14 October 2014 - Science Daily - New approaches needed for people with serious mental illnesses in criminal justice system

In many ways, the criminal justice system is the largest provider of mental health services in the country. Estimates vary, but previous research has found that about 14 percent of persons in the criminal justice system have a serious mental illness, and that number is as high as 31 percent for female inmates. Researchers are defining serious mental illnesses to include such things as schizophrenia, bipolar spectrum disorders and major depressive disorders.

"It has been assumed that untreated symptoms of mental illness caused criminal justice involvement, but now we're seeing that there is little evidence to support that claim," said Matthew Epperson, assistant professor at the University of Chicago School of Social Service Administration. Specialized interventions for people with mental illness in the criminal justice system have been developed over the past 20 years, such as mental health courts and jail diversion programs, Epperson said.

"But we need a new generation of interventions for people with serious mental health issues who are involved in the criminal justice system, whether it be interactions with police, jails, probation programs and courts," he said. "Research shows that people with serious mental illnesses, in general, display many of the same risk factors for criminal involvement as persons without these conditions."

More potent interventions are needed, the study's authors report. "First, effective and accessible mental health treatment will be an active component of any intervention for this population," said Epperson. He adds that it is vital to develop a better understanding of the many factors, in addition to mental illness, that place persons with serious mental illness at risk for criminal involvement. There is also a need to define which risk factors are modifiable as targets for the next generation of interventions.

"We need to move our collective thinking away from the uncomplicated notion that mental illness is the sole cause of criminal behavior and criminal justice involvement," Epperson said. The study's authors suggest an intervention program targeting multiple issues, including medication adherence, developing alternatives to criminal thinking patterns, providing supports for more stable and healthy living situations and personal relationships, decreasing substance abuse, helping to build skills to reduce stress and addressing trauma exposure and its negative effects.