A juvenile history of criminal involvement may signal the presence of heightened criminogenic need among adults with serious mental illness, offering significant implications for efforts aimed at reducing repeat incarceration among mentally disordered offenders. This is the bottom line of a recently published article in Law and Human Behavior. Below is a summary of the research and findings as well as a translation of this research into practice.
Featured Article | Law and Human Behavior | 2017, Vol. 41, No. 1, 68-79
Does Early Onset of Criminal Behavior Differentiate for Whom Serious Mental Illness Has a Direct or Indirect Effect on Recidivism?
Jason Matejkowski and Aaron Conrad, University of Kansas
Michael Ostermann, Rutgers University
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.
serious mental illness, early start offenders, criminal risk, conditional process analysis
Summary of the Research
“For many complex and not fully understood reasons, several different branches of empirical research have coalesced to demonstrate that people with SMI tend to have higher criminal justice involvement than the general population. Researchers have suggested that this justice involvement may be a direct result of disruptive and unsafe expressions of psychiatric symptoms being responded to by law enforcement or that SMI may indirectly lead to justice involvement, through the environmental and social learning processes experienced by people with SMI which contribute to behaviors and thinking patterns that place them at a greater risk for criminal behavior. It has been further suggested that, for some, the direct effect of SMI on criminal behavior may more accurately reflect their criminal behaviors and justice involvement while, for others, the indirect effect of SMI on criminal behaviors (through criminal risk) is a more accurate reflection of their path to justice involvement. The current study examines the potential of early onset of criminal behavior to distinguish those groups for whom SMI plays a direct effect or an indirect effect on criminal behavior” (p. 68).
“Mental illness may have a direct effect on violent and criminal behavior through disruptive or unsafe expressions of psychiatric symptoms … It appears that a small but substantial portion of crimes committed by adults with SMI can be directly attributed to symptoms of their psychiatric disorder. In terms of criminal recidivism, former inmates who have mental health problems have not fared well in the community following release from incarceration when compared with otherwise similar released offenders who do not have mental health problems” (p. 68-69).
“The presence of criminal risk factors increases the level of risk an individual has for being involved in criminal behavior … Research on the principles of effective correctional interventions in general, and criminogenic risks in particular, have identified a “central eight” set of risk factors that are more predictive of recidivistic behavior patterns when compared with other risk factors … Dynamic risk factors are strongly predictive of criminal behavior among adults regardless of the presence of a mental health problem. However, research indicating higher levels of criminal risk among offenders with mental illness compared with offenders without such illnesses suggest the possibility of a relative increase in criminal involvement as well as postrelease supervision violations for technical infractions among inmates with mental illness” (p. 69).
“Studies suggest that mental illness may be related to an increased presence of criminal risk factors (i.e., a higher level of criminal risk) that, in turn, are related to increased criminal recidivism and return to incarceration. Thus, while not a direct effect of mental illness on criminal behavior, these relationships may partially explain the higher rates of recidivism observed by others … It is important to explore for moderators to inform prevention efforts as to how and with whom to target methods that ameliorate the criminal risk that contributes to recidivism. One promising area for exploration is the role that juvenile justice involvement may play in the relationships among SMI, risk level and criminal behavior” (p. 69).
“Research in the fields of juvenile criminal behavior, mental illness, and recidivism has identified offenders as either early start (ES) or late start (LS) offenders … The criminal behavior of ES offenders’ begins in childhood or early adolescence, prior to the onset of mental illness. LS offenders engage in antisocial activities after the emergence of mental illness and their criminal behavior is more likely as a result of the mental illness … Individuals with SMI who are also ES offenders may reflect criminal risk profiles of the general offender population more so than offenders with SMI whose criminal behaviors commence later in life. Early start offenders who are arrested before the age of 14 are two to three times more likely than LS offenders to commit significant or violent crimes as adults as well as experience high levels of recidivism” (p. 69).
