Criminogenic Factors and Psychotic Symptoms Predict Arrest Rates Among People With Serious Mental Illnesses

Prins, Seth J., Columbia University
Skeem, Jennifer L., University of California, Berkley
Mauro, Christine, Columbia University
Link, Bruce G., Columbia University

Although research robustly indicates that general or “criminogenic” factors predict various measures of recidivism, there is controversy about the extent to which these factors, versus untreated symptoms, lead to justice involvement for people with mental illnesses. Based on a sample of 183 people in intensive outpatient treatment followed for an average period of 34.5 months, the present study tested whether criminogenic factors (i.e., factor-analytically derived proxies of some of the “Central Eight”; Andrews & Bonta, 2010) and psychotic symptoms were independently associated with arrest. The study also compared the predictive utility of these domains. In the fully adjusted model, the antisocial subscale and male sex were associated with increased arrest rates, whereas psychosis and age were associated with decreased arrest rates. Criminogenic factors and psychotic symptoms had comparable predictive utility. We conclude that criminogenic factors—chiefly arrest history—and psychotic symptoms predict arrest rates. Both sets of variables appear useful for assessing risk of arrest among people with mental illnesses who are not under current correctional supervision.

crime, mental illness, risk assessment, arrest, psychosis

Extensive research has proposed that criminogenic risk factors (i.e., major changeable risk factors for criminal behavior that do not include symptoms of mental illnesses) are strong predictors of recidivism and that these measures are useful targets for intervention to reduce re-arrest rates for individuals who are under correctional supervision. “However, there is debate among researchers and practitioners about the extent to which the involvement of people with mental illness in the justice system is maintained by criminogenic risk factors, which are shared among all justice-involved people, or by untreated symptoms, which are specific to people with mental illness (p. 177).”

Research findings are mixed with regard to higher arrest rates among people with mental illness. “Until recently, correctional policy for individuals with mental illnesses was premised on the belief that symptoms caused arrest: a lack of (or inadequate) treatment brought deviant, symptomatic behavior to the attention of law enforcement (p. 177).” The primary goal was to connect individuals with mental illness to treatment under the supervision of the courts or community correction agencies. However, research findings are also mixed with regard to a reduction in recidivism based on treatment-centered programs. There has been no evidence that supports the belief that a reduction of mental health symptoms is the reason why individuals who succeed in these programs do not recidivate.

“Relatively little research has been conducted among a subgroup of individuals for whom untreated symptoms may more directly cause justice system involvement, including defendants who have been acquitted of a crime as not guilty by reason of insanity (NGRI). Still, criminogenic variables seem to predict revocation in this subgroup, as well (p. 178).” A history of substance abuse, prior arrest(s) or revocation, and non-adherence to treatment have all been identified as variables associated with the revocation among NGRI acquitees. “There is growing evidence that roughly 8% of justice-involved people with mental illnesses have an arrest or pattern of arrests that are directly attributable to symptoms of psychosis (p. 178).”

Utilizing a sample of 183 individuals with serious mental illness this study sought to examine if certain criminogenic factors and psychotic symptoms are independently associated with arrest. “From the perspective of policy and programming, at issue is whether risk assessment and targeted risk reduction as a general model is applicable in criminal justice and mental health collaborations or whether it requires theoretical or methodological adaptation (p. 178).”

Findings highlighted criminogenic factors and psychotic symptoms are both associated with rate of arrest. Specifically, criminogenic factors were associated with an increased rate of arrest and psychotic symptoms with a decreased rate of arrest. Arrest history was the most predominant criminogenic factor associated with an increased rate of arrest.

“There are at least two competing perspectives on the causes of criminal behavior or arrest among individuals with mental illnesses. The first posits that untreated psychiatric symptoms cause arrest directly by drawing the attention of law enforcement officials or indirectly by resulting in circumstances that subsequently result in criminal behavior or arrest. We found that psychotic symptoms and arrest had the opposite association in our sample. The second perspective posits that criminal history and a subset of variable risk factors—changeable behaviors, attitudes, and personality characteristics proximate to crime (i.e., “the immediate situation”)—maintain recidivism. We found that such factors were associated with arrest, but arrest history, a static risk factor, was more operative than proximate changeable factors (p. 182).”

“Assessing individual differences in these risk factors is a centerpiece of evidence-based practice for corrections agencies. The goal is to identify relatively high-risk individuals, prioritize them for intensive intervention services that target these criminogenic factors, and thereby meaningfully reduce recidivism. Research suggests that four risk factors consistently predict criminal conduct in almost any justice-involved sample: history of antisocial behavior, antisocial personality pattern, antisocial cognition, and antisocial associates (p. 178).” Examining these previously identified risk factors when working with individuals with mental illnesses who are connected with the criminal justice system may be valuable. Benefits from treatment may increase if clinicians are able to identify these risk factors and additionally assist individuals with developing realistic goals to change their antisocial habits.

“From an actuarial perspective, the independent predictive utility of criminogenic risk factors appears contingent on whether the goal is primarily prediction or intervention; that is, if the goal is merely to predict arrest, fixed markers like arrest history may be sufficient, but if the goal is to reduce risk, identifying changeable risk factors to target in treatment is essential. That said, used in conjunction with symptom and demographic information, criminal risk factors will improve prediction of arrest for individuals with serious mental illnesses not under current correctional supervision (p. 183).” (emphasis added)

As always, please join the discussion below if you have thoughts or comments to add!