Effectiveness of a Mental Health Court in Reducing Criminal Recidivism and Violence
01 Sep 2007-American Journal of Psychiatry (American Psychiatric Association)-Vol. 164, Iss: 9, pp 1395-1403
TL;DR: It is shown that participation in the mental health court program was associated with longer time without any new criminal charges or new charges for violent crimes and maintenance of reductions in recidivism and violence after graduates were no longer under supervision of themental health court.
Abstract: Objective: In response to the large-scale involvement of people with mental disorders in the criminal justice system, many communities have created specialized mental health courts in recent years. However, little research has been done to evaluate the criminal justice outcomes of such courts. This study evaluated whether a mental health court can reduce the risk of recidivism and violence by people with mental disorders who have been arrested. Method: A retrospective observational design was used to compare the occurrence of new criminal charges for 170 people who entered a mental health court after arrest and 8,067 other adults with mental disorders who were booked into an urban county jail after arrest during the same interval. A matching strategy based on propensity scores was used to adjust analyses for nonrandom selection into mental health court. Results: Propensity-weighted Cox regression analysis, controlling for other potential confounding variables (demographic characteristics, clinical variables, and criminal history), showed that participation in the mental health court program was associated with longer time without any new criminal charges or new charges for violent crimes. Successful completion of the mental health court program was associated with maintenance of reductions in recidivism and violence after graduates were no longer under supervision of the mental health court. Conclusions: The results indicate that a mental health court can reduce recidivism and violence by people with mental disorders who are involved in the criminal justice system.
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Book•
01 Nov 2009
TL;DR: It is tested whether significant differences in mental illness exist in a matched sample of Mental illness and the criminal justice system.
Abstract: We test whether significant differences in mental illness exist in a matched sample of Mental illness and the criminal justice system. In T. L. Scheid T. N. Brown (Eds.), A handbook for the study of mental health: Social contexts, theories. Find 9780521567633 A Handbook for the Study of Mental Health : Social Contexts, Theories, and Systems by Horwitz et al at over 30 bookstores. Buy, rent. A review of mental health problems in fathers following the birth of a child. for the study of mental health:Social contexts, theories, and systems (2nd ed., pp.
842 citations
TL;DR: Because severe mental illness did not independently predict future violent behavior, these findings challenge perceptions that mental illness is a leading cause of violence in the general population.
Abstract: Context: The relationship between mental illness and violence has a significant effect on mental health policy, clinical practice, and public opinion about the dangerousness of people with psychiatric disorders. Objective: To use a longitudinal data set representative of the US population to clarify whether or how severe mental illnesses such as schizophrenia, bipolar disorder, and major depression lead to violent behavior. Design:Data on mental disorder and violence were collected as part of the National Epidemiologic Survey on AlcoholandRelatedConditions(NESARC),a2-wavefaceto-face survey conducted by the National Institute on Alcohol Abuse and Alcoholism. Participants: A total of34653 subjects completed NESARC waves 1 (2001-2003) and 2 (2004-2005) interviews. Wave 1 data on severe mental illness and risk factors were analyzed to predict wave 2 data on violent behavior.
795 citations
TL;DR: Inmates with major psychiatric disorders (major depressive disorder, bipolar disorders, schizophrenia, and nonschizophrenic psychotic disorders) had substantially increased risks of multiple incarcerations over the 6-year study period.
Abstract: Objective: A number of legal, social, and political factors over the past 40 years have led to the current epidemic of psychiatric disorders in the U.S. prison system. Although numerous investigations have reported substantially elevated rates of psychiatric disorders among prison inmates compared with the general population, it is unclear whether mental illness is a risk factor for multiple episodes of incarceration. The authors examined this association in a retrospective cohort study of the nation’s largest state prison system. Method: The study population included 79,211 inmates who began serving a sentence between September 1, 2006, and August 31, 2007. Data on psychiatric disorders, demographic characteristics, and history of incarceration for the preceding 6-year period were obtained from statewide medical information systems and analyzed. Results: Inmates with major psychiatric disorders (major depressive disorder, bipolar disorders, schizophrenia, and nonschizophrenic psychotic disorders) had sub...
