Drug-Related Arrests in a Cohort of Public Mental Health Service Recipients

Abstract

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 ...

Envisioning the next generation of behavioral health and criminal justice interventions

“…Crowding people with SMI into these communities increases their exposure to crime, criminal elements, and opportunities for criminal activity, including but not limited to substance use and distribution. Findings from the Massachusetts Mental Health - Criminal Justice Cohort Study indicate that many drug arrests among persons with SMI involve not only possession, but drug trafficking and manufacturing (Fisher et al, 2007). The fact that persons with SMI take on the level of antisocial behavior characteristic of their surroundings is further reinforced by data from the MacArthur Risk Study, which found that the likelihood of such individuals engaging in acts of interpersonal violence was roughly the same as those of persons without SMI living in the same neighborhoods (Monahan et al, 2001).…”

Psychiatric and criminal histories of persons referred for pretrial evaluations: Description and policy implications

“…Our finding that there were no differences in prior contact in persons with an SMI with or without a secondary diagnosis of SUD or ASPD was not expected given the overwhelming evidence that persons with these cooccurring disorders have lower levels of functioning and greater involvement in the criminal justice system (Crocker et al, 2005;Drake & Burnett, 1998;Fisher et al, 2007;Mueser et al, 2006) than individuals with an SMI alone. However, several reasons may account for the lack of differences.…”

“…A few studies have found a higher rate of criminal recidivism for co-disordered offenders (Messina, Burdon, Hagopian & Pendergast, 2004), offenders with psychiatric problems (Draine, Wolff, Jacoby, Hartwell, & Duclos, 2005) and shorter times until re-incarceration (Cloyes, Wong, Latimer, & Abarca, 2010) for persons with SMI when compared with offenders without SMI. In a study of persons who were receiving treatment for an SMI, Fisher et al (2007) found that 5% of the sample was arrested on drug-related charges. Of those with a drug arrest, approximately 95% had also been arrested for a non-drug-related charge.…”

Co-occurring risk factors for arrest among persons with opioid abuse and dependence: Implications for developing interventions to limit criminal justice involvement

“…In doing so we drew on a taxonomy developed in a study of arrest patterns among a cohort of persons with severe mental illnesses (Fisher et al, 2006; 2007). For the present study we created the following categories that subsumed the principal charges observed in our data: 1) Crimes Against Persons (aggravated assault, forced sex, robbery, kidnapping, homicide); Property Crimes (arson, burglary, forgery, fraud, motor vehicle theft, larceny, (a general, non-specific term that refers to the taking of property belonging to others in a non-violent fashion, as opposed to robbery, which involves a physical confrontation), receiving stolen property and vandalism); Drug Offenses (drug/paraphernalia possession, distribution); motor vehicle offenses (motor vehicle violations; operating under the influence of drugs or alcohol); Public Order Offenses (disorderly conduct; drinking in public; liquor law violation); and Non-Violent Sex – related offenses (non-forced sex & prostitution).…”

“…Our approach differs in a number of ways that adopted in many previous studies examining the correlation between substance abuse, psychiatric illnesses and criminal justice involvement. First, we begin with a population of individuals with medical claims-based diagnoses of opioid abuse and dependence, and treat psychiatric illnesses as co-occurring conditions, in contrast to the opposite perspective typically taken in the psychiatric literature (e.g., Fisher, Wolff, Grudzinksas, 2007; Drake, Wallach &, McGovern, 2005; Mueser, Crocker, Frisman et al, 2006). Also, unlike studies that begin with a justice - involved population and retrospectively assess substance patterns (e.g., James & Glaze, 2006; Nurco et al, 1985; Nurco et al, 1984), we begin with a population of individuals of persons who are addicted to or abuse opioids and who may or may not have additional co-occurring disorders, in particular a severe mental illness, and model criminal justice involvement within that population.…”