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Research ArticleRegular Article

Criminal Recidivism in Inmates with Mental Illness and Substance Use Disorders

Kristen M. Zgoba, Rusty Reeves, Anthony Tamburello and Lisa Debilio
Journal of the American Academy of Psychiatry and the Law Online February 2020, JAAPL.003913-20; DOI: https://doi.org/10.29158/JAAPL.003913-20
Kristen M. Zgoba
Dr. Zgoba is Assistant Professor, Florida International University, Department of Criminology & Criminal Justice, Miami, Florida. Dr. Reeves is Director of Psychiatry, Rutgers University Correctional Health Care, and Professor, Department of Psychiatry, Rutgers University, Robert Wood Johnson Medical School. Dr. Tamburello is Associate Director of Psychiatry, Rutgers University Correctional Health Care, and Clinical Associate Professor, Rutgers University, Robert Wood Johnson Medical School. Dr. Debilio is Director of Quality Improvement, Rutgers University Correctional Health Care.
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Rusty Reeves
Dr. Zgoba is Assistant Professor, Florida International University, Department of Criminology & Criminal Justice, Miami, Florida. Dr. Reeves is Director of Psychiatry, Rutgers University Correctional Health Care, and Professor, Department of Psychiatry, Rutgers University, Robert Wood Johnson Medical School. Dr. Tamburello is Associate Director of Psychiatry, Rutgers University Correctional Health Care, and Clinical Associate Professor, Rutgers University, Robert Wood Johnson Medical School. Dr. Debilio is Director of Quality Improvement, Rutgers University Correctional Health Care.
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Anthony Tamburello
Dr. Zgoba is Assistant Professor, Florida International University, Department of Criminology & Criminal Justice, Miami, Florida. Dr. Reeves is Director of Psychiatry, Rutgers University Correctional Health Care, and Professor, Department of Psychiatry, Rutgers University, Robert Wood Johnson Medical School. Dr. Tamburello is Associate Director of Psychiatry, Rutgers University Correctional Health Care, and Clinical Associate Professor, Rutgers University, Robert Wood Johnson Medical School. Dr. Debilio is Director of Quality Improvement, Rutgers University Correctional Health Care.
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Lisa Debilio
Dr. Zgoba is Assistant Professor, Florida International University, Department of Criminology & Criminal Justice, Miami, Florida. Dr. Reeves is Director of Psychiatry, Rutgers University Correctional Health Care, and Professor, Department of Psychiatry, Rutgers University, Robert Wood Johnson Medical School. Dr. Tamburello is Associate Director of Psychiatry, Rutgers University Correctional Health Care, and Clinical Associate Professor, Rutgers University, Robert Wood Johnson Medical School. Dr. Debilio is Director of Quality Improvement, Rutgers University Correctional Health Care.
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Article Figures & Data

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    Table 1

    Full Sample Descriptives

    VariablesFrequency (%)
    Gender, n (%)
        Male8,992 (93.0)
        Female677 (7.0)
    Race/ethnicity, n (%)
        White2,727 (28.5)
        Black5,407 (56.5)
        Hispanic1,394 (14.6)
        Other45 (0.5)
    Marital status, n (%)
        Single6,066 (83.0)
        Married608 (8.3)
        Divorced367 (5.0)
        Separated225 (3.1)
        Widowed45 (0.6)
    Education level, n (%)
        Some schooling, not a HS graduate2,420 (26.4)
        HS graduate/equivalent5,870 (64.1)
        Some college and beyond869 (9.5)
    Prior arrests, mean (SD)7.4 (7.3)
    Prior convictions, mean (SD)4.4 (4.7)
    Prior DOC admissions, mean (SD)1.1 (1.3)
    Prior DOC history, n (%)
        No prior admissions4,573 (47.3)
        1 prior admission2,314 (23.9)
        2 prior admissions1,370 (14.2)
        3 prior admissions801 (8.3)
        4+ prior admissions611 (6.3)
    Index incarceration offense, n (%)
        Violent2,149 (22.4)
        Weapons903 (9.4)
        Property1,497 (15.6)
        Drugs2,466 (25.6)
        Community supervision violation1,985 (20.6)
        Other615 (6.4)
    Release age, mean (SD)35.1 (10.4)
    Time served (days), mean (SD)841.8 (1082.2)
    • N = 9,669 subjects.