567 citations
Cites background from "Effectiveness of a Mental Health Co..."
...Unlike traditional courts, mental health courts have therapeutic goals, such as increasing treatment adherence, and they are presided over by designated judges (18, 27)....
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...For example, inmates with psychiatric disorders are reported to stay in prison longer than others charged with similar crimes (18)....
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...Preliminary evidence indicates that participation in a mental health court is associated with longer periods without criminal recidivism (18)....
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TL;DR: This article uses research to evaluate the effectiveness of current interventions, and the larger viability of psychiatric, criminological, and social psychological models of the link between mental illness and criminal justice involvement, and proposes three priorities for advancing research, articulating policy, and improving practice.
Abstract: Offenders with mental illness have attracted substantial attention over the recent years, given their prevalence and poor outcomes. A number of interventions have been developed for this population (e.g., mental health courts). They share an emphasis on one dimension as the source of the problem: mental illness. Their focus on psychiatric services may poorly match the policy goal of reducing recidivism. In this article, we use research to evaluate (a) the effectiveness of current interventions, and (b) the larger viability of psychiatric, criminological, and social psychological models of the link between mental illness and criminal justice involvement. We integrate theory and research to offer a multidimensional conceptual framework that may guide further research and the devel- opment of efficient interventions that meaningfully reduce recidivism. We hypothesize that the effect of mental illness on criminal behavior reflects moderated mediation (i.e., the effect is direct in the case of one subgroup, but fully mediated in another); and that the effect of mental illness on other '' recidivism'' is partially mediated by system bias and stigma. We use this framework to propose three pri- orities for advancing research, articulating policy, and improving practice.
373 citations
DOI•
01 Jan 2013TL;DR: Men and women experience different kinds of mental health problems as mentioned in this paper, while women exceed men in internalizing disorders such as depression and anxiety, men exhibit more externalizing disorders, such as substance abuse and antisocial behavior, which are problematic for others.
Abstract: Men and women experience different kinds of mental health problems. While women exceed men in internalizing disorders such as depression and anxiety, men exhibit more externalizing disorders such as substance abuse and antisocial behavior, which are problematic for others. These differences also vary by race and social class: for example, African Americans possess better mental health and, thus, a smaller gender gap in psychiatric problems. What explains these differences? We concentrate on conceptions of gender and gender practices. Research on gender and mental health suggests that conceptions of masculinity and femininity affect major risk factors for internalizing and externalizing problems, including the stressors men and women are exposed to, the coping strategies they use, the social relationships they engage in, and the personal resources and vulnerabilities they develop. This chapter investigates explanations in these areas for gender differences both in general and by race and class.
365 citations
References
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TL;DR: The authors discusses the central role of propensity scores and balancing scores in the analysis of observational studies and shows that adjustment for the scalar propensity score is sufficient to remove bias due to all observed covariates.
Abstract: : The results of observational studies are often disputed because of nonrandom treatment assignment. For example, patients at greater risk may be overrepresented in some treatment group. This paper discusses the central role of propensity scores and balancing scores in the analysis of observational studies. The propensity score is the (estimated) conditional probability of assignment to a particular treatment given a vector of observed covariates. Both large and small sample theory show that adjustment for the scalar propensity score is sufficient to remove bias due to all observed covariates. Applications include: matched sampling on the univariate propensity score which is equal percent bias reducing under more general conditions than required for discriminant matching, multivariate adjustment by subclassification on balancing scores where the same subclasses are used to estimate treatment effects for all outcome variables and in all subpopulations, and visual representation of multivariate adjustment by a two-dimensional plot. (Author)
23,744 citations
TL;DR: In this article, the authors review the state of the art in estimating average treatment effects under various sets of assumptions, including exogeneity, unconfoundedness, or selection on observables.
