Within the criminal justice system, there is a wide variety of offenders. They range from different diversity, juveniles, elderly, physically disabled, and also including the mentally ill. The phrase mental disorder or mentally ill refers to a condition that interferes with a person’s mind that affects their mood, their behavior and the way they think every day (Masters et. al., 2013). This could be a problem with the way society is today, however the number of people that are incarcerated throughout the criminal justice system that are mentally ill may be a bit more troubling. The United States Department of Justice found in a study in 2006 that around 64 percent of jail inmates, 54 percent of state inmates, and about 45 percent of federal inmates have symptoms consistent with a mental health disorder (Masters et. al., 2013). In the United States psychiatrists use the Diagnostic and Statistical Manual of Mental Disorders or also know as the DSM. The DSM lists the classification for symptoms and attributes of disorders within mental health. More and more offenders are getting released on probation or getting paroled from prisons which then leads to more offenders with mental disorders being released into the communities.
Offenders with Mental Health Problems
Mental illnesses or disorders can vary, depending on the person. They can go from schizophrenia, post-traumatic stress disorder, depression or even multiple personalities. These are, however, just a few of the close to 400 mental disorders that are categorized in the DSM (Masters et. al., 2013). The National Institute of Mental Health has estimated that there is about 26 percent of Americans being diagnosed with some type of mental disorder every year, with ages ranging from young to old. (Masters et. al., 2013) Treatment for offenders with mental disorders in the criminal justice system fluctuates throughout the system, either during the initial contact with police or at the time of their release, offenders with mental disorders are being treated.
In the United States, there are several types of courts, one being special courts. These courts range from drug courts, family courts, and even mental health courts. Mental health courts use a therapeutic jurisprudence theory when dealing with people that use insanity please during court cases (Lim & Day, 2016). Mental health courts tend to use more of a rehabilitative approach to their actions, which in turn helps the offender “avoid prosecution, incarceration, and/or sentencing” (Landess & Holoyda, 2017). Using a plea of guilty or not guilty by reason of insanity can be used by all offenders within the criminal justice system if the offender believes that they have a mental disorder. Mental health courts also have their own structure within the court system, being more of a heterogeneous type of court they have their own procedures and even policies (Landess & Holoyda, 2017). When a person is taken into the mental health court system consent for participation must be given by the individual for the treatment program. These programs range from anger management, substance abuse, and compile with any psychotropic medication. They must also attend all court hearings and consent to constant monitoring. (Landess & Holoyda, 2017)
Reason of Insanity Pleas
The United States Supreme Court had a case in 1992, that being Foucha v. Louisiana, 504 U.S. 71. The court ruled that “individuals adjudicated not guilty by reason of insanity (NGRI) could not remain in a forensic hospital if they were no longer mentally ill and dangerous” (Tabernik & Vitacco, 2016). When the court was adjourned, this ruling left several questions and concerns when it comes to an insanity plea, along with people’s post-adjudication (Tabernik & Vitacco, 2016). There was an article written by Tabernik and Vitacco (2016) called Psychosis and Substance Use: Implications for Conditional Release Readiness Evaluations. In the article a study was conducted to see if substance abuse could lead to psychosis and their conjunction in defenses of insanity. Also, “this article investigates how substance-induced psychosis may impact both insanity opinions and subsequent conditional release decisions” (Tabernik & Vitacco, 2016). The sad thing is when people are charged with an offense most people will do or say whatever they can to get out of it, even if they have to use a reason of insanity plea. Nevertheless, research has shown that there is a correlation between psychosis and a person with a substance abuse problem (Tabernik & Vitacco, 2016). It was also stated in the article that “there are times when a psychotic condition brought on solely through the ingestion of substance use is mistaken for schizophrenia, rather than a substance-induced psychotic disorder that clears up after a period of abstinence, which leads to an erroneous NGRI verdict” (Tabernik & Vitacco, 2016). So, how does this affect offenders that do have mental disorders? Simply put, the meaning is “substance abuse as a risk factor for conditional release revocation, both as a rule violation and potentially as a putative risk factor for violence and dangerous behavior” (Tabernik & Vitacco, 2016). Consequently, even if a court rules on an offender with a not guilty verdict because of an insanity plea, substance abuse could be the actual cause of it.
