Understanding Persons With Mental Illness Who Are and Are Not Criminal Justice Involved: A Comparison of Criminal Thinking and
Psychiatric Symptoms
Nicole R. Gross and Robert D. Morgan Texas Tech University
Research has begun to elucidate that persons with mental illness become involved in the criminal justice system as a result of criminality and not merely because of their mental illness. This study aims to clarify the similarities and differences in criminal thinking and psychiatric symptomatology between persons with mental illness who are and are not criminal justice involved. Male and female (n ? 94) participants admitted to an acute psychiatric facility completed measures to assess criminal thinking (i.e., Psycho- logical Inventory of Criminal Thinking Styles and Criminal Sentiments ScaleModified) and psychiatric symptomatology (Millon Clinical Multiaxial InventoryThird Edition). In addition to the inpatient sample, 94 incarcerated persons with mental illness from a previously conducted study were selected based on their match with the current sample on several key demographic and psychiatric variables. The results of this study indicated that hospitalized persons with mental illness with a history of criminal justice involvement evidenced similar thinking styles to persons with mental illness who were incarcer- ated. Persons with mental illness without criminal justice involvement evidenced fewer thinking styles supportive of a criminal lifestyle than the incarcerated sample. Furthermore, the persons with mental illness sample with no history of criminal justice involvement showed significantly lower levels of psychopathology shown to be risk factors for criminal justice involvement (e.g., antisocial personality, drug dependence, alcohol dependence). These findings have implications for offender-type classification, development of targeted treatment interventions, and program placement.
Keywords: criminal thinking, offender, criminal justice involvement, mental illness
Persons with mental illness (PMI) are 3 times more likely to be incarcerated than admitted to a psychiatric facility (Abramsky & Fellner, 2003; Torrey, Kennard, Eslinger, Lamb, & Pavle, 2010). Consequently, correctional institutions have become the largest providers of mental health treatment in the United States (Abram- sky & Fellner, 2003). Notably, 14.5% of male and 31% of female offenders in jails have a serious mental illness (i.e., schizophrenia spectrum disorder; schizoaffective disorder; schizophreniform disor- der; brief psychotic disorder; delusional disorder; psychotic disorder not otherwise specified [NOS]; bipolar disorder I, II, and NOS; major depressive disorder; and depressive disorder NOS; Steadman, Osher, Robbins, Case, & Samuels, 2009). PMI are disproportionally repre- sented in correctional institutions because less than 6% of the general population is estimated to suffer from a severe mental illness (Amer- ican Psychiatric Association, 2000; Kessler, Chiu, Demler, & Walters, 2005). It appears that PMI are involved in and affected across criminal justice (CJ) and mental healthcare systems; however, it remains un- clear how PMI involved in the mental healthcare system compare to PMI involved in the CJ system.
When compared to offenders without mental illness, PMI who are placed in community supervision (i.e., probation and parole) after being released from a correctional facility are significantly more likely to recidivate (continued criminal behavior resulting in arrest and reincarceration; Messina, Burdon, Hagopian, & Prendergast, 2006). Likewise, it is estimated that 3753% of PMI released from mental health facilities psychiatrically recidivate (decompensate and are con- sequently readmitted to a mental health facility) within 1 year of being discharged (Hillman, 2001; Segal & Burgess, 2006). Commonalities such as high criminal recidivism and psychiatric hospitalization rates between PMI who are and are not CJ involved may indicate common risk factors such as criminal thinking, poverty, homelessness, and unemployment (Draine, Salzer, Culhane, & Hadley, 2002; Mgust- shini, 2010) between the two groups. Such results would identify a neglected treatment area for PMI regardless of setting (CJ or mental health) that, if addressed, may improve treatment outcomes (e.g., symptom reduction, reduced criminal recidivism, and psychiatric hos- pitalizations). Investigating the role of mental illness in the provoca- tion and exacerbation of criminal behavior is thus warranted. PMI who are CJ involved may have unique mental health needs and criminal risk factors when it comes to offending behavior. Addition- ally, similarities in criminal thought patterns may affect psychological functioning and mental health recovery (e.g., symptom management, rehospitalization) of PMI who are not CJ involved.
Although it may seem plausible that PMI enter the CJ system as a result of their mental health symptoms, it has been suggested that some PMI have comorbid criminal dispositions that result in their