Abstract: Recently there has been a surge in econometric work focusing on estimating average treatment effects under various sets of assumptions. One strand of this literature has developed methods for estimating average treatment effects for a binary treatment under assumptions variously described as exogeneity, unconfoundedness, or selection on observables. The implication of these assumptions is that systematic (for example, average or distributional) differences in outcomes between treated and control units with the same values for the covariates are attributable to the treatment. Recent analysis has considered estimation and inference for average treatment effects under weaker assumptions than typical of the earlier literature by avoiding distributional and functional-form assump- tions. Various methods of semiparametric estimation have been proposed, including estimating the unknown regression functions, matching, meth- ods using the propensity score such as weighting and blocking, and combinations of these approaches. In this paper I review the state of this literature and discuss some of its unanswered questions, focusing in particular on the practical implementation of these methods, the plausi- bility of this exogeneity assumption in economic applications, the relative performance of the various semiparametric estimators when the key assumptions (unconfoundedness and overlap) are satise ed, alternative estimands such as quantile treatment effects, and alternate methods such as Bayesian inference.
2,370 citations
TL;DR: Propensity score weights estimated using boosting eliminate most pretreatment group differences and substantially alter the apparent relative effects of adolescent substance abuse treatment.
Abstract: Causal effect modeling with naturalistic rather than experimental data is challenging. In observational studies participants in different treatment conditions may also differ on pretreatment characteristics that influence outcomes. Propensity score methods can theoretically eliminate these confounds for all observed covariates, but accurate estimation of propensity scores is impeded by large numbers of covariates, uncertain functional forms for their associations with treatment selection, and other problems. This article demonstrates that boosting, a modern statistical technique, can overcome many of these obstacles. The authors illustrate this approach with a study of adolescent probationers in substance abuse treatment programs. Propensity score weights estimated using boosting eliminate most pretreatment group differences and substantially alter the apparent relative effects of adolescent substance abuse treatment.
1,143 citations
"Effectiveness of a Mental Health Co..." refers methods in this paper
...A method that can attenuate the biasing effects of nonrandom assignment to treatment versus comparison groups is propensity score weighting (16, 17)....
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TL;DR: In this paper, the authors consider methods for estimating causal effects of treatments when treatment assignment is unconfounded with outcomes conditional on a possibly large set of covariates, and apply these methods to data on the effects of right heart catheterization (RHC) studied in Connors et al.
Abstract: We consider methods for estimating causal effects of treatments when treatment assignment is unconfounded with outcomes conditional on a possibly large set of covariates. Robins and Rotnitzky (1995) suggested combining regression adjustment with weighting based on the propensity score (Rosenbaum and Rubin, 1983). We adopt this approach, allowing for a flexible specification of both the propensity score and the regression function. We apply these methods to data on the effects of right heart catheterization (RHC) studied in Connors et al (1996), and we find that our estimator gives stable estimates over a wide range of values for the two parameters governing the selection of variables.
1,070 citations
Book•
01 Jan 2001
TL;DR: Rethinking Risk Assessment as discussed by the authors is a pioneering investigation that challenges preconceptions about the frequency and nature of violence among persons with mental disorders, and suggests an innovative approach to predicting its occurrence.
Abstract: Rethinking Risk Assessment tells the story of a pioneering investigation that challenges preconceptions about the frequency and nature of violence among persons with mental disorders, and suggests an innovative approach to predicting its occurrence.
1,060 citations
"Effectiveness of a Mental Health Co..." refers methods in this paper
...Following Naples and Steadman (23), we categorized charges according to concepts developed by the MacArthur Study of Mental Disorder and Violence (24)....
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...Am J Psychiatry 164:9, September 2007 1395 Article ajp.psychiatryonline.org Effectiveness of a Mental Health Court in Reducing Criminal Recidivism and Violence...
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