criminal justice system, mental health court clients are more likely to be older, White, and women than individuals in the general criminal justice system. Furthermore, this over-representation occurs at the point of referral, rather than at the point of the court's decision to accept or reject a referral. In addition, the length of time from referral to diversion is much longer in these mental health courts than in other types of diversion programs. Implications of these findings are discussed.
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Objective: This study explored whether a crisis intervention team (CIT) promotes public safety and diversion from jail to treatment. Methods: Police reports (N=655) were analyzed for CIT events that occurred between March 2003 and May 2005 to determine each subject's potential for violence to self or others. Results: Some 45% of CIT events involved suicide crises, 26% involved a threat to others, and average violence potential ratings suggested minor to moderate risk. Officers' use of force related strongly to violence potential (eta of .54). Nevertheless, officers used force in only 15% of 189 events posing serious to extreme risk of violence and used low-lethality methods. Of events, 74% were resolved through hospitalization, whereas only 4% were resolved through arrest. Conclusions: Although the study lacked a comparison group, the results are consistent with some studies suggesting that CIT holds promise in meeting safety and jail diversion goals.
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Purpose – This chapter describes the problem of and approaches to ex-inmates with psychiatric disabilities exiting correctional custody. Although all ex-inmates must find housing and employment, persons with psychiatric disabilities require linkages to various health-related services and supports. These linkages are necessary, but it is unknown whether they are sufficient because discharge planning services and transition programs for ex-inmates with psychiatric disabilities historically lack an evidence base. Approach – After a decade, the first-generation re-entry programs for ex-inmates with psychiatric disabilities have yielded little in the way of empirical data, but they have provided models for program expansion and imperatives for second-generation program assessment. Related research findings for first- and second-generation programs are highlighted with an emphasis on a unique statewide program in Massachusetts. Findings – A review of the first- and second-generation programs suggests that progress has been slow in identifying empirically supported best practices for this population. There is a growing evidence base that community reintegration outcomes for ex-inmates with psychiatric disabilities are the result of demographic and criminal history variations, yet implications of these variations needs further exploration in the realms of service access and receptivity as well as variations in postrelease adaptation. Implications – More knowledge and innovative research is needed on the experience of ex-inmates with psychiatric disabilities and social integration. Resources for cost effectiveness studies as well as long-term follow-up qualitative studies are necessary.
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The nationwide drug court movement represents one of the most recent innovations aimed at decreasing the number of drug-involved offenders by providing drug treatment and intensive court supervision. Although the majority of drug courts are diversion programs, the Maricopa County (Arizona) Drug Court is a postadjudication program for probationers with a first-time felony conviction for drug possession. Probationers are required to participate in an outpatient comprehensive drug treatment program, and their progress is monitored by the judge. The drug court emphasizes individual accountability through a system of rewards and sanctions. A total of 630 offenders sentenced in 1992 or 1993 were randomly assigned to either the drug court or routine probation for RAND's experimental evaluation and tracked for a period of twelve months. Results show that 40 percent of drug court participants successfully completed the treatment program within twelve months. Although there was no statistically significant difference between participants in the drug court program and those on routine probation in terms of new arrests, drug court participants had a lower overall rate of technical violations with fewer drug violations in particular. The Maricopa County Adult Probation Department has continued the drug court program, with slight modifications, and hopes to increase the number of clients served within the next year.
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It was hypothesized that clients receiving case management services will improve to a moderate extent in terms of a variety of psychosocial and clinical outcomes compared with clients served by the usual system of care. It was further hypothesized that clients served by an Assertive Community Treatment (ACT) team will have significantly greater improvement than clients served by forensic case managers working individually. Two hundred seriously mentally ill inmates leaving jail were assigned to three conditions, and 94 remained in the study at 1 year. One-year outcomes were analyzed by service condition, using a hierarchical block discriminant function analysis. Contrary to the hypothesis, more clients in the experimental condition returned to jail within a year. No differences were found among the three conditions in social or clinical outcomes. Greater jail recidivism among clients receiving the more intensive service raises questions concerning tendencies to emphasize monitoring with this population.
