Abstract This chapter identifies the challenges encountered by people with mental health problems who contact criminal law enforcement along with the roles that social workers have in assisting this population to overcome these challenges. The chapter presents three prominent and rigorously tested theories explaining the high rates of justice system contact among this population: the criminalization hypothesis, general personality and cognitive social learning theory (i.e., the risk-need-responsivity model), and the focal concerns theory addressing stigma and discrimination. Through the lens of these theories, the chapter identifies many of the complex needs of justice system–involved adults with mental illness. The chapter also identifies various settings along the sequential intercept model in which social workers are called upon to address these needs, either through direct clinical intervention or through the enactment of agency- and system-level policy reform.

A multigenerational case study in an outpatient clinic setting was utilized to allow advanced practice nursing and graduate level social work students to practice interprofessional collaboration. The primary objective of this event was for the learners to better understand each other's roles and practice communication techniques to facilitate the development of a collaborative plan of care. The learning activity included pre-event didactic education, collaborative plan of care development with unfolding case details, and facilitator-led debriefing. A pre/post reflection and survey were used to assess the impact and value of the experience and understanding of the partnering profession. In the third year, the delivery format was switched to virtual. Analysis showed that students valued the learning opportunity whether delivered in person or virtually. Overall, the event was shown to be effective both in-person and virtually implemented in promoting integrated care.

An interprofessional education simulation in an outpatient clinic setting was utilized to allow pharmacy and social work students to practice the warm handoff communication technique. This event included 157 pharmacy and social work students. The primary objective of this encounter was for the learner to better understand the role of the partnering profession and demonstrate an appropriate warm handoff. The simulation included pre-event didactic education, performance of a warm handoff, and faculty-led debriefing. A novel warm handoff evaluation checklist was created to evaluate the performance of the students using the warm handoff communication technique. Students successfully initiated the warm handoff and demonstrated patient engagement by asking permission and using introductions. However, students did not perform as well with the more complex skills of communicating the patient's background, situation, and assessment to their colleagues. Students were asked to complete an anonymous, pre- and post-questionnaire to assess the impact and value of the interprofessional simulation and the likelihood that they would refer a patient to the partnering profession in the future. The post-questionnaire was evaluated both quantitatively and qualitatively using a content analysis of the open-ended questions. The quantitative analysis showed that students valued the simulation and the opportunity to practice and would use the skills gained in the future. The results also revealed an increased likelihood that students would refer patients to the partnering profession post-simulation. The content analysis of the open-ended question asking the learners what they thought was valuable about the simulation demonstrated that students value communicating with another healthcare team member with the patient in the room, learning about the role of other healthcare professionals, and practicing the warm handoff communication tool. Overall, this simulation was shown to be an effective activity to promote interprofessional care between pharmacy and social work students and to practice a warm handoff that promotes integrated patient care in outpatient healthcare settings.

Adults under community corrections supervision and who have a mental illness (MI) are expected to comply with conditions of release which often include involvement with supportive social services. The rates of technical violation, arrest, and incarceration that result from failure to comply with these mandates are exceedingly high. Shared decision making among officer-supervisors and client-supervisees is a promising approach to promote engagement in community corrections services among supervisees who have MI. This paper reviews recent research on shared decision making and identifies three barriers to its implementation in this context: (1) a lack of role clarity, (2) a predilection for risk avoidance, and (3) stigma toward supervisees. Empirically supported recommendations are suggested to aid in overcoming these obstacles, facilitate shared decision making, and promote recovery among this population: (1) unification of supervisor rehabilitative and public safety roles, (2) maximizing opportunities for self-determination through low-stakes events and/or enhancement of supervisee strengths and capabilities, and (3) supervisor training in principles of mental health recovery.

For many adults leaving prison, parole supervision can provide the support necessary for successful adjustment to community life. Those leaving prison who have a mental illness (MI) may benefit particularly from such services. However, many people who are incarcerated waive their opportunity for parole and choose instead to "max out" their sentences. This study explores whether decision-making and community risk predictors differ between people who are incarcerated with (n = 1,575) and without (n = 20,220) MI and who choose to voluntarily max out their sentence (i.e., waive parole), who max out involuntarily through denial of parole, and who are released to parole supervision. We found the presence of an MI was associated with the decision to forgo parole, but not recidivism. Those who maxed out their sentence (regardless of voluntariness of decision) had increased likelihood of recidivating. Implications for parole policy, practice, and research are discussed.

Shared decision making (SDM) can be an effective method for promoting service involvement among persons with serious mental illness (SMI). This survey study sought to identify predictors of positive attitudes toward the use of SDM with people with SMI who are living under probation and parole supervision. Supervising officers' (n = 291) perceptions of the capabilities of supervisees with SMI to contribute to their supervision plans, and their familiarity with recovery-oriented mental health services, were positively associated with attitudes toward using SDM. Training officers in common human goals and mental health recovery may advance SDM with supervisees with SMI.

