Identifying Discrete Subgroups of Chronically Homeless Frequent Utilizers of Jail and Public Mental Health Services

Abstract

A sizable group of individuals in the United States cycle in and out of jails, prisons, mental health hospitals, homeless shelters, and other expensive public institutions over time. This little-studied population represents significant unmet need and the inadequacy of services for complex consumers. The current study examined a sample (N = 161) of chronically homeless frequent utilizers of jail and mental health systems in Chicago, Illinois. Cluster analysis was used to differentiate the sample into four reliable subgroups based on measures for prior homelessness, jail incarcerations, mental health hospitalizations, poor current mood, and limitations due to physical health. Logistic regression revealed that clusters differed significantly on reincarceration at 6 months postrelease. Implications for programming and policy for each cluster are discussed, including suggestions for targeting services to distinguishing characteristics for each subgroup. These findings argue for the importance of coordinating efforts across services systems to better identify and serve shared clients.

Two-year prevalence rates of mental health and substance use disorder diagnoses among repeat arrestees

“…However, our findings suggest individuals with a mental diagnosis, other than psychosis, are not at higher odds for repeat arrests, compared to individuals arrested only once. These findings partially support the public narrative about "frequent fliers" within the justice system, which presumes that individuals are repeatedly arrested because of behavioral health conditions (Akins et al, 2016;Harding & Roman, 2017). However, our findings may suggest the "frequent fliers" may well be distinct by the type of mental health disorder (e.g., psychosis versus depression, etc.)…”

“…Individuals with mental illness tend to cycle through the justice system rapidly (i.e., multiple arrests per year). Prior studies demonstrate repeat arrestees frequent hospital emergency rooms (Akins, Burkhardt, & Lanfear, 2016 ), are disproportionately homeless (Green, 1997 ; Harding & Roman, 2017 ; Tentner et al, 2019 ), and have co-occurring mental health and SUD diagnoses (White et al, 2006 ). For instance, nearly half of individuals arrested for a mental health protection hold were rearrested within 60 days, and nearly a quarter of those were rearrested within the first 14 days of release from incarceration (Akins et al, 2016 ).…”

A Typology of Lifetime Criminal Justice Involvement Among Homeless Individuals With Mental Illness: Identifying Needs to Better Target Intervention

“…The present study is the largest to empirically delineate and examine profiles of lifetime criminal justice involvement among homeless individuals with mental illness. Unlike past studies with similar samples (Benda et al, 2003; Harding & Roman, 2017; Roy, Crocker, Nicholls, Latimer, Gozdzik, et al, 2016), we examined lifetime criminal justice involvement. Considering lifetime criminal justice involvement along with historical criminogenic factors may contribute to our understanding of criminal justice involvement as well as better predict future needs and behavior (Bonta & Andrews, 2007).…”

“…Finally, a third cluster comprised participants with a single arrest and associated charge, who were most likely to have severe substance misuse and low impulse control. Similarly, when examining 5-year jail bookings and psychiatric hospitalizations in a sample of 161 homeless individuals with mental illnesses, Harding and Roman (2017) identified four distinct profiles of frequent system users with cluster analysis: (a) the largest group comprised the average frequent user in terms of episodes of homelessness, jail admissions, or psychiatric hospitalization; (b) the second group was persistently homeless/rapidly cycling users, and had the most felony convictions; (c) the third group had the worst mood as well as the most issues in terms of alcohol and drug abuse; and (d) the smallest cluster were lifetime cyclers who had the most jail bookings. Although these findings provide a portrait of the criminal justice involvement of individuals who are homeless, 6 months to a few years may be too short a period to identify clear profiles and their associated characteristics.…”

Successful Reintegration and Mental Health: An Examination of Gender Differences Among Reentering Offenders

“…Individuals leaving prison face multiple, often simultaneous tasks as they embark on the process of reestablishing their lives outside prison—finding housing, getting a job, earning enough money to support themselves, reconnecting with children and family—and these intermediary steps influence the ability to live a drug-free and crime-free life. Unresolved mental health and substance use problems likely complicate an already challenging transition (Harding & Roman, 2016; Mallik-Kane & Visher, 2008; Travis, 2005). Returning prisoners with health problems may be unable to engage in work or other activities, and their families may be unwilling or unable to support them.…”