Article
This evaluation of the Baltimore City Drug Treatment Court randomly assigned 235 eligible clients to either drug treatment court or "treatment as usual." The program provides an alternative to incarceration for drug-involved, nonviolent offenders. Drug court judges imposed harsher sentences but suspended these sentences condi- tional on compliance with the drug court regimen. Drug court clients were more likely than controls to participate in drug testing and treatment and to attend status hear- ings. During the 12 months following the date of randomization into the study, 48 per- cent of drug treatment court clients and 64 percent of controls were arrested for new offenses. Among the more serious cases heard in the circuit court, 32 percent of drug court clients versus 57 percent of controls were rearrested. When differences in the opportunity to reoffend are taken into consideration, controls were arrested at a rate nearly three times that of drug treatment court clients. During the 1980s,a dramatic increase in drug-related arrests and prosecu - tions clogged the criminal justice system. Court dockets became inundated with drug cases,and prisons were filled to overcrowding with drug offenders (The National Center on Addiction and Substance Abuse at Columbia Uni- versity (CASA) 1998; U.S. General Accounting Office (GAO) 1997). Today,
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This study sought to evaluate the effectiveness of residential substance abuse treat- ment in reducing recidivism among high-risk offenders. The study employed a quasi- experimental research design to match 82 probationers who participated in residential drug treatment program to 82 probationers with similar demographics and criminal his- tory who did not attend treatment. The findings revealed that residential substance abuse treatment had no statistically significant effect on several dichotomous measures of recidivism but that treatment participation substantially reduced the amount of criminal activity in which offenders engaged in during the 18-month follow-up period. Furthermore, among those arrested, the treatment group was more likely to be charged with a probation violation, whereas controls were substantially more likely to be arrested for a new crimi- nal offense. The results serve as the foundation for future examinations into the efficacy of residential drug treatment for high-risk offenders under community supervision.
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Jail diversion programs are designed to prevent the incarceration of mentally ill offenders and to facilitate their entrance into appropriate community-based treatment, while also guarding the safety of the general public. This study sought to determine the effectiveness of one such program. Initial outcomes are described for mentally ill offenders who participated in the program. A total of 50 participants completed the following self-report measures: the Government Performance and Result Act (GPRA) instrument, and the Colorado Symptom Index. Participants were interviewed again at 6 and 12 months. Results indicate the program significantly assisted participants in obtaining income supports such as Medicaid, Social Security, and Food Stamp benefits, but had little impact on housing outcomes.
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The authors bring the "person" back into criminology by focusing on understanding individual differences in criminal conduct and recognizing the importance of personal, interpersonal, and community factors. What results is a truly interdisciplinary general personality and social psychology of criminal behavior that is open to a wide variety of factors that relate to individual differences - a perspective with both theoretical and practical significance in North America and Great Britain.The book is now organized into four parts: (1) The Theoretical Context and Knowledge Base to the Psychology of Criminal Conduct, (2) The Major Risk/Need Factors of Criminal Conduct, (3) Applications, and (4) Summary and Conclusions. Chapters include helpful Resource Notes that explain important concepts. A selection of technical notes, separated from the general text, allows the advanced student to explore complex research without distracting readers from the main points. Resource notes throughout explain important concepts. Technical notes at the back of the book allow the advanced student to explore complex research without distracting readers from the main points. An acronym index is also provided.
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Research Summary: Study randomly assigned 235 offenders to drug treatment court (DTC) or “treatment as usual.” Analyses of official records collected over a two‐year follow‐up period show that DTC is reducing crime in a population of drug‐addicted offenders. DTC subjects who participated in treatment were significantly less likely to recidivate than were both untreated drug court subjects and control subjects. Policy Implications: Continued enthusiasm for DTCs is warranted. Both sanctions and treatment are important elements of the DTC model. However, DTCs will not necessarily result in cost reductions because DTC and control cases are incarcerated for approximately equal numbers of days. Implementation fidelity is important, and DTCs can be strengthened if they engage a higher percentage of their clients in drug treatment.
Article
Drug courts have been proposed as a solution to the increasing numbers of drug involved offenders entering our criminal justice system, and they have become widespread since their introduction in 1989. Evaluations of these programs have led to mixed results. Using meta-analytic methods, we systematically reviewed the extant evidence on the effectiveness of drug courts in reducing future criminal offending. Fifty studies representing 55 evaluations were identified, including both experimental and quasi-experimental comparison group designs. The overall findings tentatively suggest that drug offenders participating in a drug court are less likely to reoffend than similar offenders sentenced to traditional correctional options. The equivocation of this conclusion stems from the generally weak methodological nature of the research in this area, although higher quality studies also observed positive results. Furthermore, the evidence tentatively suggests that drug courts using a single model (pre- or post-plea) may be more effective than those not employing these methods. These courts have a clear incentive for completion of the drug court program.
Article
Research techniques in the fields of mental health courts and diversion need to be improved. As well, insights are provided as to how the evaluations of these programs could be strengthened. There are reports from jurisdictions managing mentally disordered accused in the criminal justice system without the benefit of these programs. A distillation of the commonalities from those jurisdictions suggests that providing the police with better options at first instance (pre-arrest diversion), broader discretion on the part of the prosecutor (pre-plea diversion), and greater jurisdiction on the part of the courts (to impose treatment and monitoring) may have provided those jurisdictions with an adequately functioning system which, as of yet, has not created a need for mental health courts and formal diversion programs. Recommendations are made for future directions.