“In examining the role mental illness may play in criminal involvement, it has been suggested that direct effects of psychiatric sequela play a minor role. An alternative model to this direct relationship posits general risk factors as mediating this relationship between mental illness and criminal behavior and that differences in whether mental illness exhibits a direct or indirect relationship on criminal behavior may reflect differences in age of onset of criminal behavior … The current study builds upon prior research in order 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” (p. 70).
The New Jersey State Parole Board (SPB) provided the authors with a dataset reflecting all inmates housed in a New Jersey Department of Corrections facility that had a parole release decision in 2007. The sample size consisted of 379 former inmates with (n = 190) and without (n = 189) SMI.
“Findings partially supported the study’s hypotheses. SMI did exhibit a significant relationship with recidivism when considering both variables’ relationship with actuarially assessed risk. Individuals with SMI had significantly higher risk levels than those without SMI, and increased risk level was significantly associated with a rearrest or technical parole violation within 1 year of being released from prison. Results also indicate that this indirect effect of SMI on recidivism (through risk level) was conditioned by whether the individual had a juvenile conviction. Specifically, for those with a juvenile conviction, risk level was positively related to recidivism while this relationship was not observed for those identified as late start offenders. When exploring the direct effects of SMI on recidivism, however, we found no conditioning effect of juvenile criminal onset” (p. 74-75).
Translating Research into Practice
“The observation that the presence of a serious mental illness was related to increased risk level and risk level was positively related to recidivism supported the hypothesized relationships among these variables … For offenders with a history of juvenile criminal involvement, criminal risk was related to recidivism; however, this was not the case for LS offenders. Thus, the recidivism of ES offenders with SMI appears to be driven by increased level of criminal risk; whereas, recidivism of LS offenders is not … There are a variety of criminogenic needs that may be heightened among ES offenders as opposed to LS offenders. Early problems in the domains of stable housing, relationships with family and friends, and substance abuse are all predictive of early onset of and continuing involvement in criminal behavior as an adult. Therefore, targeting such criminogenic needs with the population of ES offenders is critical for interrupting criminal involvement and recidivism” (p. 76).
“Efforts aimed at preventing further criminal justice involvement among ES offenders should therefore include collaboration between juvenile justice authorities and child protective services as well as addiction treatment programs and other preventative and remedial interventions to address issues like stable housing, education, and employment. For those beginning to display signs of a mental health problem, diversion programs that integrate psychiatric treatment and criminal rehabilitation to minimize the criminogenic impact of incarceration on youth should also be an option. Furthermore, these interventions should have an evidence base supporting their effectiveness at reducing criminogenic needs among young people experiencing mental health problems and be implemented as consistently and as early as possible in order to have the greatest impact” (p. 76).
Other Interesting Tidbits for Researchers and Clinicians
“While limited to New Jersey, the current study has significant implications for efforts aimed at reducing repeat incarceration among offenders with SMI. Findings indicate that the presence of 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 those adults who are good candidates for exploring further and potentially targeting for amelioration those criminogenic needs to reduce further criminal involvement. However, it should be noted that the current study was unable to explore specific juvenile offenses. It is possible that some offenses (e.g., violent, property, drug) may serve as a better indicator of the presence of criminogenic needs as an adult. Future research could explore this possibility with the subgroup of ES offenders with SMI to potentially enhance the specificity of this juvenile-involvement indicator at identifying adults with SMI for whom criminogenic needs are likely to be present and contributing to their involvement in criminal behavior” (p. 76).
“Moreover, it appears critical to act early with young adults who have a mental illness and become justice-involved to prevent the accumulation of criminogenic needs that can contribute to further criminal behavior. It is important to note that no finding observed in the current study could be taken to negate the need for medically appropriate mental health treatment. However, when crime reduction is the aim, it is also important to remain vigilant as to the presence and need for treatment of criminogenic needs among these young people as their psychiatric symptoms progress; as findings indicate it is these criminogenic needs, not the psychiatric disorder itself, which is contributing to recidivism among ES offenders” (p. 76-77).
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