Slide 1

Individuals with Mental Illnesses in the Criminal Justice System: Addressing Both Criminogenic Risks and Mental Health Needs
Jennifer Skeem, Ph.D.

November 18th, 2009Justice and Mental Health Collaboration Program Webinar

+

Overview; introducing criminogenic risk into the policy discussion
Statement of the problemRoot of the problemModel of intervention

People with serious mental illness are overrepresented in U.S. criminal justice system
Source: Teplin, 1990; Teplin, Abram, & McClelland, 1996
%
Steadman, Osher, et al. (2009): 14% men and 31% women

Chart1

1.13.98.6216.99

0.92.72.822.64

0.11.41.092.89

1.86.410.6220.35

Community men

Incarcerated men

Community women

Incarcerated women

Sheet1

DepressionSchizophreniaBipolarAny

Community men1.10.90.11.8

Incarcerated men3.92.71.46.4

Community women8.622.821.0910.62

Incarcerated women16.992.642.8920.35

To resize chart data range, drag lower right corner of range.

Most have co-occurring substance abuse disorders
Source: The National GAINS Center, 2004

Most are supervised in the communityand often fail
Sources: Bureau of Justice Statistics (2007); Skeem, Emke-Francis, et al. (2006)
Probation
Prison
Parole

Jail

Chart1

1118097183988319598220438

1225934196785360029225539

1357264209582402914224604

1582947223551423898246440

1740948234500448264266992

1968712256615487593300203

2114621274444526436325638

2247158295873562814355505

2356483343569607766407977

2522125395553683367456803

2670234405320743382531407

2728472426479792535590442

2811611444584850566658601

2903061459804909381676100

2981022486474990147690371

30778615070441078542679421

31649965184921127528679733

32965135670791176564694787

36704415924621224469696385

37799226059431287172714457

38262096211491316333723898

39317316312401330007732333

40240676654751367547750934

41200126913011390279769925

41437927139901421345771852

41667577475291448344780616

42370237660101492973798202

Probation

Jail

Prison

Parole

Sheet1

ProbationJailPrisonParoleTotal

198011180971839883195982204381842100

198112259341967853600292255392008300

198213572642095824029142246042194400

198315829472235514238982464402476800

198417409482345004482642669922690700

198519687122566154875933002033013100

198621146212744445264363256383241100

198722471582958735628143555053461400

198823564833435696077664079773715800

198925221253955536833674568034057800

199026702344053207433825314074350300

199127284724264797925355904424537900

199228116114445848505666586014765400

199329030614598049093816761004948300

199429810224864749901476903715148000

1995307786150704410785426794215342900

1996316499651849211275286797335490700

1997329651356707911765646947875734900

1998367044159246212244696963856134200

1999377992260594312871727144576340800

2000382620962114913163337238986445100

2001393173163124013300077323336581700

2002402406766547513675477509346758800

2003412001269130113902797699256924500

2004414379271399014213457718526995100

2005416675774752914483447806167051900

2006423702376601014929737982027211400

The current situation not only exacts a significant toll on the lives of people with mental illness, their families, and the community in general, it also threatens to overwhelm the criminal justice system.
-Council of State Governments Criminal Justice/Mental Health Consensus Project (2002)

+

Overview; introducing criminogenic risk into the policy discussion
Statement of the problemRoot of the problemModel of intervention

The perceived root of the problem
People on the front lines every day believe too many people with mental illness become involved in the criminal justice system because the mental health system has somehow failed. They believe that if many of the people with mental illness received the services they needed, they would not end up under arrest, in jail, or facing charges in court

Implicit model of what works

Symptom change often unrelated to recidivism
Revoked M=-1.23, sd= .80
Not revokedM= -1.29, sd= .60
Same as in multi-site jail diversion & mental health court evaluationsSteadman & Naples (2005); Steadman et al. (2009)
Skeem et al. (2009)

Research indicates that the root of the problem is more complex
Increased mental health services often do not translate into reduced recidivism, even for state of the art servicesCaslyn et al., 2005; Clark, Ricketts, & McHugo, 1999; Skeem & Eno Louden, 2006; Steadman & Naples, 2005Untreated mental illness is a criminogenic need for only a small proportion of offenders with serious mental illnessJunginger et al. (2006), Peterson et al. (2009)Strongest criminogenic needs are shared by those with- and without- mental illnessBonta et al., (1998); Skeem et al. (2009)

Offenders with mental illness have significantly more central 8 risk factors for crime
Source: Skeem, Nicholson, & Kregg (2008)
.and these predict recidivism more strongly than risk factors unique to mental illness (e.g., diagnosis, symptoms, treatment compliance)
**

Chart1

52.0848.170.8910.941

PMI

Non-PMI

Sheet1

PMINon-PMISTD error

LS/CMI Tot52.0848.170.890.94

CrimHis50.7349.210.831.08

EdEmploy51.6948.310.940.95

FamMarital5247.960.880.99

LeisureRec50.6549.330.910.99

Companions50.2849.720.881.03

AlcoholDrug50.7349.270.970.97

Procriminal51.348.670.910.98

AntPattern53.2646.710.880.95

Central eight for criminal behavior (Andrews, 2006)
***p