    • DOC, Department of Corrections.

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    Table 2

    Substance Use and Mental Health Characteristics of Sample on Release

    DiagnosisFrequency (%)
    MHSNR1,175 (12.2)
    Substance use disorder, Total4,005 (41.4)
    Substance use disorder and MHSNR1,020 (10.6)
    Substance use disorder, no MHSNR2,985 (30.9)
    No substance use disorder, Total5,664 (58.6)
    No substance use disorder and MHSNR155 (1.6)
    No substance use disorder, no MHSNR5,509 (57.0)
    Diagnosed with mood disorder997 (10.3)
    Diagnosed with psychotic disorder259 (2.7)
    Prescribed antipsychotic medication244 (2.5)
    Prescribed injectable medication36 (0.4)
    Approved for involuntary medication32 (0.3)
    • Data are presented as n (%). N = 9,669 subjects.

    • MHSNR, Mental Health Special Needs Roster.

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    Table 3

    Rearrest by Diagnosis

    DiagnosisRearrest, %Number of Rearrests, Mean (SD)
    Substance abuse indication and placement on MHSNR55.201.47 (2.09)
    Substance abuse indication no MHSNR58.461.52 (2.08)
    Substance abuse total56.831.50 (2.09)
    No substance abuse indication and no MHSNR48.721.13 (1.77)
    MHSNR and no substance abuse indication42.580.92 (1.48)
    No substance abuse total45.051.00 (1.62)
    Prescription of antipsychotic meds upon release50.411.39 (2.28)
    Prescription of injectable antipsychotic meds upon release44.441.58 (2.43)
    Receiving involuntary medication in prison upon release46.881.19 (1.58)
    Psychotic disorder48.651.29 (2.18)
    Mood disorder55.471.43 (1.88)
    • MHSNR, Mental Health Special Needs Roster.

    • View popup
    Table 4

    Display of Statistical Differences

    Reference CategoryComparison GroupStatistical Results
    Substance Use Disorder Total (n = 4,005) x̄ = 1.50, SD = 2.09No Substance Use Disorder (n = 5,664) x̄ = 1.00, SD = 1.62F = 32.30 df = 2 P < .001
    Mental Illness Alone (n = 155) x̄ = 0.92, SD = 1.48
    Mental Illness and Substance Use Disorder (n = 1,020) x̄ = 1.47, SD = 2.09Substance Use Disorder Total (n = 4,005) x̄ = 1.50, SD = 2.09F = 27.14 df = 3 P < .001
    No Substance Use Disorder and No Mental Illness (n = 5,509) x̄ = 1.13, SD = 1.77
    Mental Illness Alone (n = 155) x̄ = 0.92, SD = 1.48
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Journal of the American Academy of Psychiatry and the Law Online: 53 (1)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 53, Issue 1
1 Mar 2025
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Criminal Recidivism in Inmates with Mental Illness and Substance Use Disorders
Kristen M. Zgoba, Rusty Reeves, Anthony Tamburello, Lisa Debilio
Journal of the American Academy of Psychiatry and the Law Online Feb 2020, JAAPL.003913-20; DOI: 10.29158/JAAPL.003913-20

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Criminal Recidivism in Inmates with Mental Illness and Substance Use Disorders
Kristen M. Zgoba, Rusty Reeves, Anthony Tamburello, Lisa Debilio
Journal of the American Academy of Psychiatry and the Law Online Feb 2020, JAAPL.003913-20; DOI: 10.29158/JAAPL.003913-20
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