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Does Transinstitutionalization Explain the Overrepresentation of People with Serious Mental Illnesses in the Criminal Justice System?

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Abstract

Although there is broad consensus that people with serious mental illnesses (SMI) are overrepresented in correctional settings, there is less agreement about the policy trends that may have created this situation. Some researchers and policymakers posit a direct link between deinstitutionalization and increased rates of SMI in jails and prisons, a phenomenon described as transinstitutionalization. Others offer evidence that challenges this hypothesis and suggest that it may be a reductionist explanation. This paper reviews claims from both sides of the debate, and concludes that merely increasing access to state psychiatric hospital beds would likely not reduce the number of people with SMI in jails and prisons. A more nuanced approach is recommended for explaining why people with SMI become involved in the criminal justice system and why developing effective strategies to divert them out of jails and prisons and into community-based treatment is needed to improve both their mental health and criminal justice outcomes.

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References

  • Abram, K. M., & Teplin, L. A. (1991). Co-occurring disorders among mentally ill jail detainees. American Psychologist, 46(10), 1036–1045.

    Article  PubMed  CAS  Google Scholar 

  • Abram, K. M., Teplin, L. A., & McClelland, G. M. (2003). Comorbidity of severe psychiatric disorders and substance use disorders among women in jail. American Journal of Psychiatry, 160, 1007–1010.

    Article  PubMed  Google Scholar 

  • Abramson, M. F. (1972). The criminalization of mentally disordered behavior: Possible side-effects of a new mental health law. Hosp Community Psychiatry, 4, 101–105.

    Google Scholar 

  • Center for Substance Abuse Treatment. (2007). The epidemiology of co-occurring substance use and mental disorders. Rockville, MD: Substance Abuse and Mental Health Services Administration, Center for Mental Health Services. SMA 07–4308.

  • Council of State Governments. (2002). Criminal justice/mental health consensus project. New York: Council of State Governments.

    Google Scholar 

  • Council of State Governments Justice Center. (2010). Mentally Ill Offender Treatment and Crime Reduction Act Fact Sheet. New York, New York. Retrieved from http://consensusproject.org/jc_publications/mentally-ill-offender-treatment-and-crime-reduction-act-fact-sheet.

  • Cusack, K. J., Morrissey, J. P., Cuddeback, G. S., Prins, A., & Williams, D. M. (2010). Criminal justice involvement, mental health service use, and costs of forensic assertive community treatment: A randomized trial. Community Mental Health Journal, 46(4), 356–363.

    Article  PubMed  Google Scholar 

  • Dewees, M., Pulice, R. T., & McCormick, L. L. (1997). Community integration of former state hospital patients: outcomes for a policy shift in Vermont. Psychiatric Services, 47, 1088–1092.

    Google Scholar 

  • Ditton, P. (1999). Mental health and treatment of inmates and probationers. Washington DC: US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

    Google Scholar 

  • Earley, P. (2006). Crazy: A father’s search through America’s mental health madness. New York: Berkley books.

    Google Scholar 

  • Erickson, S. K., Rosenheck, R. A., Trestman, R. L., Ford, J. D., & Desai, R. A. (2008). Risk of incarceration between cohorts of veterans with and without mental illness discharged from inpatient units. Psychiatric Services, 59(2), 178–183.

    Article  PubMed  Google Scholar 

  • Federal Bureau of Investigation. (Annual). Crime in the United States. Washington, DC: United States Department of Justice. Retrieved from http://www.fbi.gov/ucr/ucr.htm.

  • Fisher, W. H., Barreira, P. J., Geller, J. L., White, A. W., Lincoln, A. K., & Sudders, M. (2001). Long-stay patients in state psychiatric hospitals at the end of the 20th century. Psychiatric Services, 52(8), 1051–1056.

    Article  PubMed  CAS  Google Scholar 

  • Florida’s Criminal Justice, Mental Health, and Substance Abuse Reinvestment Act Grant Program. (n.d.). § 394.656, Fla. Stat. (2007).

  • Frank, R. G., & Glied, S. A. (2006). Better but not well: mental health policy in the United States since 1950. Baltimore: Johns Hopkins University Press.

    Google Scholar 

  • Geller, J. L. (2000). The last half-century of psychiatric services as reflected in psychiatric services. Psychiatric Services, 51, 41–67.

    PubMed  CAS  Google Scholar 

  • James, D. J., & Glaze, L. E. (2006). Mental health problems of prison and jail inmates. Washington DC: US Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.

    Google Scholar 

  • King, R. S. (2008). Disparity by geography: The war on drugs in America’s cities. Washington, DC: The Sentencing Project.

    Google Scholar 

  • Koyanagi, C. (2007). Learning from history: Deinstitutionalization of people with mental illness as precursor to long-term care reform. Washington, DC: Kaiser Commission on Medicaid and the Uninsured.

    Google Scholar 

  • Lamb, R. H., & Weinberger, L. E. (2005a). One-year follow-up for persons discharged from a locked intermediate care facility. Psychiatric Services, 56(2), 198–201.

    Article  PubMed  Google Scholar 

  • Lamb, R. H., & Weinberger, L. E. (2005b). The shift of psychiatric inpatient care from hospitals to jails and prisons. Journal of the American Academy of Psychiatry and the Law, 33(4).

  • Leff, J., Trieman, N., Knapp, M., & Hallmam, A. (2000). The TAPS project: A report on 13 years of research, 1985–1998. Psychiatric Bulletin, 24, 165–168.

    Article  Google Scholar 

  • Linhorst, D. M., & Turner, M. A. (1999). Treatment of forensic patients: An expanding role for public psychiatric hospitals. Health and Social Work, 24(1), 18–26.

    PubMed  CAS  Google Scholar 

  • Manderscheid, R. W., Atay, J. E., & Crider, R. A. (2009). Changing trends in state psychiatric hospital use from 2002 to 2005. Psychiatric Services, 60(1), 29–34.

    Article  PubMed  Google Scholar 

  • Mangrum, L. F., Spence, R. T., & Lopez, M. (2006). Integrated versus parallel treatment of co-occurring psychiatric and substance use disorders. Journal of Substance Abuse Treatment, 30, 79–84.

    Article  PubMed  Google Scholar 

  • McGrew, J. H., Wright, E. R., Pescosolido, B. A., & McDonel, E. C. (1999). The closing of central state hospital: Long-term outcomes for persons with severe mental illness. Journal of Behavioral Health Services & Research, 26(3), 246–261.

    Article  CAS  Google Scholar 

  • New Freedom Commission on Mental Health. (2003). Achieving the promise: Transforming mental health care in America. Final report. Rockville, MD: DHHS Pub. No. SMA-03-3832.

  • Osher, F. C., & Han, Y. L. (2002). Jails as housing for persons with serious mental illnesses. American Jails Magazine, 16(1), 36–41.

    Google Scholar 

  • Osher, F. C., & Steadman, H. J. (2003). A best practice approach to community reentry from jails for inmates with co-occurring disorders: The APIC model. Crime and Delinquency, 49, 79–96.

    Article  Google Scholar 

  • Pasic, J., Russo, J., & Roy-Byrne, P. (2005). High utilizers of psychiatric emergency services. Psychiatric Services, 56(6), 678–684.

    Article  PubMed  Google Scholar 

  • Pennsylvania Legislative and Budget Finance Committee. (2007). Lessons learned from three mental health diversion and post-release programs. Harrisburg, PA: Pennsylvania General Assembly.

    Google Scholar 

  • Pepper, B., Kirshner, M. C., & Ryglewicz, H. (2000). The young chronic adult patient: overview of population. 1981 [Comment]. Psychiatric Services, 51(8), 989–995.

    Article  PubMed  CAS  Google Scholar 

  • Pinta, E. (2009). Psychiatric disorders and repeat incarcerations: Is there an epidemic? [Letter to the editor]. The American Journal of Psychiatry, 166, 489-490.

    Google Scholar 

  • Prins, S. J., & Draper, L. (2009). Improving outcomes for people with mental illnesses under community corrections supervision: A guide to research-informed policy and practice. New York: Council of State Governments Justice Center.

    Google Scholar 

  • Rothbard, A. B., Kuno, E., Schinnar, A. P., Hadley, T. R., & Turk, R. (1999). Service utilization and cost of community care for discharged state hospital patients: a 3-year follow-up study. American Journal of Psychiatry, 156(6), 920–927.

    PubMed  CAS  Google Scholar 

  • Schwarzfeld, M., Reuland, M., & Plotkin, M. (2008). Improving responses to people with mental illnesses: The essential elements of a specialized law enforcement-based program. New York: Council of State Governments Justice Center.

    Google Scholar 

  • Steadman, H. J., & Naples, M. A. (2005). Assessing the effectiveness of jail diversion programs for persons with serious mental illness and co-occurring substance use disorders. Behavioral Sciences and the Law, 23(2), 163–170.

    Article  PubMed  Google Scholar 

  • Steadman, H. J., Monahan, J., Duffee, B., Hartstone, E., & Robbins, P. C. (1984). The impact of state mental hospital deinstitutionalization on United States prison populations, 1968–1978. Journal of Criminal Law and Criminology, 75(2), 474–490.

    Article  Google Scholar 

  • Steadman, H. J., Osher, F. C., Robbins, P. C., Case, B., & Samuels, S. (2009). Prevalence of serous mental illness for jail inmates. Psychiatric Services, 60(6), 761–765.

    Article  PubMed  Google Scholar 

  • Stephey, M. J. (2007). De-criminalizing mental illness. Time.

  • Teplin, L. A. (1990a). The prevalence of severe mental disorder among urban male detainees: Comparison with the epidemiologic catchment area program. American Journal of Public Health, 80(6), 663–669.

    Article  PubMed  CAS  Google Scholar 

  • Teplin, L. A. (1990b). Detecting disorder: The treatment of mental illness among jail detainees. Journal of Consulting and Clinical Psychology, 58, 233–236.

    Article  PubMed  CAS  Google Scholar 

  • Teplin, L. A. (1994). Psychiatric and substance abuse disorders among mail urban jail detainees. American Journal of Public Health, 84(2), 290–293.

    Article  PubMed  CAS  Google Scholar 

  • Teplin, L. A., Abram, K. M., & McClelland, G. M. (1996). Prevalence of psychiatric disorders among incarcerated women. Archives of General Psychiatry, 53, 505–512.

    PubMed  CAS  Google Scholar 

  • The Pew Center on the States, Public Safety Performance Project. (2008). One in 100: Behind bars in America 2008. Washington, DC: The Pew Charitable Trusts.

    Google Scholar 

  • Thompson, M., Osher, F., & Tomasini-Joshi, D. (2008). Improving responses to people with mental illnesses: The essential elements of a mental health court. New York: Council of State Governments Justice Center.

    Google Scholar 

  • Trestman, R. L., Ford, J., Zhang, W., & Wiesbrock, V. (2007). Current and lifetime psychiatric illness among inmates not identified as acutely mentally ill at intake in Connecticut’s jails. Journal of the American Academy of Psychiatry and the Law, 35, 490–500.

    PubMed  Google Scholar 

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Acknowledgments

Special thanks to Dr. Fred C. Osher and Martha Plotkin for providing comments on multiple drafts of this paper.

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Correspondence to Seth J. Prins.

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Points of view or opinions expressed in this article are those of the author and do not represent the official position or policies of the Council of State Governments Justice Center or its members.

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Prins, S.J. Does Transinstitutionalization Explain the Overrepresentation of People with Serious Mental Illnesses in the Criminal Justice System?. Community Ment Health J 47, 716–722 (2011). https://doi.org/10.1007/s10597-011-9420-y

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