Offenders with mental illness have attracted substantial attention over the recent years, given their prevalence and poor outcomes. A number of interventions have been developed for this population (e.g., mental health courts). They share an emphasis on one dimension as the source of the problem: mental illness. Their focus on psychiatric services may poorly match the policy goal of reducing recidivism. In this article, we use research to evaluate (a) the effectiveness of current interventions, and(b) the larger viability of psychiatric, criminological, and social psychological models of the link between mental illness and criminal justice involvement. We integrate theory and research to offer a multidimensional conceptual framework that may guide further research and the development of efficient interventions that meaningfully reduce recidivism. We hypothesize that the effect of mental illness on criminal behavior reflects moderated mediation (i.e., the effect is direct in the case of one subgroup, but fully mediated in another); and that the effect of mental illness on other "recidivism" is partially mediated by system bias and stigma. We use this framework to propose three priorities for advancing research, articulating policy, and improving practice.

A growing body of research suggests that high quality dual role relationships between community corrections officers and offenders reduce risk of recidivism. This study assesses whether this finding generalizes from offenders with mental illness to their relatively healthy counterparts. More importantly, this study tests the possibility that this finding is spurious, reflecting the influence of pre-existing offender characteristics more than a promising principle of practice. In this study of 109 parolees without mental illness, the authors found that (a) firm, fair, and caring relationships protect against rearrest, and (b) do so even after accounting for offenders' pre-existing personality traits and risk for recidivism. These findings are consistent with the theoretical notion that good dual role relationships are an essential element of core correctional practice, even (or particularly) for difficult or high risk offenders.

Probationers with co-occurring mental and substance abuse problems (PCPs) are both subject to considerable social control, and at high risk of probation failure. In this study, we screened 601 probationers for symptoms, interviewed 82 identified PCPs about their relationships, and then followed these PCPs for eight months to record treatment nonadherence and other probation violations. First, PCPs' social networks were small, heavily comprised of professionals and opposing forces who engaged in risky behavior, and saturated with pressure to adhere to treatment. Second, the size and composition of PCPs' social networks were more relevant to rule compliance than social support and undermining. Third, the quality of PCPs' relationships was key: satisfying relationships with clinicians and, to a lesser extent, officers and the core network related to low perceived coercion, high treatment adherence, and low risk of future violations. In particular, having a likable clinician who engaged in participatory decision-making reduced the risk of violations. Implications for contextually sensitive risk reduction efforts are discussed.

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Although the new policy emphasis shows substantial promise, the field must avoid rushing to the next "evidence base" too rapidly and with too little data. There must be explicit recognition that RNR principles are being applied to a new population with unique characteristics (mental illness combined with justice system involvement), such that generalizability from general offender samples is uncertain. Moreover, public safety goals for the target population should not eclipse those related to public health. This group's unique features may affect both the process and outcomes of treatment.