Little is known about how mental health court (MHC) experiences (including satisfaction and sanctioning, incentivizing, and life change events) differ by race and how this variation affects recidivism among MHC participants. This study examined how MHC experiences and recidivism differ between White ( n = 170) and Black ( n = 132) participants from four different MHCs in the United Sates. Negative binomial regression models, conducted separately for the two groups, indicated that life changes were associated with decreased arrests and that court sanctions were associated with increased number of arrests for both White and Black participants. Higher program satisfaction was positively associated with recidivism among Black participants only. To provide equitable services for people convicted of a crime with mental illness, professionals should acknowledge racial variation in the experiences of MHC participants (both within the MHC and the communities in which they are situated) and how these experiences relate to recidivism.

Although research has indicated that mental health court (MHC) participation is associated with positive criminal justice outcomes, it remains unclear whether and how MHC participation may improve participants' quality of life (QOL). Utilizing MacArthur MHC study data (357 MHC and 348 traditional court participants), we explored the relationships among MHC participation, perceived voluntariness of treatment (VOL), mental health services utilization, and QOL. Our path analysis found that MHC participation was negatively related to VOL. In addition, VOL was positively related to service utilization, but service utilization was unrelated to QOL. Perceived voluntariness mediated the relationship between MHC participation and QOL. Because VOL was associated with QOL for both MHC participants and traditional court participants, implications include the need for a reevaluation of community supervision processes to increase VOL, with the aim of increasing QOL among those with mental illness living under community supervision. Because participation in MHC was associated with low VOL, MHC participants could benefit substantially from such efforts.

Mental health courts (MHCs) are specialized dockets for defendants with mental illnesses that seek the adjudication of criminal charges and municipal code violations by using a problem-solving model. Modeled after drug treatment courts, MHCs provide an alternative to incarceration for individuals with mental illness charged with criminal offenses. Mental health courts are but one of an array of problem-solving courts (PSCs) that have proliferated over the past three decades (e.g., drug courts, veterans courts, co-occurring disorder courts) and, as such, share come commonalities with these other PSCs. The populations served by these PSCs often overlap with MHCs as do many of the courts’ approaches (e.g., the use of incentives and sanctions to motivate clients to engage in treatment and support services). This entry will focus on MHCs but, when necessary, also include references pertaining to PSCs. Although MHCs may differ somewhat in structure and function by jurisdiction, this entry begins with resources (including reports, theoretical manuscripts, and empirical studies) identifying counts, structural components, and operational approaches common to MHCs. The entry then highlights the peer-reviewed literature on MHC outcomes, including program completion, recidivism, cost analysis, as well as alternative outcomes. Given the relative paucity of literature on juvenile MHCs, this entry focuses primarily on adult MHCs. Literature on juvenile MHCs is covered near the end of this entry. Similarly, the overwhelming majority of published research and commentary on MHCs pertains to MHCs that operate in the United States. This entry reflects that current state of the research. Finally, the entry concludes with published critiques of the MHC model.

Community corrections professionals may employ shared decision making (SDM) in many ways with those they supervise who have serious mental illness (SMI). This study examined the psychometric properties of the Community Corrections Shared Decision Making Scale (CCSDM), an instrument developed to measure attitudes that support SDM in community corrections settings. Community corrections professionals were surveyed as to their support of collaborative decision making with their supervisees with SMI. Exploratory factor analysis (n = 146) and confirmatory factor analysis (n = 145) were used to explore and validate the scale's factor structure. Results indicate the CCSDM functions as an internally consistent, two-factor scale useful for measuring attitudes toward SDM with people who have SMI and are under community supervision. Respondents were generally supportive of SDM. Given the benefits of SDM, assessment of these beliefs is essential to inform implementation strategies aimed at establishing SDM policies and practices in community corrections settings.

This study aimed to examine how states' Medicaid expansion affected insurance status and access to health care among low-income expansion state residents in 2015, the second year of the expansion. Data from the 2012 and 2015 Behavioral Risk Factor Surveillance System were linked to state-level data. A nationally representative sample of 544,307 adults (ages 26-64 years) from 50 states and Washington, DC were analyzed using multilevel modeling. The results indicate substantial increases in health care access between 2012 and 2015 among low-income adults in Medicaid expansion states. The final conditional multilevel models with low-income adults who had income at or below 138% of the poverty line indicate that, after controlling for individual- and state-level covariates, those who resided in the Medicaid expansion states were more likely to have health insurance (OR = 1.97, P < .001), have a usual source of care (OR = 1.37, P < .01), and receive a routine checkup (OR = 1.24, P < .01), and were less likely to not see a doctor because of cost (OR = 0.66, P < .001) compared with low-income residents in non-expansion states in 2015. Moreover, the significant interaction terms indicate that adults living in non-expansion states with income below 100% of the poverty line are the most vulnerable compared with their counterparts in expansion states and with those with income between 100%-138% of the poverty line. This study demonstrates that state-level Medicaid expansion improved health care access among low-income US residents. However, residents with income below 100% of the poverty line in non-expansion states were disproportionately negatively affected by states' decision to not expand Medicaid coverage.

