Reducing Recidivism and Symptoms in Emerging Adults with Serious Mental Health Conditions and Justice System Involvement

Abstract

The peak years of offending in the general population and among those with serious mental health conditions (SMHC) are during emerging adulthood. There currently are no evidence-based interventions for reducing offending behavior among 18–21 year olds, with or without SMHC. This open trial examined outcomes from an adaptation of Multisystemic Therapy (MST), an effective juvenile recidivism reduction intervention, modified for use with emerging adults with SMHC and recent justice system involvement. MST for emerging adults (MST-EA) targets MH symptoms, recidivism, problem substance use, and young adult functional capacities. All study participants (n=41) were aged 17–20 and had a MH diagnosis and recent arrest or incarceration. Implementation outcomes indicated that MST-EA was delivered with strong fidelity, client satisfaction was high, and the majority of participants successfully completed the intervention. Research retention rates also were high. Pre-post analyses revealed significant reductions in participants’ MH symptoms, justice-system involvement, and associations with antisocial peers.

Multisystemic Therapy for Emerging Adults With Serious Mental Illness and Justice Involvement

“…However, only 10% of clients in the program were using other drugs and/or alcohol in the last 30 days of treatment, and only five clients in the program had new arrests for drug related offenses during treatment. Although these data are limited to that collected by the community-based program, the clinical data from the first 80 pilot cases of MST-EA is promising and is consistent with outcomes in the small open trial (Davis et al, 2015). In addition, we are identifying enhancements that might further improve outcomes.…”

“…Currently there are no proven effective interventions to reduce recidivism in EAs, with or without SMI, but MST-EA has been piloted over the past 4 years to target this high-risk population. Promising results from a small open trial demonstrating efficacy of MST-EA were recently published (Davis, Sheidow, & McCart, 2015). Presented here is the first description of the MST-EA model, as well as clinical data on all pilot cases to date and a case example that demonstrate important characteristics of the model.…”

The Cost of Incarceration: A Descriptive Analysis of Low-income Mentally Ill Misdemeanor Offenders in DeKalb County, Georgia (2012)

“…Studies have shown an association between mental health treatment and reduced rates of arrest and recidivism [10][11][12][13][14][15][16][17][18]. However, many Americans with mental health conditions who are at a higher risk of arrest, due to low income for example, go untreated [19].…”

Vocational coaches for justice-involved emerging adults.

“…However, vocational outcomes (when looking at school and/or work) were weak. Overall, there was only a gain from 70% being in school and/or working pre-treatment to 73% being in school and/or working post-treatment (Davis et al, 2015). An enhancement of MST-EA was proposed, and a pilot randomized controlled trial was undertaken to examine different MST-EA approaches to enhancing vocational outcomes through comparing two versions of MST-EA Coaches.…”

“…The investigators already established the safety, feasibility, and preliminary efficacy of this MST adaptation in a successfully completed study (Davis et al, 2015). Therefore, the purpose of the current study was to develop and investigate age-appropriate vocational supports for MST-EA clients, thus filling a critical gap in vocational support interventions for this disadvantaged population.…”