Roughly, there is about 50 percent of the people that are put in jails or prisons are being diagnosed or are showing symptoms of having a mental health illness. Most facility whether it be jail or prison has started to employ some sort of treatment program for offenders that have been diagnosed. There is a state facility in Independence, Virginia by the name of River North Correctional that has implemented such programs to their all-male max level security facility. This program consists of units that are specifically designed for mental health inmate that give them treatment and rehabilitation. The facility also has a range of staff members to run the Secure Diversionary Treatment Program. These include; Counselors, Certified Mental Health Professionals, Treatment Officers, Unit Managers, and a Lieutenant to oversee everything. In these units there are several programs utilized to help deter, rehabilitate, and reintegrate offenders back into society. Some of the programs include; substance abuse, anger management, decision making, financing, and impact on victims along with several others. One useful program that is being used incorporates music as a therapeutic tool. It has been seen that using music for therapy has helped offender’s anxiety and depression which in-turn helps their social functionality (Chen, Leith, AarØ, Manger, and Gold, 2016). There was also a study conducted in 2016 that analysis the use music as a therapy for offenders that were diagnosed with mental disorders. The study showed that mental health offenders with at least 20 plus sessions showed more progress then offenders that had less amount of sessions (Chen et. al., 2016). There have been several times that offenders have stated how much they liked having the music to listen to and that has helped give them a way deal with being in prison. Using music as a therapeutic tool can sometimes be referred as “systematic process of intervention wherein the therapist helps the client to improve health, using music experiences and the relationships that develop through them as dynamic forces of change” (Chen et. al., 2016). Using music as a type of treatment has been used since the 1930s, with the main goal of allowing the offender to have emotional self-expression, greater self-awareness, self-esteem, and moods. Thusly, affecting their anxiety and depression. (Chen et. al., 2016)
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Another program used at River North Correctional is for substance abuse and anger management, as these two tend to coinhere with each other and utilize the same programs. Sadly, there are several offenders with substance abuse that also have mental health disorders coexisting with each other or also know as a co-occurring disorder. Moreover, offenders that have mental illnesses that also have a reoccurring substance abuse problem are more prone to criminal activities (Woodhouse, Neilson, Martyn-St James, Glanville, Hewitt & Perry, 2016). An article was written in 2016 by Woodhouse et. al., showed that there were 2,058 partakers in the study that had a decline in being put back in jail due to the programs using therapeutic types of programs (Woodhouse et. al., 2016). At the River North Correctional facility, a program is being used by the name of Substance Abuse and Mental Health Services Administration or (SAMHSA) for short. This program’s goal is to concentrate on how substance abuse and anger management correlate with each other and the effects. It has been reported by several offenders that by using this program they know have a better grasp on why they use drugs and that trauma and anger during their childhood could be the culprit for their current actions. The use of this program was intended for offenders with mental illnesses but has since been extended to the surrounding communities. It is important for offender with mental disorders to understand they have a substance abuse problem because there is a risk and often some side effects when mixing psychotropic medication and illegal drugs at the same time. In the end, using treatment programs to help offenders with mental disorders has had a considerable effect on keeping offender from repeating crime.
Unfortunately, the criminal justice system, as of late has not put a lot of resources into offenders being re-entered back into society. Sometimes it is difficult for and offender that has a mental disorder along with co-occurring substance abuse without having problems. When they leave prison or jail there are times, they end up with health issue and with the challenge of reintegrating back into society (Denton, Foster, & Bland, 2015). There was a study done by Denton, Foster, and Bland (2015), that did research on “18 men with co-occurring severe mental illness and substance use disorder leaving prison in Queensland, Australia” (Denton, Foster, & Bland, 2015). Before they were released and even after release the participants were interviewed. By using evidence-based support the study showed that having treatment when in the transitional period along with aggressive substance abuse treatment there was a greater improvement in the health, wellbeing and even behavior of the offender. (Denton, Foster & Bland, 2015) Then there is community-based service for those with mental health disorders. A service known as the Community Mental Health Initiative or CMHI was “mandated to assist offenders with serious mental disorders in their transition from institutions to the community” (Stewart, Farrell-MacDonald, & Feeley, 2017). The service was designed for offender that was going back into the community and was diagnosed with an extreme mental health disorder. The services of CMHI offered several different programs to help offenders. Examples are; “first clinical discharge planning only; second community mental health services only; three the combined services or the final option none, although meeting criteria for any CMHI service” (Stewart, Farrell-MacDonald, & Feeley, 2017). In the end, the research showed that community mental health services did improve recidivism more than offends that did not use any of the services. This was shown to also have an effect on the short and long term (Stewart, Farrell-MacDonald, & Feeley, 2017).
