Jail-Based For-Profit Mental Health Providers and Treatment Engagement After Release.

OBJECTIVE: This study compared mental health treatment engagement among people with serious mental illness after release from jails that had either a for-profit (N=3 jails) or a nonprofit mental health provider (N=7 jails). METHODS: Across the 10 jails, data were collected in 2019 for 1,238 individuals with serious mental illness. Data included demographic characteristics (age, race-ethnicity, gender, geography, and jail type) and behavioral health variables (previous mental health treatment, psychotropic medication use, substance use, and receipt of jail-based mental health services). Logistic regression was used to predict treatment engagement during the year after release, stratified by type of jail-based mental health provider, in analyses controlled for demographic and behavioral health variables. RESULTS: Almost half (46%, N=573) of the individuals had stayed in jails with a for-profit mental health provider; the other half (54%, N=665) had stayed in jails with a nonprofit provider. In the year after release, 37% (N=458) of all individuals engaged in mental health treatment, and 63% (N=780) did not. Those who had stayed in a jail with a for-profit provider were significantly less likely to engage in mental health treatment during the year after release (AOR=0.59, 95% CI=0.42-0.83, p<0.01), compared with those in jails having a nonprofit provider. CONCLUSIONS: Staying in a jail with a for-profit mental health provider was associated with reduced postrelease engagement with community service providers. Less engagement with services during a pivotal time after release may increase behavioral health crises that erode individuals' well-being and may raise downstream costs due to further criminal legal involvement and emergency care use.

Assessing County-Level Behavioral Health and Justice Systems with the Sequential Intercept Model Practices, Leadership, and Expertise Scorecard.

The Sequential Intercept Model has helped conceptualize interventions for people with serious mental illness in the criminal/legal system. This paper operationalizes the Sequential Intercept Model into a 35-item scorecard of behavioral health and legal practices. Using interviews, survey, and observational methods, the scorecard assesses an exploratory sample of 19 counties over 27 independent data collections. A series of ordinary least squares regression models assessed the predictor scores on four jail outcomes: prevalence of serious mental illness, length of stay, connections to treatment, and recidivism. Increases in pre-booking scores showed significant decreases in jail prevalence of serious mental illness at the p < 0.05 level, and post-booking scores and overall scores showed significant positive associations with connections to treatment at the p < 0.05 level, though these were non-significant after correcting for multiple comparisons. Preliminary findings suggest a combination of practices across the Sequential Intercept Model could have synergistic impacts on key jail diversion outcomes.

County jails' responses to COVID-19: Practices, procedures, and provisions of behavioral health services.

Michigan was one of the first states to feel the effects of the coronavirus disease 2019 (COVID-19) pandemic. This exploratory, mixed-methods study describes 20 county jails' responses to the pandemic across Michigan and presents a case study of one rural jail to examine changes in booking trends and behavioral health needs and services. Qualitatively, jails decreased their population at the outset of the pandemic via early releases, reconsideration of bond, and reductions in arrests. Quantitatively, the greatest prevalence of serious mental illness was found during the spring (initial shutdown period), which had the lowest weekly booking rates. Significant differences were found when comparing charge severity and charge type between study periods. Bookings occurring during the spring were significantly related to felony charges and drug/alcohol charges while individuals were less frequently booked because of violations. Past year recidivism significantly decreased from the winter to summer phase. Policy should mandate that jails screen for behavioral health problems and provide access to behavioral health services, while also expanding diversion opportunities during and after a pandemic. Innovations in continuity of care are critical for both behavioral and public health needs given the high risk for suicide, overdose, and viral spread after release from jail. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Transition Planning from Jail; Treatment Engagement, Continuity of Care, and Rearrest.

Mental illness is experienced at a higher rate among incarcerated individuals than the general population. This study is one of the first assessing the association of a jail-based mental health (MH) transition planning program with continuity of care (CoC) (defined as no gap in treatment upon reentry), behavioral health treatment engagement, and rearrest. A one group pre-posttest design merged three data sources: program, community-based MH treatment, and jail data. Participants included 161 people from a Midwest metropolitan county jail. The utilization of MH treatment significantly increased after the program, particularly stabilizing services (i.e. case management). Individuals who engaged most in the program had greater odds of treatment engagement and increased odds of CoC. Time to first rearrest was delayed for those who received CoC. By providing transition planning services, jails and community-based services may increase treatment engagement and CoC, and reduce the risk and frequency of rearrest.

Comparing Women's and Men's Sexual Offending Using a Statewide Incarcerated Sample: A Two-Study Design.

This study identifies the characteristics that distinguish between women's and men's sexual offending. We compare women and men currently incarcerated for a sex offense in one state using two data sources: administrative data on sex offenders in the state prison (N = 9,235) and subsample surveys (n = 129). Bivariate and logistic regressions were used in these analyses. Women account for a small proportion (1.1%, N = 98) of incarcerated sex offenders. In the population, women and men were convicted of similar types of sex offenses. The subsample was demographically similar to the population. In the subsample, women were more likely than men to have a child victim, be the parent/guardian of the victim, have a co-offender, and repeatedly perpetrate against the same victim. Findings suggest that women convicted and sentenced for a sex offense differ from their male counterparts, with predictive factors being dependent upon the age of their victim(s). Sex offender treatment interventions developed for men are poorly suited to and may have limited efficacy for women.

