More than 25 years ago, researchers noted that persons with serious mental illness (PSMIs) were being processed increasingly through the criminal justice system instead of through the mental health system. Nearly 1 of every 15 admissions, or approximately6% of jail detainees, suffers fromsevere mental disorders at the time of arrest. Many PSMIs in jail receive psychiatric services during their incarceration but are usually discharged with no referrals to community treatment and no income or housing. Such persons can be managed effectively with Assertive Community Treatment (ACT) models. Thresholds, a psychiatric rehabilitation center, has funded a 2-year ACT Demonstration Project for PSMIs involved in Cook County’s (Chicago) criminal justice system. The project’s basic goals are to reduce the numbers of rearrests, reincarcerations, and rehospitalizations among project participants. To achieve these goals, project staff assists PSMIs to obtain psychiatric treatment, health care, housing, benefits, and other social services.

No abstract

This paper presents a case study that illuminates the clinical and practical challenges that accompany the treatment of people with serious mental illness (SMI) and criminal involvement. We discuss the historical conditions that led to the influx of a large number of people with SMI into the criminal justice system. We discuss the case history of Richard P., which illustrates the use of Assertive Community Treatment (ACT) to care for criminally involved people with SMI. We focus on the ACT model that was employed by Thresholds to treat Richard P. It was known as the Thresholds Jail Program. We track his progress in the program and explicate the case management considerations that are most salient in treating offenders with SMI.

No abstract

Older adults appear to experience high levels of sub-clinical emotional distress. Past literature has predominantly focussed on ameliorating suffering in individuals with diagnosed mental illnesses, while neglecting research investigating online therapies for enhancing wellbeing in community-dwelling older adults. A potential therapy might be Dignity Therapy, a brief psychotherapy originally designed to be delivered face-to-face for terminally ill patients. We piloted a Telehealth Dignity Therapy (TDT) program and tested its acceptability (e.g., satisfaction), practicality (e.g., time spent completing TDT), and the potential benefits for participants. Five community-dwelling older adults were recruited and completed TDT. Participants completed surveys on their satisfaction with TDT. Time spent completing TDT was recorded. We interviewed participants to identify the potential benefits of TDT; their responses were analysed with qualitative methods. All five participants successfully completed the study and reported high levels of satisfaction with TDT. Levels of acceptability and practicality were similar to another online Dignity Therapy study. Participants reported several benefits including: a chance to inscribe their legacy, a deeper connection with others, triggering new self-insight, a strengthened view of self, and heightened acceptance and self-compassion. TDT appears to be acceptable and practical, and provided numerous qualitative benefits for participants. These findings suggest that Dignity Therapy is suitable is suitable to be conducted online and advantageous for community-dwelling older adults without life-limiting illnesses. Further larger-scale, quantitative research on TDT needs to be completed to better ascertain its effectiveness and feasibility.