Assessing the Potential Efficacy of an Intervention for Incarcerated People With Mental Illness.

OBJECTIVE: This preliminary study tested the efficacy of an evidence-based correctional intervention (Thinking for a Change) with an adapted delivery to incarcerated people with mental illness. METHODS: A small-scale randomized controlled trial (N=47 men) was conducted. Outcomes were changes in aggression, number of behavioral infractions, and days in administrative segregation. Treatment targets were impulsivity, interpersonal problem-solving skills, and attitudes supportive of crime. Linear mixed-effects models were used to examine within-person and between-group differences over time, and nonparametric tests were used to examine between-group differences in criminal legal outcomes postintervention. RESULTS: Statistically significant within-person differences were found for all treatment targets and for one study outcome (aggression). Statistically significant differences in impulsivity were found between the experimental and control groups (B=-7.10, p=0.02). CONCLUSIONS: Existing evidence-based correctional interventions can affect the lives of people with mental illness. Accelerated research in this area may benefit people with mental illness at high risk for criminal legal system involvement.

Feasibility of recruiting in prisons during a randomized controlled trial with people with serious mental illness.

BACKGROUND: Successful participant recruitment is vital to the feasibly of intervention research. In the behavioral and social sciences, intervention researchers face a myriad of recruitment barriers, many of which stem from working in real-world settings and among hard-to-access populations. Optimizing recruitment efforts requires being intentional about study planning and resource allocation, carefully documenting the outcomes of recruitment efforts, and developing and implementing procedures and strategies to overcome anticipated recruitment barriers. METHODS: The current article presents recruitment flowcharts to illustrate (a) the multistep recruitment process and (b) the points of potential participant attrition during recruitment from a two-phase group-based intervention study conducted among individuals with serious mental illness incarcerated in a state prison system in the U.S. In addition, qualitative methods are used to examine strategies employed during the study to support recruitment efforts. RESULTS: Despite challenges, this study was able to achieve recruitment goals. Analyses found the majority of potential participant attrition occurred prior to informed consent, highlighting the need for studies to track recruitment efforts in more detail than is currently recommended by commonly used guidelines. Strategies to optimize recruitment efforts included maximizing recruiter availability, developing a responsive communication approach, demonstrating respect for facility procedures and operations, and ensuring peak preparedness. CONCLUSION: Careful documentation of recruitment efforts and the early deployment of recruitment strategies is vital to the feasibility of intervention studies conducted in real-world settings with hard-to-access populations. The publication of recruitment procedures and outcomes can help future researchers anticipate recruitment challenges and inform recruitment goals, timelines, and strategies.

North Carolina's Healthy Opportunities Pilots Focus Attention on Housing as a Health Care Intervention.

The social conditions in which people live, including their housing, can have a profound impact on their health. The North Carolina Healthy Opportunities Pilots aim to address housing problems and other social needs to improve health. The results from the Pilots' evaluation will have important implications for health policy and practice.

A Systematic Review of Interventions Targeting Criminogenic Risk Factors Among Persons With Serious Mental Illness.

OBJECTIVE: Individuals with serious mental illness are overrepresented in the criminal justice system. Research has found that interventions targeting risk factors for recidivism (i.e., criminogenic risks) reduce justice involvement in the general correctional population. However, more needs to be learned regarding use of these interventions among individuals with serious mental illness. To this end, this systematic review synthesized research on interventions that target criminogenic risk factors and are delivered to justice-involved individuals with serious mental illness. METHODS: A systematic search of six computerized bibliographic databases from inception to 2021 yielded 8,360 potentially relevant studies. Title and abstract screening, full-text reviews, and data extraction were performed independently, and discrepancies were resolved through discussion. To identify additional articles meeting inclusion criteria, experts in the field were contacted, and reference-harvesting techniques were used. Study quality was assessed with the Mixed Methods Appraisal Tool. RESULTS: Twenty-one studies were identified that evaluated nine interventions delivered to justice-involved individuals with serious mental illness. All identified programs targeted criminogenic risk factors, were group based, and used cognitive-behavioral strategies. Study quality was moderate to high. Interventions were associated with improvements in recidivism, violence, and criminogenic risk factors. CONCLUSIONS: This review is the first to evaluate interventions targeting criminogenic risks among justice-involved individuals with serious mental illness. Findings suggest that outcomes associated with these interventions are promising. Given the overrepresentation of persons with serious mental illness in the criminal justice system, these findings provide an important step toward identifying services that curb justice involvement in this population.