Mental Health Identification Practices of Jails: The Unmet Needs of the "Silent" Population: Special Issue: Criminal Justice and Community Psychology: Our Values and Our Work.

The overrepresentation of individuals with mental illness in the criminal/legal system is well documented. While professional associations urge diversion towards treatment, little is known about the practices these institutions use to identify this population. One understudied space in the criminal/legal continuum is jails. This exploratory study compares two types of mental health identification at jail booking to assess jail- and community-based service outcomes by identification type (N = 2956): (a) staff observation and (b) a standardized screening instrument. Individuals identified through staff observation were significantly more likely to receive jail- and community-based services, even though current symptomology and substance misuse were both significantly higher for individuals identified only by the screening instrument. These findings point to the importance of jails in providing stabilizing services during incarceration, but further, show the impact that identification practices have on individuals as they transition to the community. Community context showed varied rates of jail staff observations of mental illness, showing greater risks for individuals in rural communities. Implications include a need for system-level changes by instituting evidence-based identification practices in jails, and improving professional collaboration practices between mental health and criminal/legal practitioners as individuals enter and exit jails.

Identification, Referral, and Services for Individuals With Serious Mental Illness Across Multiple Jails.

Identification of serious mental illness (SMI) among those entering jail is the first step in diversion or appropriate services in jail. Although best practices guidelines for identifying SMI exist, many jails do not employ these standards. Researchers describe identification of SMI in the "practice as usual" and compare/contrast the results with a validated screening instrument for 2,961 individuals across eight jails. Overall, 20% scored positive on the screening instrument, and staff identification yielded an additional 16%. While the instrument was consistent in identifying the proportion of persons with SMI across each county (16% to 22%), the proportion identified by jail staff varied greatly (3% to 33%). Moreover, referral to-and receipt of-subsequent services for the staff-identified individuals varied greatly, leading to recommendations for improved processes.

Factors Related to Co-Offending and Coerced Offending Among Female Sex Offenders: The Role of Childhood and Adult Trauma Histories.

Research suggests two important domains of women's sexual offending: co-offending, in which additional perpetrators are present with the woman during the crime, and coerced offending, in which the woman feels pressured by someone else to commit the crime. This exploratory analysis examines these 2 domains using self-report data from 60 incarcerated female sex offenders (FSOs) in a Midwestern state. In addition to indicating whether a co-offender was present and whether they felt pressure to commit the sex offense for which they were incarcerated, participants provided demographic information about themselves, the victim, and the offense, as well as about their own trauma, substance abuse, and mental illness histories. Results indicate that childhood and adult trauma histories are related to both co-offending and coerced offending among FSOs. Implications for theory, policy and practice, and future research are discussed.

Comparing Female- and Male-Perpetrated Child Sexual Abuse: A Mixed-Methods Analysis.

This mixed-methods study compares experiences of female- and male-perpetrated child sexual abuse using self-report data from a correctional subsample of 26 women and 25 men currently incarcerated for a sex crime against a child. First, we use bivariate and logistic regression analyses to determine whether there are differences in offender, victim, and offense characteristics between women and men who commit child sexual abuse. Second, we examine participants' open-ended responses eliciting details about their offenses. Quantitative results reveal some differences between women and men in victim characteristics, presence of a co-offender, and adulthood experiences with violence but no differences between women and men in experiences of childhood adversity, including prior child sexual abuse victimization. Qualitative results, however, suggest marked differences in the way women and men characterize their offenses. Overall, findings indicate that women and men report unique experiences with child sexual abuse perpetration and therefore would benefit from gender-specific treatment.

Mental health court outcomes by offense type at admission.

Using a statewide database of mental health court (MHC) defendants, this study examines criminal justice outcomes by target arrest offense type. Findings suggest that defendants with a felony are less likely to complete MHC but those who do are at no greater risk of recidivism post-exit than those with a misdemeanor. In terms of jail days, both completers and noncompleters with a felony had reductions in jail days; however, misdemeanor defendants, especially those who did not complete MHC, had increases. We discuss why MHC supervision may sometimes have a negative effect and offer recommendations on how courts might modify supervision.

Family experiences of young adult sex offender registration.

Since 1994, policies have been instituted throughout the United States that require sex offenders to register their personal information with law enforcement officials (Jacob Wetterling Crimes against Children and Sexually Violent Offender Registration Program, 1994). With the passage of additional laws, this information is now available to the public via the Internet or a request to a police department. These laws have brought about consequences for both the registrants and for members of their families. A focus group was held with four mothers who have sons listed on the Michigan Sex Offender Registry. Psychological and social consequences of registration were found and policy implications are discussed.