In conclusion, in the past, it was believed that deterrents through prisons or jails had little to no effect on offenders or the effects on substance abuse and crime. Even in this day and age, there are still those who think prisons or jails do anything for those with mental health disorders. Prisons and jails are becoming filled more and more with offenders with mental illnesses (Lamb & Weinberger, 2017). With the more times they return back they become more institutionalized and start to rely on the structure of prison or jail to survive. Which makes it even harder for them to get back into society (Lamb & Weinberger, 2017). As mentioned early, that are programs that will help lower recidivism and allow offenders to go back into society and finally make it work.
It is strange but true that a lot of the time when offenders go to prison or jail, they tend to look to religion to help them. One scripture that many people look to is ” Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own”. (Matthew 6:34, NIV) We as a society need to treat every day like it might be that last, enjoy life and what it has to offer us or there may be a day that we miss something important, even if it might not seem that way. One of my favorite scriptures is “So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand. (Isaiah 41:10, NIV) I like this one because it shows that no matter what one might be going through God will always be there. There to help you and guide you through it all, the good and the bad. God has the answers for everyone even the sinners, who don’t know him yet. For God did not die just for me, He died for everyone.
- Chen, X., Leith, H., Aarø, L., Manger, T., & Gold, C. (2016). Music therapy for improving mental health problems of offenders in correctional settings: systematic review and meta-analysis. Journal of Experimental Criminology, 12(2), 209–228. https://doi-org.ezproxy.liberty.edu/10.1007/s11292-015-9250-y
- Denton, M., Foster, M., & Bland, R. (2017). How the prison-to-community transition risk environment influences the experience of men with co-occurring mental health and substance use disorder. Australian & New Zealand Journal of Criminology (Sage Publications Ltd.), 50(1), 39–55. https://journals.sagepub.com/doi/pdf/10.1177/0004865815620703
- Lamb, H. R., & Weinberger, L. E. (2017). Understanding and Treating Offenders with Serious Mental Illness in Public Sector Mental Health. Behavioral Sciences & the Law, 35(4), 303–318. https://doi-org.ezproxy.liberty.edu/10.1002/bsl.2292
- Landess, J., & Holoyda, B. (2017). Mental health courts and forensic assertive community treatment teams as correctional diversion programs. Behavioral Sciences & the Law, 35(5/6), 501–511. https://doi-org.ezproxy.liberty.edu/10.1002/bsl.2307
- Lim, L., & Day, A. (2016). Mental health diversion courts: A prospective study of reoffending and clinical outcomes of an Australian mental health court program. Journal of Offender Rehabilitation, 55(4), 254–270. https://doi-org.ezproxy.liberty.edu/10.1080/10509674.2016.1159639
- Masters, R.E., Way, L.B., Gerstenfeld, P. B., Muscat, B.T., Hopper, M., Dusch, J, P., Pincu., L., & Skrapec, C. A. (2013). CJ realities and challenges (2nd. ed.). New York, NY: McGraw-Hill.
- Stewart, L. A., Farrell, M. S., & Feeley, S. (2017). The impact of a community mental health initiative on outcomes for offenders with a serious mental disorder. Criminal Behaviour & Mental Health, 27(4), 371–384. https://doi-org.ezproxy.liberty.edu/10.1002/cbm.2005
- Tabernik, H. E., & Vitacco, M. J. (2016). Psychosis and Substance Use: Implications for Conditional Release Readiness Evaluations. Behavioral Sciences & the Law, 34(2/3), 295–307. https://doi-org.ezproxy.liberty.edu/10.1002/bsl.2229
- Woodhouse, R., Neilson, M., Martyn-St James, M., Glanville, J., Hewitt, C., & Perry, A. (2016). Interventions for drug-using offenders with co-occurring mental health problems: a systematic review and economic appraisal. Health & Justice, 4(1), 1–15. https://doi-org.ezproxy.liberty.edu/10.1186/s40352-016-0041-y
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