Stopping the Revolving Door: A Meta-Analysis on the Effectiveness of Interventions for Criminally Involved Individuals with Major Mental Disorders
- 137 Downloads
Faced with high and increasing rates of mental disorder within the criminal justice system (CJS), a range of interventions have been implemented in an effort to prevent continued involvement in criminal activities among this population. A meta-analytic review was undertaken to consider the effectiveness of interventions for criminally involved adults with a mental disorder targeting either improved criminal justice or mental health outcomes. Furthermore, characteristics that were hypothesized to predict better outcomes were examined. Studies that considered sex offender interventions, or focused solely on antisocial personality, intellectual and cognitive, or substance use disorders were excluded. Results assuming a fixed-effects model combining 37 effect sizes from 25 studies (N = 15,678) support the effectiveness of these interventions in terms of reductions in any CJS involvement (d = 0.19 excluding one outlier). Interventions had no significant effect on an aggregate mental health outcome (d = 0.00). However, when considering distinct mental health outcomes, intervention participants had significantly better functioning (d = 0.20) and fewer symptoms (d = 0.12). There were no significant effects of the interventions on mental health service or medication use. Moderator analyses identified seven sample, intervention, and design characteristics that were related to the magnitude of the effect sizes for criminal justice outcomes, and suggest implications for service provision, policy, and research. Results suggested some relationship between intervention effects on mental health and criminal justice reinvolvement, although future research is needed in this area, especially given the absence of mental health outcome data in many studies.
KeywordsMeta-analysis Mental health Criminal justice Interventions Outcomes
Studies included in the meta-analysis are indicated by a superscript number at the beginning of the reference, which corresponds to references in Tables 1 and 2. Sacks, Sacks, McKendrick, Banks, & Stommel (2004) and Sullivan et al. (2008) were both assigned the same number as the former reported CJS outcomes, and the latter reported mental health outcomes for the same sample.
- Adair, C. E., McDougall, G. M., Beckie, A., Joyce, A., Mitton, C., Wild, C. T., et al. (2003). History and measurement of continuity of care in mental health services and evidence of its role in outcomes. Psychiatric Services, 54(10), 1351–1356. doi:10.1176/appi.ps.54.10.1351.PubMedCrossRefGoogle Scholar
- American Psychiatric Association. (2004). Mental illness and the criminal justice system: redirecting resources toward treatment, not containment. Resource document. Arlington: Author.Google Scholar
- Andrews, D. A. (2000). Principles of effective corrections. In L. Motiuk & R. Serin (Eds.), Compendium on effective correctional programming (Chapter 2). Ottawa: Correctional Service Canada.Google Scholar
- Andrews, D. A., & Bonta, J. (2003). The psychology of criminal conduct (3rd ed.). Cincinnati: Anderson Publishing Co.Google Scholar
- Beech, A., Bourgon, G., Hanson, K. R., Harris, A. J. R., Langton, C., Marques, J., et al. (2007a). The Collaborative Outcome Data Committee’s Guidelines for the Evaluation of Sexual Offender Treatment Outcome Research. Part 2: CODC Guidelines. Ottawa: Public Safety Canada.Google Scholar
- Beech, A., Bourgon, G., Hanson, K. R., Harris, A. J. R., Langton, C., Marques, J., et al. (2007b). Sexual Offender Treatment Outcome Research: CODC Guidelines for Evaluation. Part 1: Introduction and Overview. Ottawa: Public Safety Canada.Google Scholar
- 2Belfrage, H. (1991). The crime preventive effect of psychiatric treatment on mentally disordered offenders in Sweden. International Journal of Law and Psychiatry, 14, 237–243. doi:10.1002/bsl.605.
- Bloom, B., Owen, B., & Covington, S. (2003). Gender-responsive strategies: Research, practice, and guiding principles for women offenders. Washington: National Institute of Corrections.Google Scholar
- Borenstein, M. (2009). Effect sizes for continuous data. In H. Cooper, L. V. Hedges, & J. C. Valentine (Eds.), The handbook of research synthesis and meta-analysis (2nd ed., pp. 221–236). New York: Russell Sage Foundation.Google Scholar
- 3Broner, N., Lattimore, P. K., Cowell, A. J., & Schlenger, W. E. (2004). Effects of diversion on adults with co-occurring mental illness and substance use: Outcomes from a national multi-site study. Behavioral Sciences and the Law, 22, 519–541. doi:10.1002/bsl.605.
- 4Chandler, D. W., & Spicer, G. (2006). Integrated treatment for jail recidivists with co-occurring psychiatric and substance use disorders. Community Mental Health Journal, 42(4), 405–425. doi:10.1007/s10597-006-9055-6.
- Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). New York: Psychology Press.Google Scholar
- Correctional Service of Canada (2009). Quick facts: Mental health strategy. Ottawa: Author. Retrieved December 31, 2009 from http://www.csc-scc.gc.ca/text/pblct/qf/11-eng.shtml.