This study examined whether the well-established racial/ethnic differences in mental health service utilization among individuals with mental illness are reflected in the treatment utilization patterns of individuals experiencing both mental illness and substance use disorders, particularly in regards to the use of contemporaneous mental health and substance abuse treatment. Using pooled data from the National Survey on Drug Use and Health (2009–2013), the patterns of mental health and substance use treatment utilization of 8748 White, Black, or Latino individuals experiencing both mental illness and substance use disorders were analyzed. Multinomial logistic regression was conducted to test the relationships among racial/ethnic groups and the receipt of contemporaneous treatment, mental health treatment alone, and substance use treatment alone as compared with no treatment utilization. Results indicated that Black and Latino respondents were less likely to receive contemporaneous treatment than Whites respondents. Also, significantly associated with outcomes were several interactions between race/ethnicity and predisposing, need and enabling factors known to be associated with service utilization. The findings suggest that an underlying mechanism of racial/ethnic differences among individuals with co-occurring mental illness and substance use disorders in the treatment utilization may differ by the specific types of treatment and between Blacks and Latinos. Therefore, efforts to reduce these disparities should consider specialty in each treatment settings and heterogeneity within diverse racial/ethnic groups.

The involvement of people with serious mental illness (SMI) with the justice system may be a direct result of their disruptive/unsafe expression of psychiatric symptoms being responded to by law enforcement. SMI may also indirectly contribute to justice involvement, through exposure to environmental and social learning processes that place people with SMI at risk for criminal behavior. This study addresses the question: For whom does SMI directly or indirectly relate to criminal behavior? Mediation and conditional effects testing were used to examine the potential of early onset of criminal behavior to distinguish those groups for whom SMI displays a direct effect or an indirect effect on criminal recidivism. This study utilized a disproportionate random sample of 379 inmates released from New Jersey Department of Corrections; 190 of whom had SMI and 189 of whom did not have SMI. Data were collected from clinical and administrative records. Results indicate that criminal risk mediated the relationship between SMI and recidivism. This indirect effect was conditioned by whether the individual had a juvenile conviction. Specifically, for early start offenders, criminal risk was positively related to recidivism while this relationship was not observed for late start offenders. Juvenile criminal onset did not condition the direct effects of SMI on recidivism. A juvenile history of criminal involvement may signal the presence of heightened criminogenic need among adults with SMI. This simple indicator could function to differentiate for clinicians those adults who are good candidates for exploring further, and targeting for amelioration, criminogenic needs to reduce further criminal involvement.

Using a nationally representative sample, this study examined the extent to which the utilization of various mental health services was associated with racial–ethnic identity among people with major affective disorders who have a criminal history. Approximately 33.7 % of the sample received any type of mental health services in a given year. Multivariate models indicated that married Blacks and Latinos were less likely to use specialty mental health care than their white counterparts. To provide equitable mental health treatment for vulnerable subgroups of this population, mental health professionals should account for the heterogeneity of mental health care in diverse cultural contexts.

Inmates with serious mental illness (SMI) or antisocial personality disorder (APD) average higher rates of disciplinary infractions than inmates without these conditions. This study builds upon these lines of research by examining the relationships among SMI and various types of prison misconduct, and whether these relationships are moderated by the presence of APD. SMI was observed significantly related to annual rates of both violent and serious nonviolent misconduct. APD moderated the relationship between SMI and serious nonviolent charges but not the relationship between SMI and violent charges. Implications for inmate management and classification practices aimed at ameliorating misconduct are discussed.

Using a nationally representative sample, this study examined to what extent the number of comorbid health conditions was associated with various mental health service utilization among people with bipolar disorder. The results of logistic regression models indicate that a greater number of comorbid medical conditions were associated with higher odds of using specialty mental health service, while they were not associated with utilization of services provided by general health care providers. The type of bipolar disorder, functional impairment, and marital status were found to be associated with the use of a specialty service, while ethnicity was the only covariate significantly related to general health care use.

OBJECTIVE:This study examined whether a history of criminal justice involvement is related to the use of contemporaneous mental health and substance abuse treatment among adults experiencing co-occurring disorders.METHODS:Pooled 2009-2013 data from the National Survey on Drug Use and Health were used to analyze patterns of mental health and substance abuse treatment utilization of 8,740 adults with past-year co-occurring disorders.RESULTS:Individuals with a criminal history were more likely than those without a criminal history to receive both types of treatment or substance abuse treatment alone.CONCLUSIONS:The criminal justice system appears to be facilitating mental health and substance abuse treatment among people experiencing co-occurring disorders but may also be overreliant on substance abuse treatment alone.