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...

The substantial number of persons with mental illness encountered in many sectors of the criminal justice system has spurred actors from various agencies within that system to take actions aimed at reducing the growth of this population. These actions have included the development of specialty police units, jail diversion programs, and other mechanisms for channeling persons with mental illness out of the criminal justice system and into mental health treatment. The courts, too, have become involved in this effort with the recent development of the "mental health court," the latest of the "specialty" or "problem solving courts." These courts have not been without their critics, however, nor are they the only feasible approach to court-based diversion. This paper identifies and explores a range of options for structuring the relationship between criminal courts and local mental health systems. Beginning with a discussion of the rationale motivating the development of mental health courts, two alternatives to this specialty court model are discussed. One involves judges dealing with defendants having mental illness and substance abuse on a case-by-case basis. The other takes advantages of linkages that may already exist between most courts and the mental health providers who conduct their forensic assessments, expanding the role of these providers to serve as boundary spanners between courts and the components of local mental health systems. Regardless of the model adopted, however, appropriate linkages must exist between the courts and relevant providers. A case study is provided that demonstrates how the status of a locale's linkages can be evaluated and how the information derived from such evaluation can be used to improve the linkages between police, courts, and health and human services agencies.

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