Objective-Although criminal justice involvement among persons with severe mental illness is a much discussed topic, few large-scale studies systematically describe the patterns and prevalence of arrest in this population. This study examined rates, patterns, offenses, and sociodemographic correlates of arrest in a large cohort of mental health service recipients.Methods-The arrest records of 13,816 individuals receiving services from the Massachusetts Department of Mental Health from 1991 to 1992 were examined over roughly a ten-year period. Bivariate relationships between sociodemographic factors and arrest were also examined.Results-About 28 percent of the cohort experienced at least one arrest. The most common charges were crimes against public order followed by serious violent offenses and minor property crime. The number of arrests per individual ranged from one to 71. Five percent of arrestees (roughly 1.5 percent of the cohort) accounted for roughly 17 percent of arrests. The proportion of men arrested was double that of women. Persons 18 to 25 years of age had a 50 percent chance of at least one arrest. This rate declined with age but did so unevenly across offense types.Conclusions-The likelihood of arrest appeared substantial among persons with severe mental illness, but the bulk of offending appeared concentrated in a small group of persons and among persons with sociodemographic features similar to those of offenders in the general population. Data such as these could provide a platform for designing jail diversion and other services to reduce both initial and repeat offending among persons with serious mental illness.Minimizing criminal justice involvement among persons with severe mental illness has become a major focus of policy makers and officials from both the mental health and criminal justice systems. From the collaboration of these systems various interventions have evolved over the past ten to 15 years to help divert arrestees with mental illness to an appropriate array of mental health services (1). These mechanisms, which target primarily low-level offenders, have been introduced at several points within the criminal justice process-from the street to the courthouse. Such interventions include specialized training for police officers (2,3), pre-and postbooking jail diversion programs (4,5), mental health courts (6,7), and reentry programs for individuals with serious mental illness who have been released from correctional settings (8). Support for these programs has been forthcoming from local, state, and federal agencies and was the focus of the Mentally Ill Offender Treatment and Crime Reduction Act of 2004 (S.1194), which passed both houses of Congress and was signed into law by President George W. Bush.Empirical evidence marshaled to contextualize these interventions comes from various sources and settings. Among the most frequently cited are data on the considerable prevalence of mental illness in correctional settings. These prevalence estimates have been NIH Public Access T...

Findings justify concerns of public mental health systems regarding justice system involvement of adolescent clients. Risk of first arrest was significant from early adolescence through age 24, indicating a need for arrest prevention into young adulthood. The heightened arrest risk at all ages among those who were recently arrested demarcates a population in need of immediate intervention.

Objectives-The excessive prevalence of comorbid substance abuse among persons with severe mental illness has been well established and identified as the source of numerous negative outcomes. An overlooked aspect of illicit drug use in this population is its illegality and the potentially dire criminal sanctions. This study examined the prevalence of drug arrests in a cohort of persons receiving services from a state mental health agency who were followed for roughly ten years.Methods-Data on arrest spanning from 1991 to 2000 were obtained for all individuals receiving inpatient, case management, or residential services from July 1991 to June 1992 (N=13,816). Reports of prevalence were based on the number with at least one drug-related arrest in the observation period.Results-Five percent of individuals in the cohort experienced at least one drug-related arrest (N=720). These included simple possession as well as manufacturing and distribution. The prevalence was much higher (15%) among persons aged 18 to 25 years than in other age groups. Roughly 95% of persons with a drug arrest also had an arrest for another type of offense. This pattern is similar to that observed among persons with a drug-related arrest in the general population.Conclusions-Convictions on drug charges can void access to Section Eight housing and other benefits and are associated with other patterns of offending that also carry significant criminal sanctions. State mental health agencies may wish to target interventions toward youthful clientele by focusing specifically on the risks associated with involvement with illicit drugs.The many problems associated with substance abuse among persons with severe mental illness have been a prominent focus of the psychiatric and mental health services research communities for at least three decades. Data from both the Epidemiologic Catchment Area Study (1) and the National Comorbidity Study (2) reveal an extremely high prevalence of co-occurring substance abuse among persons with serious psychiatric disorders. Comorbid substance abuse has been linked to numerous negative clinical and behavioral outcomes in this population (3-5). It has been implicated in exacerbating persons' risk of engaging in violence toward others (6,7) as well as being victims of crime themselves (8). Failure to comply with substance abuse treatment protocols can result in expulsion from various programs, and inability to maintain abstinence can lead to ejection from some residential programs and increase risk of homelessness (9). There is a tendency in much of the literature on substance abuse and mental illness to treat the use and abuse of alcohol and drugs as a single problem. Lumping the two practices together is not unreasonable; both are risk factors for many of the same undesirable outcomes, and many individuals with co-occurring disorders likely use both drugs and alcohol. But the negative consequences of illicit drug use are arguably greater. It is well known that significant drug use and especially maintaining a ...