Treating offenders with mental illness: A research synthesis.

Abstract

The purpose of this research synthesis was to examine treatment effects across studies of the service providers to offenders with mental illness. Meta-analytic techniques were applied to 26 empirical studies obtained from a review of 12,154 research documents. Outcomes of interest in this review included measures of both psychiatric and criminal functioning. Although metaanalytic results are based on a small sample of available studies, results suggest interventions with offenders with mental illness effectively reduced symptoms of distress, improving offender's ability to cope with their problems, and resulted in improved behavioral markers including institutional adjustment and behavioral functioning. Furthermore, interventions specifically designed to meet the psychiatric and criminal justice needs of offenders with mental illness have shown to produce significant reductions in psychiatric and criminal recidivism. Finally, this review highlighted admission policies and treatment strategies (e.g., use of homework), which produced the most positive benefits. Results of this research synthesis are directly relevant for service providers in both criminal justice and mental health systems (e.g., psychiatric hospitals) as well as community settings by informing treatment strategies for the first time, which are based on empirical evidence. In addition, the implications of these results to policy makers tasked with the responsibility of designating services for this special needs population are highlighted.

Non-pharmacological interventions for reducing aggression and violence in serious mental illness: A systematic review and narrative synthesis

“…Previous reviews which have focussed on violence reduction in a mental health population either took a broader approach to included diagnoses and outcomes or focus on mixed/ exclusively pharmacological interventions [19,20,21].…”

Therapeutic governmentality and biopower in a Canadian mental health court

“…The professional stakeholders of the TMHC believe recidivism is positively impacted by their efforts, but to my knowledge no evidence has been published. There is little evidence to support improved therapeutic outcomes in other MHCs, in part because few MHC evaluations include mental health outcomes, showing almost uniform preference for recidivism outcomes (Morgan et al, 2012). While the actual therapeutic validity of the courts is questionable, the framing of these new courts as therapeutic rests on more solid ground.…”

Directions for Future Patient-Centered and Comparative Effectiveness Research for People With Serious Mental Illness

“…In their meta-analysis of 37 effect sizes from 25 studies assessing the effectiveness of interventions for justice-involved individuals with a mental illness, Martin et al 430 tentatively concluded that these interventions were modestly effective in reducing criminal justice involvement but had no significant effects on mental health service use, medication use, or mental health outcomes. In contrast, Morgan et al 431 synthesized treatment effects of interventions on criminal recidivism (ie, return to the criminal justice system) and psychiatric recidivism (ie, placement in a psychiatric hospital), finding strong positive treatment effects on general mental health symptoms and coping, and moderate effects on institutional adjustment and behavioral functioning. Mean effect sizes for criminal and psychiatric recidivism were inconclusive, however, and the review was limited by the quality of available research and limited numbers of RCTs.…”

“…They further suggest that these findings demonstrate that traditional services are not the sole solution, and they argue for the design of a new generation of person-centered services tailored to the actual (rather than perceived) needs and risks of justice-involved individuals with serious mental illnesses. For example, there is emerging evidence that offenders with mental illness are equivalent in their criminal thinking 431 and antisocial attitudes 412 compared with nonmentally ill offenders. This suggests that in addition to their mental health needs, justice-involved individuals with serious mental illnesses have needs related to criminogenic characteristics that must be addressed.…”