Criminogenic Risk Levels of Justice Involved People with Serious Mental Illness

Background: A growing body of research suggests that treatment services for justice involved people with serious mental illness (SMI) need to engage interventions that directly target the risk factors most strongly associated with criminal behavior (i.e. criminogenic risk factors). However, much is yet to be learned about criminogenic risk factors among justice involved people with SMI. This paper contributes to this knowledgebase by examining the criminogenic risk levels of people with SMI and those without SMI across different levels of incarceration.

Method: Data was drawn from three studies of incarcerated individuals to compare the criminogenic risk levels of people with SMI in jail (N=93), with people with SMI in prison (N=217), and people in prison without SMI (N=126). Each study measured criminogenic risk levels using the Level of Service Inventory (LSI). The LSI assesses criminogenic risk levels using the eight risk factors for recidivism identified in the Risk-Needs-Responsivity Framework. These criminogenic risk factors include antisocial attitudes, personality and peers, substance use, employment/education, family, leisure/recreation, and criminal history. The LSI provides an overall criminogenic risk score, as well as risk scores for each of the 8 criminogenic risk factors. These risk scores are then used to categorize individuals by risk level (low, moderate, high, and very high). The LSI is used extensively in correctional settings and has been proven to be a reliable and valid measure of criminogenic risk factors. 

Results: People with SMI in jail were found to have overall criminogenic levels that were significantly higher than the other two groups both in terms of risk scores (M=3.24, SD=.73), and the percentage of individuals with high/very high risk levels (87%). Analyses of scores in each of the eight specific criminogenic domains found that people with SMI in jail had significantly higher risk scores and percentage of individuals with high/very high risk levels on six of the eight criminogenic risk factors (leisure/recreation, anti-social peers, anti-social attitudes, alcohol/drugs, education/employment, family). People with SMI in prison had significantly higher risk scores and percentage of individuals with high/very high risk levels on the two remaining criminogenic risk factors (antisocial personality, criminal history).

Discussion: The data from this study demonstrates that people with SMI in jail and prison have criminogenic risk levels that place them at high risk for recidivism. These results support the claim that in order to reduce justice involvement, mental health services must include interventions to address criminogenic risk factors. The fact that people with SMI in jail had the highest criminogenic risk levels draws into question the long held assumption that people with mental illness in jail are there solely due to the criminalization of their mental illness, and suggests that more interventions need to target this population in particular. These results also suggest that criminogenic interventions could be optimized if more research examines the criminogenic needs of people with SMI both within and across levels of incarceration.