- Fleiss, J. L., & Berlin, J. A. (2009). Effect sizes for dichotomous data. In H. Cooper, L. V. Hedges, & J. C. Valentine (Eds.), The handbook of research synthesis and meta-analysis (2nd ed., pp. 237–254). New York: Russell Sage Foundation.Google Scholar
- Hedges, L. V. (2010). Statistical considerations. In H. Cooper, L. V. Hedges, & J. C. Valentine (Eds.), The handbook of research synthesis and meta-analysis (2nd ed., pp. 221–236). New York: Russell Sage Foundation.Google Scholar
- Heilbrun, K., & Peters, L. (2000). Community-based treatment programmes. In S. Hodgins & R. Muller-Isberner (Eds.), Violence, crime and mentally disordered offenders (pp. 193–216). New York: Wiley.Google Scholar
- 7Hoff, R. A., Baranosky, M. V., Buchanan, J., Zonana, H., & Rosenheck, R. A. (1999). The effects of a jail diversion program on incarceration: A retrospective cohort study. Journal of the American Academy of Psychiatry and the Law, 27(3), 377–386.Google Scholar
- James, D. J., & Glaze, L. E. (2006). Mental health problems of prison and jail inmates. Washington: U.S. Department of Justice.Google Scholar
- 8Khodayarifard, M., Pritz, A., & Khodayarifard, S. (2008). The impact of group and individual cognitive-behavioral intervention on the mental health state of male prisoners. International Journal of Psychotherapy, 12(2), 50–66.Google Scholar
- Kirby, M., & Keon, W. (2006). Out of the shadows at last: Transforming mental health, mental illness and addictions services in Canada. Final report of the Standing Senate Committee on Social Affairs, Science and Technology. Retrieved September 30, 2007, from http://www.parl.gc.ca.
- Laishes, J. (2002). The 2002 mental health strategy for women offenders. Ottawa: Correctional Service of Canada. Retrieved online March 30, 2010, from http://www.csc-scc.gc.ca/text/prgrm/fsw/mhealth/toc-eng.shtml.
- Latimer, J., & Lawrence, A. (2006). The review board systems in Canada: An overview of the results from the mentally disordered accused data collection study. Ottawa: Department of Justice Canada.Google Scholar
- Lattimore, P. K., Broner, N., Sherman, R., Frisman, L., & Shafer, M. S. (2003). A comparison of prebooking and postbooking diversion programs for mentally ill substance-using individuals with justice involvement. Journal of Contemporary Criminal Justice, 19, 30–64. doi:10.1177/1043986202239741.CrossRefGoogle Scholar
- 10Moore, M. E., & Hiday, V. A. (2006). Mental health court outcomes: A comparison of re-arrest and re-arrest severity between mental health court and traditional court participants. Law and Human Behavior, 30, 659–674. doi:10.1007/s10979-006-9061-9.
- Motiuk, L. L. (2000). Contribution to safe reintegration: Outcome measurement. In L. Motiuk & R. Serin (Eds.), Compendium on effective correctional programming (Chapter 23). Ottawa, Canada: Correctional Service Canada.Google Scholar
- Muller-Isberner, R., & Hodgins, S. (2000). Evidence-based treatment for mentally disordered offenders. In S. Hodgins & R. Muller-Isberner (Eds.), Violence, crime and mentally disordered offenders (pp. 7–38). New York: Wiley.Google Scholar
- Prins, S., & Draper, L. (2009). Improving outcomes for people with mental illnesses under community corrections supervision: A guide to research-informed policy and practice. New York: Council of State Governments Justice Center.Google Scholar
- Rosenthal, R. 1979. The “file drawer problem” and tolerance for null results. Psychological Bulletin, 86(3), 638–641. doi: 10.1037/0033-2909.86.3.638.
- 15Sacks, J. Y., Sacks, S., McKendrick, K., Banks, S., Schoeneberger, M., Hamilton, Z., et al. (2008). Prison therapeutic community treatment for female offenders: Profiles and preliminary findings for mental health and other variables (crime, substance use and HIV risk). Journal of Offender Rehabilitation, 46(3), 233–261. doi:10.1080/10509670802143680.Google Scholar
- 16Sacks, S., Sacks, J. Y., McKendrick, K., Banks, S., & Stommel, J. (2004). Modified TC for MICA offenders: Crime outcomes. Behavioral Sciences and the Law, 22, 477–501. doi:10.1002/bsl.599.
- 18Silver, S. B., Cohen, M. I., & Spodak, M. K. (1989). Follow-up after release of insanity acquittees, mentally disordered offenders, and convicted felons. Bulletin of the American Academy of Psychiatry and the Law, 17(4), 387–400.Google Scholar
- Skeem, J. L., Manchak, S., & Peterson, J. K. (2010). Correctional policy for offenders with mental illness: Creating a new paradigm for recidivism reduction. Law and Human Behavior. Advance online publication. doi:10.1007/s10989-010-9223-7.
- 20Taylor, N. (2005). An analysis of the effectiveness of Santa Clara county’s mentally ill offender crime reduction program (Doctoral Thesis, Pacific Graduate School of Psychology, Palo Alto). UMI Number: 3181686.Google Scholar
- 21Tellefsen, C., Cohen, M. I., Silver, S. B., & Dougherty, C. (1992). Predicting success on conditional release for insanity acquittees: Regionalized versus nonregionalized patients. Bulletin of the American Academy of Psychiatry and the Law, 20(1), 87–100.Google Scholar
- 23Van Stelle, K. R., & Moberg, D. P. (2004). Outcome data for MICA clients after participation in an institutional therapeutic community. Journal of Offender Rehabilitation, 39(1), 37–62. doi:10.1300/J076v39n01_03.
- 24Wilson, D., Tien, G., & Eaves, D. (1995). Increasing the community tenure of mentally disordered offenders: An assertive case management program. International Journal of Law and Psychiatry, 18(1), 61–69. doi:10.1016/0160-2527(94)00027-1.
- 25Zlotnick, C., Johnson, J., & Najavits, L. M. (2009). Randomized controlled pilot study of cognitive-behavioral therapy in a sample of incarcerated women with substance use disorder and PTSD. Behavior Therapy, 40, 325–336. doi:10.1016/j.beth.2008.09.004.