A pilot study: Positive behavioral support assessment and intervention for individuals with serious mental illness and criminal justice involvement.

Abstract

Individuals with serious mental illness (SMI) are consistently interfacing with the criminal justice (CJ) system. They are overrepresented in our nation’s prisons and jails rather than being in appropriate treatment settings. They also exhibit behavioral challenges in such CJ settings that result in rule violations leading to punitive consequences, such as segregation and isolation, which have deleterious effects on their mental health and well-being. Individuals with SMI who are incarcerated also make up the majority of suicide attempts and stay longer than those without SMI. Positive Behavioral Support (PBS) is a form of assessment and intervention with demonstrated efficacy for mitigating disruptive behaviors in individuals with SMI. This article describes a pilot study aimed at evaluating the efficacy of implementing PBS to decrease behaviors of concern (BOC) by those who experience SMI and interface with the CJ system. Findings indicated that PBS has a positive impact on reducing the frequency and severity of challenging behaviors and consequentially reducing interactions with the CJ system. Implications of this intervention are explored as a mechanism to support recovery and build lives of meaning.

From the medical model to the recovery model: Psychologists engaging in advocacy and social justice action agendas in public mental health.

“…Staff meetings are also a valuable opportunity for psychologists to foster ongoing stakeholder engagement and education around noncoercive; skill building interventions that may be challenging to adopt without considerable staff support. PBS planning, for example, is designed to reduce an individual’s challenging behaviors and reinforce skillful communication, all while reducing or eliminating the use of seclusion and restraint (Carr & Hillbrand, 2022).…”

“…An overwhelming number of patients in state hospitals and community settings struggle with the symptoms of SMI and substance abuse, as well as poverty, legal involvement, isolation, discrimination, medication side effects, and the effects of trauma (Carr & Hillbrand, 2022; Jonikas et al, 2003; Morrison et al, 2012; Mowbray et al, 2003). Many of these individuals are members of minority groups (Fisher et al, 2009) and racial diagnostic disparities are likely to occur such as the diagnosis of schizophrenia being disparately diagnosed among Black versus White individuals (Olbert et al, 2018).…”

“…to reduce an individual's challenging behaviors and reinforce skillful communication, all while reducing or eliminating the use of seclusion and restraint (Carr & Hillbrand, 2022). Supervising psychologists-in-training is a powerful means by which psychologists in inpatient settings can teach future change agents about the application of recovery-oriented care provision in the inpatient setting.…”

“…Such settings have the propensity to be supported immensely by the unique skill set that comes with the training and competence of a psychologist (O'Connor & Yanos, 2021). The aforementioned challenges can be mitigated in such settings, by the rewards of seeing people with SMI as they make dramatic improvements and move towards recovery (Carr & Hillbrand, 2022).…”

Legally involved individuals in state hospitals and community mental health settings: Introduction to the special section.

“…In addition to advancements in assessment, this special section provided the opportunity to review innovations in treatment for individuals in criminal justice populations. Carr and Hillbrand (2022) provide a helpful overview of the significant challenge for overrepresentation of those with SMI within the criminal justice system and their increased lengths of stay within the system. The use of Positive Behavioral Support (PBS) interventions has previously been found to address suicidal behaviors, aggression, safety, and self-care issues, including for individuals with SMI.…”