Case management and the forensic client

Published date10 December 2002
Date10 December 2002
AuthorPhyllis Solomon
Phyllis Solomon
This chapter reviews the literature on case management for those with
severe mental illness and then reviews the specific research on case
management for forensic clients. It concludes with implications for case
management programs for forensic clients and directions for future
research in this area.
Case management for persons with severe mental illness became prominent in
the late 1970s in response to the consequences of deinstitutionalization of state
psychiatric hospitals. Given the multiplicity of psychiatric and psychosocial
needs of persons being released from psychiatric hospitals, there was a need for
a mental health provider to coordinate the diversity of resources required to
support these individuals in the community (Turner & Tenhor, 1978).
Consequently, case management was the linchpin of the community support
system of services and benefits which enabled this population to live outside of
hospital. Although deinstitutionalization had started more than a decade
before this, the pressing need for such a service function emerged later as those
initially released from hospitals returned to families who served as de facto
case managers, providing the assistance their relatives required to obtain
Community-Based Interventions for Criminal Offenders with Severe Mental Illness,
Volume 12, pages 53-71.
Copyright © 2003 by Elsevier Science Ltd.
All rights of reproduction in any form reserved.
ISBN: 0-7623-0972-5
resources and benefits for remaining in the community (Intagliata, Willer &
Egri, 1986).
Another consequence that resulted from the major policy shift of
deinstitutionalization was the transinstitionalization of those with severe
psychiatric disorders to a variety of institutional settings, including local jails
(Johnson, 1990; Scull, 1981). The increasing criminal involvement of those
with severe mental illness became known as the criminalization of those with
mental illness (Abramson, 1972; Teplin, 1983, 1991). This hydraulic phe-
nomenon was the result of the diversion of those with mental illness from the
state institutions, due both to hospital releases and restrictive admission
policies, to the use of arrest for minor offenses as a strategy for managing this
population's unacceptable community behavior (Torrey et al., 1992). Although
the longitudinal data do not exist to be able to establish a direct causal link
between deinstitutionalization and criminalization, there became a pressing
concern to respond to the needs of this forensic population (Teplin, 1983).
Until very recently, there has been little dialogue or coordination between the
mental health and criminal justice systems, despite there being a good deal of
overlap in the populations served by the two systems (Lurigio, Fallon &
Dincin, 2000). It is estimated that between 42% and 52% of individuals with
a psychiatric disorder have had at least one arrest (McFarland, Faulner, Bloom,
Hallaux & Bray, 1989; Muntaner, Wolyniec, McGrath & Pulver, 1998;
Solomon & Draine, 1993; Solomon & Draine, 1995); and recently, it was
determined that 16% of jail inmates and 16% of persons on probation have a
mental illness (Ditton, 1999). Various efforts have attempted to address this
population, including diversion programs (see chapter by Desai, this volume),
post release or re-entry programs (see chapter by Hartwell, this volume), and
currently, the development of mental health courts (see Wolff, this volume).
Unfortunately, all too often, once a person with severe mental illness
becomes involved in the criminal justice system it is extremely difficult for
them to exit the system, as this population is not always able to comply with
the stipulations of probation or parole, which frequently include psychiatric
and substance abuse treatment as well as specified housing arrangements.
Consequently, mental health professionals have begun to recognize the need for
psychiatric service intervention strategies which coordinate criminal justice
community supervision of probation and parole in order to break the pernicious
cycle of criminal entanglements marked by rearrests, reincarcerations, and
probation or parole for this population. Given the service design and goals of
case management, this service approach seems to be a potentially effective
means to serving a multi-problem population with multiple system involve-
ment, which is likely to include corrections, mental health, substance abuse,

To continue reading

Request your trial

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT