Mental Health and Criminal Justice: Identifying Needs

The Vera Institute of Justice recently released a report examining the mental health needs of those in the Washington DC criminal justice system. Given the lack of mental health services in New Orleans, the relationship between mental health and homelessness, crime and repeat offending, and a growing interest in establishing a mental health municipal court (based on personal communication I know Judge Sens is interested), this report might have something useful to offer this city. I pasted some of the key findings from the report below, and a podcast with one of the key researchers (Richard G. Dudley).  I also created a link to the full report and summary fact sheet.  This might also interest some other local bloggers.  I know my pal Noitsjustme will find this interesting.

Here's a link to the full report: Closing the Gap: Using Criminal Justice and Public Health Data to Improve the Identification of Mental Illness

Here's a link to the summary Fact Sheet.

Some of the basic findings are below the fold.

Executive Summary:

The key study findings include:

   About 33 percent of adult DC residents arrested during June 2008 had some indication of mental health need in partner agency records between 2006 and 2011.

   Many of those arrested with mental health needs were not known to community mental health care providers. Most of the cohort members who had mental health needs (83 percent) were known to at least one criminal justice agency as having such a need between 2006 and 2011. Yet the Department of Mental Health knew about only 59 percent of the cohort members who had mental health needs during that same period.

CLOSING THE GAP: USING CRIMINAL JUSTICE AND PUBLIC HEALTH DATA TO IMPROVE THE IDENTIFICATION OF MENTAL ILLNESS

  Criminal justice agencies often failed to identify the mental health needs of the people that they encountered. Six hundred sixty-six cohort members with mental health needs came into contact with probation, pretrial services, or the jail as a result of the June 2008 arrest; however, almost half (46 percent) of this group was not identified as having a mental health need by any of the agencies during those contacts. 

   Thirty-three percent of the cohort members known to the Department of Mental Health as having a psychotic spectrum disorder or bipolar disorder were not identified by any of the criminal justice agencies; rates of identification of mental health need by the criminal justice agencies were even lower for people with other diagnoses, such as depression and anxiety disorders. 

The report concludes with a series of recommendations aimed at increasing rates of identification of mental health problems by DMH and criminal justice agencies in DC. Building on related initiatives in DC and the findings of this research, the recommendations fall into two main categories:

RECOMMENDATION 1: CAPITALIZE ON OPPORTUNITIES TO IDENTIFY THOSE WHO ARE INVOLVED IN THE DC CRIMINAL JUSTICE SYSTEM AND MAY BENEFIT FROM MENTAL HEALTH SERVICES BY:

a) making the most of opportunities for early identification;

b) improving and leveraging agencies’ internal data systems;

c) developing performance measures to describe and monitor rates of identification and service provision;

d) increasing interagency communication; and

e) targeting high-need groups. 

RECOMMENDATION 2: ENSURE CONTINUITY OF TREATMENT FOR PEOPLE WITH MENTAL HEALTH NEEDS AS THEY MOVE BETWEEN SETTINGS BY:

a) initiating targeted information-sharing initiatives between criminal justice agencies and DMH; and,

b) expanding strategies for engaging underserved groups and linking clients with service providers in the community, such as jail in-reach programs.

While this report focuses on data from agencies in DC, issues related to the identification of people with mental illness and coordination between health and justice agencies are widespread. The recommendations in this report address challenges that arise in many jurisdictions throughout the United States. Moreover, the methods used in this study may provide a template for conducting similar projects in other jurisdictions seeking to improve services for the large numbers of people with mental health needs who come into contact with the criminal justice system. 

1 MPD is responsible for providing policing services in the District of Columbia; CSOSA manages probation, parole, and supervised release for DC Code offenders; DOC is responsible for operating the DC jail system; DMH oversees the provision of mental health services to residents of DC who are seriously and persistently mentally ill; and, PSA provides supervision and services to defendants awaiting trial in the federal and local courts in DC.

2 Given the unique status of the District of Columbia, there are both local and federal agencies that serve DC residents. Of the agencies partnering with Vera on this study, PSA and CSOSA are federal agencies, while MPD, DOC, and DMH are city-level government agencies.