Article
The Crisis intervention team model (CIT) is possibly the most well known and widely adopted model to improve police response to persons with mental illness. A primary goal of CIT programs is to divert individuals with mental illness from the criminal justice system to mental health services. In this paper we examine the effectiveness of fielding CIT trained and supported officers for influencing call outcomes using data from patrol officers (n = 112) in four Chicago Police districts. Results from regression analysis indicate that CIT certified officers directed a greater proportion of persons with mental illness to mental health services than their Non-CIT certified peers. CIT did not have an immediate effect on arrest. Moderator analysis indicates that CIT had its biggest effect on increasing direction to services and decreasing "contact only" among officers who have a positive view of mental health services and who know a person with mental illness in their personal life. Additional moderators of the CIT effect on call outcomes include level of resistance and the presence of a weapon. Findings from this study have important implications for policy, practice and future research.
Article
This study examined how the characteristics of people with mental illness who are participants in post-booking jail diversion programs affect recidivism and time spent incarcerated. The study employed data from a multi-site, federally funded jail diversion initiative. A pre-post comparison design was used to compare experiences of arrest and days spent in jail of diverted individuals for the 12 months following enrollment with the 12 months prior to enrollment. Also compared were differences in 12-month public safety outcomes. Data were collected between February 2003 and August 2007. The findings suggest that people with mental illness who are diverted from jail to community-based services experience fewer arrests and jail days. Approximately half of the sample were never arrested during the 12 months following enrollment. The strongest differences between people who experienced reduced contact with the criminal justice system and people with unchanged or increased contact were found in measures of criminal history. The results suggest that services targeted to diverted individuals with mental illness should address public safety goals, not just those of public health.
Article
This article explores the factors related to jail recidivism among clients receiving case management services who were seriously mentally ill, homeless, and former inmates in a large urban jail. The authors interviewed six case managers about 51 clients and examined the use of treatment stipulations as a condition of probation, clients' major diagnostic and behavioral problems, and case management strategies. Clients whose case managers actively sought legal stipulations to case management as a condition of probation and parole were more likely to return to jail. Implications for service planning and future research are discussed.
Article
In this study, we sampled sworn police officers from three law enforcement agencies (n = 452), each of which had different system responses to mentally ill people in crisis. One department relies on field assistance from a mobile mental health crisis team, a second has a team of officers specially trained in crisis intervention and management of mentally ill people in crisis, and a third has a team of in-house social workers to assist in responding to calls. Calls involving mentally ill people in crisis appear to be frequent and are perceived by most of the officers to pose a significant problem for the department; however, most officers reported feeling well prepared to handle these calls. Generally, officers from the jurisdiction with a specialized team of officers rated their program as being highly effective in meeting the needs of mentally ill people in crisis, keeping mentally ill people out of jail, minimizing the amount of time officers spend on these calls, and maintaining community safety. Officers from departments relying on a mobile crisis unit (MCU) and on police-based social workers both rated their programs as being moderately effective on each of these dimensions except for minimizing officer time on these calls where the MCU had significantly lower ratings.
Article
Unlabelled: The objective of this retrospective cohort study was to determine whether a jail diversion program significantly reduced the number of days of incarceration over the year following arrest in a sample of seriously mentally ill (SMI) people who had been arrested for a minor crime. Methods: A group of 314 SMI detainees were diverted out of jail and into mental health treatment. They were compared with a sample of 124 people who would have been eligible for diversion but were not diverted. For each group, the authors compared the total days incarcerated in the year after index arrest. Analyses indicated that jail diversion significantly reduced incarceration time during the next year (40.51 versus 172.84 days, p = .0001). However, the effect of diversion differed depending upon the level of criminal charge: diversion significantly reduced jail time only among those who were arrested for more serious offenses. Those arrested for Class D felony and Class A misdemeanor charges and diverted into mental health treatment spent significantly less time in jail in the next year than those not diverted (260 and 110 fewer days, respectively; p = .0001 for both). Those arrested for Class B or C misdemeanors had similar days incarcerated regardless of diversion. These results remained after adjusting for age, race, gender, and diagnosis. This study presents the first evidence that jail diversion may produce positive longitudinal criminal justice outcomes for SMI people. It also suggests that diversion may not reduce incarceration in all sub-groups of SMI people who are arrested for minor crimes.
Article
A case-management model for individuals with substance abuse and mental health disorders who are involved in the criminal justice system is described, based on the experience of a rural demonstration project. Detailed descriptions of case-management activities and the philosophy underlying this model of case management are provided. A major goal of these case-management services was to improve access to appropriate treatment for the target population. Evaluation data describing the population served, case-management implementation, and outcomes are presented along with a case vignette. Six-month follow-up data revealed significantly fewer legal problems and apparent symptom relief for participants in the project. Participants reported improvement in most life areas measured compared to the year before, and were generally satisfied with the case-management services. Barriers observed in implementing these types of services and issues for replication are outlined and discussed.