(Aug. 15, 2017) Individuals with mental illness discharged from jails and prisons to specialized mental health probation officers are significantly less likely to be re-arrested, improving their outcomes and saving taxpayer money, according to a new study.
Jennifer L. Skeem and colleagues followed more than 300 men and women probationers with mental illness for up to five years to assess whether mental health probation lowered their risk of committing violent acts.
The study published in JAMA Psychiatry found no difference in the rates of violence in the two groups (more than one-third of both groups were involved in violence within a year of discharge) but revealed a major impact on re-arrest.
Lasting Results
The odds of re-arrest during the first two years following discharge were more than two and a half times higher for traditional probationers (51.8%) than for mental health probationers (28.5%), the study found.
What's more, the effect lasted. At five years post-discharge from correctional settings, 62% of the traditional probationers had been re-arrested, compared with 36% of the specialty probationers.
Four practices differentiated traditional and specialty probation:
- Smaller caseloads. Specialty probation officers supervised 50 probationers each compared with 100 probationers for traditional probation.
- Specialized training. Specialty officers received sustained training in mental health.
- Treatment coordination. Specialty officers coordinated and were directly involved with their probationers' treatment.
- Linkages. Specialty probation officers collaborated with psychiatric service providers to solve problems.
Overall, the specialty officers were found to rely more on positive compliance strategies than traditional officers and to experience better relationships with their probationers. Their probationers were significantly more likely to stay in mental health treatment and integrated dual-diagnosis treatment.
Implications
An estimated 2 million people with serious mental illness are booked into the nation's jails annually, and rates of schizophrenia, bipolar disorder and major depression are three to six times higher in correctional settings than in the general population.
Overall, individuals with mental illness spend longer behind bars than the general correctional population and are more likely to be re-incarcerated. The cost to jails for incarcerating mentally ill inmates is reported to be double or triple the cost of other inmates.
Grim statistics like these have led to a growing number of efforts to reduce mental illness behind bars, among them the collaborative SteppingUp initiative to develop cost-effective, evidence-based strategies for reducing the number of people with mental illness in jails.
Probation is a cornerstone of efforts to reduce mass incarceration, in the authors' words. The study, conducted on probation populations in urban regions of Texas and California, suggests that specialty mental health probation could contribute to achieving that goal.
"In the current era of criminal justice reform, specialty probation holds substantial promise as a method for reducing mass incarceration for people with mental illness," they concluded.
In a future report, the authors said they will report that specialty probation is more cost-effective than traditional probation because the higher cost of smaller caseloads is more than offset by savings in arrests and acute services. They also will report on the mechanisms making specialty probation more effective.
Doris A. Fuller
Chief of Research and Public Affairs
References:
- Skeem, J.L. et al. Comparing public safety outcomes for traditional probation vs specialty mental health probation. JAMA Psychiatry.
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