Community mental health services and criminal justice involvement among persons with mental illness

Published date10 December 2002
Date10 December 2002
AuthorWilliam H. Fisher,Nancy Wolff,Kristen Roy-Bujnowski
William H. Fisher, Nancy Wolff and
Kristen Roy-Bujnowski
The original 'plan' for deinstitutionalization of America's population of
persons with severe and persistent mental illness saw community mental
health services as providing many of the functions of large mental
hospitals in community settings. While substantial effort and resources
have been committed to this enterprise, many persons with mental illness
encounter significant problems in adjusting to life in the community.
Prominent among these problems is the disproportionate involvement in
the criminal justice system of persons with psychiatric disorders. This
problem, popularly described as the 'criminalization' of mental illness,
often threatens the clinical stability and safety of persons with mental
disorders, and at the same taxes heavily the resources of the criminal
justice system. This paper reviews data exploring the relationship between
levels and availability of community-based services and the likelihood that
Community-Based Interventions for Criminal Offenders with Severe Mental Illness,
Volume 12, pages 25-51.
Copyright © 2003 by Elsevier Science Ltd.
All rights of reproduction in any form reserved.
ISBN: 0-7623-0972-5
persons with mental illness will become involved with the criminal justice
system. Finding no relationship, we conjecture that community mental
health services are effective with only certain individuals, and move
toward a taxonomy of offenders with mental illness. This classification
scheme takes into account the relationship between psychiatric disorder,
lifestyle and pre-morbid criminal involvement, and is designed to inform
system actors with regard to the targeting of these resources.
The problem of persons with severe mental illness who become involved with
the criminal justice system weighs heavily on both mental health and criminal
justice agencies. This problem, which has become international in scope
(Wolff, 2002), has been the focus of numerous preventive and remedial efforts
(Steadman et al., 1999; Goldkamp & Irons-Guynn, 2000). It has also become
a significant focus of inquiry among mental health services researchers
(Steadman & Cocozza, 1978; Teplin, 1984; McFarland Faulkner & Bloom,
1989; Mechanic & Surles, 1992; Torrey, Steiber, Ezekial et al., 1992; Wolff,
Diamond & Helminiak, 1997; Fisher, Packer, Simon et al., 2000).
Deinstitutionalization and the perceived failures of a weakly developed
community mental health system have been jointly implicated in the growth of
this problem. Ironically, though, community mental health measures are
inevitably identified as the solution despite the fact that evidence that this is the
best solution to this problem is murky at best. It is unclear to what extent we
can count on current or potential community mental health services to mediate
against the risk for criminal behavior. In this chapter we examine this issue,
beginning with an overview of the problem and a review of individual and
system level data on the relationship between the delivery and receipt of
community mental health services and the likelihood of arrest. We then discuss
risk factors for criminal justice involvement identified in the criminologic
literature that may override the effects of these services. Finally, we develop a
typology of mentally ill offenders that takes into account these risk factors as
well as the relationship between individuals' psychiatric disorder and the
nature of their offending. Using this taxonomy we speculate on the possible
effectiveness of community mental health interventions for reducing rates of
offending by individuals subsumed in the categories of this taxonomy.

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