What is a summary for the article "Preventing Criminal Recidivism Through Mental Health and Criminal Justice Collaboration"?

This article assesses how criminal recidivism can be tackled through collaboration between criminal justice and mental health professionals. There are a number of intervention strategies used to help treat those with serious mental illnesses within communities, such as courts for the mentally ill, specialized parole and probation, conditional release, and so on. Most of these services require the person, legally, to attend sessions and adhere to the strategy. However, studies have found that there is little evidence of these "jail diversion" programs actually reducing recidivism in the mentally ill. Likewise, among such strategies used in civil law cases to prevent recidivism, only one of two trials showed reduced rates of arrest and violence. Arguably, how effective these "leverage-based" programs can be will depend upon how well mental health and criminal justice staff can collaborate. Often these professionals have very different goals, and the involvement of criminal justice staff in mental health programs may result in threats and sanctions which can cause work to backslide. As such, new programs have been set up to help the groups integrate. This means there is a need for a framework to help them build these types of programs in a way which will be effective.
The article then goes on to set out a set of "steps" for what has been proven to work in terms of collaboration between mental health and criminal justice providers, incorporating best practice from both fields. These steps are:

Engagement. It is vital to ensure that "justice-involved individuals" are completely engaged in the process of collaboration and share the common goal of their criminal justice and mental health staff. Within this approach, the patient and the professionals must all choose to work towards both public health and public safety. Accountability should be provided for all involved and a good rapport should be built with the client by ensuring they understand the purpose of what is being offered to them and how their information will be used. Poor understanding on the part of the patient can diminish chances of success. Individuals should be catered to on an individual level, including using visual aids of explanation where necessary.


Assessment. It is very important to identify and target "crimogenic" risk factors in perpetrators or potential perpetrators of crime, whether or not they are mentally ill. Patients should be assessed for history of antisocial behavior or personality, criminal associates, problems at work and school or in a relationship, substance abuse, lack of recreational hobbies, and similar. This "risk assessment" should be conducted in any program, as it helps predict likelihood of recidivism and gear the professionals' approach to the particular patient. It also assesses how likely the patient is to commit violence to others or suicide and establishes which elements in the patient's background need to be addressed in treatment.


Planning and treatment. It is vital that criminal justice and mental health staff identify who should address what. Mental health professionals generally address substance abuse, work/school problems, relationship problems, lack of recreational pursuits, and they recommend treatment for any disorders, family-based intervention, placements and support for the unemployed. They also treat factors such as trauma and homelessness which can increase recidivism. But it is less clear who should help address the thinking that generates antisocial behavior. Criminal justice professionals sometimes develop cognitive behavioral treatment regimes among prison populations to help change attitudes, and some of these have been promising, but mental health professionals outside of prison populations rarely use such interventions. Instead, they tend to use behavioral management principles. Given that both have been successful, good planning would indicate that the two professional groups should work closely together to develop a treatment plan which includes intervention from both.


Monitoring. Monitoring has been proven to reduce recidivism, but only where a sense of collaboration is encouraged. Threats and sanctions make the patient feel attacked, whereas face-to-face meetings which encourage mutual trust help the patient feel supported in adhering to the program.


Problem solving. There will always be setbacks involved in setting a mentally ill patient on a program of this kind. It is important to address these problems through collaboration between mental health professionals, criminal justice staff, and the patient himself. Options should be weighed up and analyzed by both sets of staff. They should then attempt to recommend therapeutic alternatives to punishment, as behavioral problems can often relate to an underlying and untreated issue in the patient. Rewards and the gradual removal of sanctions have also been shown to be more effective than increased threats and punishments in helping a patient adhere to a program.


Transition. This is the point in the process at which the criminal justice staff step back from their role in supporting the patient. This is a significant point for patients and can thrust them back into relapse, so it is important to collaborate and prepare clients for this change with extra outpatient appointments and the involvement of family members as additional emotional resources. Appointing a "representative payee" for potential substance abusers can also help support these people and reduce likelihood of reoffending.

In conclusion, then: current outpatient mental health treatment does not greatly reduce criminal recidivism on its own, because only 18% of crimes among the mentally ill are motivated directly by that mental illness. In order to effectively prevent recidivism among the mentally ill, both criminal justice and mental health staff must understand which issues drive recidivism in each specific patient and how best to approach these using shared and community resources. There is a lack of systematic assessment of crimogenic risk factors among mental health professionals; likewise, correctional officers have a poor understanding of mental health issues. As such, it is necessary for the two groups to collaborate and share their knowledge in order to devise programs which will be successful.