Effectiveness of Criminal Justice Liaison and Diversion Services for Offenders With Mental Disorders: A Review
Abstract
Objective
Methods
Results
Conclusions
Methods
Literature search
Inclusion criteria
Data extraction and quality assessment
Results
MHCs with ACT
Study | Outcome measures | Summary of results | Main threats to validity |
---|---|---|---|
With ACT | |||
Cosden et al., 2003 (18) | 32-item Behavioral and Symptom Identification Scale (BASIS-32); Lehman Quality of Life Interview, short form; Addiction Severity Index (ASI); Global Assessment of Functioning (GAF); recidivism | Follow-up at 12 months; improvements on psychological distress scores for both groups; MHC group more independent at follow-up, with greater improvement in alcohol abuse | Authors removed the most frequent and most serious offenders from the analysis; the intervention provided to the intervention and comparator groups was similar; lack of blinding regarding study condition for both judges and case managers may have affected the treatment provided. |
Cosden et al., 2005 (19) | BASIS–32; Lehman Quality of Life Interview, short form; ASI; GAF | Follow-up at 24 months; BASIS-32 scores, life satisfaction, and drug scores improved for both groups, with greater improvements for MHC participants; GAF scores improved for both groups; both groups used similar amounts of service hours; MHC participants used more services earlier in the follow-up period. | Same as above |
Without ACT | |||
Boothroyd et al., 2003 (20) | Self-reported service use; insurance records of service use | More MHC users received services, but the difference was not statistically significant. | Participants were matched according to age, sex, race-ethnicity, and Brief Psychiatric Rating Scale (BPRS) scores only; violent offenders were not accepted by the MHC; lack of statistical power |
Boothroyd et al., 2005 (21) | BPRS; self-reported service use; insurance records of service use | BPRS scores did not improve for either group regardless of treatment receipt | Same as above |
Christy et al., 2005 (22) | Time in jail for index offense; arrest data 1 year after the court appearance; self-reported violent behavior | MHC participants experienced fewer days in jail during follow-up; both groups had fewer arrests than before study entry and similar time to rearrest; no significant differences were noted in self-reported aggressive acts. | Same as above |
McNiel and Binder, 2007 (24) | Recidivism in the year after arrest | At 12 months, MHC participation predicted a longer time to any new charge; at 18 months, MHC “graduates” had a longer time to any new charge. | Groups differed at baseline in severity of mental disorder, racial-ethnic background, homelessness status, and offense history; MHC participants were volunteers |
Moore and Hiday, 2006 (25) | Recidivism; severity of recidivism | MHC participants were rearrested less often and for less serious crimes; their rate of rearrest was slower. | Groups differed at baseline on measures of age, race-ethnicity, prior offense severity, and previous days in jail; possible selection bias because judges selected comparator participants; high dropout rate |
Steadman et al., 2011 (23) | Recidivism; number of jail days | Fewer rearrests for MHC participants; MHC “graduates” had fewer rearrests than MHC participants whose involvement was terminated; MHC participants spent significantly fewer days incarcerated in 18 months after index arrest. | MHCs were large, and findings may not be transferable to other settings; findings were not replicated for all MHCs; when calculating days in the community, authors were unable to include days absent for noncriminal reasons, such as inpatient stays. |
MHCs without ACT
Diversion services
Study | Outcome measures | Summary of results | Main threats to validity |
---|---|---|---|
Broner et al., 2004 (26) | Colorado Symptom Index; 12-item Short Form Health Survey; Michigan Alcohol Screening Test; Drug Abuse Screening Test; Dartmouth drug and alcohol calendar; Lehman Quality of Life Interview; recidivism | Diversion was associated with increased drug use, reduced psychiatric symptoms, and increased service use; it was not associated with reduced recidivism. | Measures of service use varied across study sites; groups and models of service provision varied across sites. |
Hoff et al., 1999 (27) | Days in jail and days in hospital in year after arrest | Diversion was associated with fewer days in jail for participants with serious mental illnesses only; female participants spent a longer time than males in jail or in the hospital. | Significant differences between groups at baseline |
James et al., 2002 (9) | Change in mental state; engagement with follow-up services; subsequent readmission and reconviction | Persons admitted through the court and those admitted through community referral had similar outcomes on most variables; substance abuse was associated with future offending and hospital admissions. | Many differences between groups at baseline; small samples; researchers not blinded to study condition |
Diversion into compulsory hospital care
Discussion
Quality of studies reviewed
Service variability
Implications for research and practice
Conclusions
Acknowledgments and disclosures
References
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