RESEARCH WEEKLY: Interventions in Prison Show Promise for Individuals with Serious Mental Illness
By Kelli South
Interventions targeting individuals with serious mental illness in the criminal justice system show promising results for improving several criminogenic risk factors, according to new research published in Psychiatric Services. Criminogenic risk factors are traits and situations in an individual’s life that may contribute to their likelihood to become involved in the criminal justice system. The risk factors included in the study are attributes commonly held by people with severe mental illness, including antisocial personality, antisocial behavior, substance abuse, problematic marital and family circumstances.
The authors, from the University of Utah and the University of North Carolina at Chapel Hill, conducted a meta-analysis of 21 studies that analyzed the impact of interventions in prisons to address the needs of people with serious mental illness. There were a variety of different interventions studied including therapeutic programs designed for people with co-occurring serious mental illness and substance use disorders and modified versions of assertive community treatment programs. Overall, there were nine different interventions included in the analysis and all interventions included some form of cognitive behavioral therapy for patients.
Results
The authors note the difficultly of drawing conclusions from such a wide variety of different programs with different populations of people. That said, they were able to draw some broad conclusions about the potential impacts of some interventions on risk factors for those with serious mental illness. Results for the impact of the treatment programs on substance abuse were mixed, but generally showed decreases in substance use and lower odds of committing a substance use-related offense after reentry into the community for those who were in a treatment program compared to those who were not.
Another important area of significance was the measure of if these programs impacted recidivism and future criminal justice involvement. All studies that included a measure of criminal justice involvement found that those who participated in a treatment program benefitted from the program in this measure. Studies found that participants in a program had lower odds of recidivism, lower odds of criminal activity, fewer arrests, and shorter lengths of stay in jail compared to those who did not participate in a treatment program.
Implications
One of the major takeaways from this meta-analysis is that there seems to be an increase in the number of interventions in jails and prisons that are targeted at improving the outcomes of criminogenic risk factors for people with serious mental illness. The authors note the importance of this growing trend –since people with severe mental illness are so heavily overrepresented in the criminal justice system, it is fitting that they receive more targeted programs and treatments while incarcerated.
The goal of these programs should be to reduce the likelihood that participants reenter the criminal justice system in the future but should also meet their treatment needs and address areas like substance abuse and mental illness symptoms while they are incarcerated. The results of the meta-analysis indicate that many of these programs tailored to people with serious mental illness are having positive impacts in the desired areas. The authors call for more research into the impacts of various interventions in the criminal justice system and how they may help improve the outcomes of those with serious mental illness.
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