Shared Decision Making in Community Corrections

Background and Purpose: More than 4.5 million people are under community corrections (parole or probation) supervision. About 15% of these individuals have a serious mental illness (SMI). Those with SMI are likely to have conditions of supervision that require engagement in mental health treatment and to have difficulties complying with these conditions. Shared decision making (SDM) is an effective method for promoting service involvement. Through the process of SDM, a partnership or a therapeutic alliance between those receiving and providing services is established and progress towards service goals is advanced when the interests of these two parties are aligned. Integrating SDM into services with those under community corrections supervision who have a SMI may increase their likelihood of engaging in recommended mental health and crime desistence programs and improve outcomes. However, the literature is undeveloped as to how SDM can be promoted among community corrections professionals serving this population. This paper reports on two studies aimed at reducing this knowledge gap: 1) the development and psychometric properties of the Community Corrections Shared Decision Making Scale (CCSDM), an instrument developed to measure attitudes that support SDM in community corrections settings and 2) an analysis to identify, among probation and parole officials, predictors of positive attitudes toward the use of SDM with people under their supervision who have SMI. Results can inform efforts to promote SDM and, in turn, improve service engagement and ultimately enhance public health and safety.

Methods: The target population for this study was community corrections professionals who work with individuals who have a SMI. Using an anonymous online survey, data were collected from 291 parole/probation professionals in 43 states and Washington, DC. Exploratory factor analysis (n = 146) and confirmatory factor analysis (n = 145) were used to explore and validate the scale’s factor structure. Next, regression modeling was used to identify relationships among professionals’ personal and agency characteristics, knowledge of various rehabilitation paradigms, and impressions of the capabilities of the people they supervise with their scores on the CCSDM.

Results: Results indicate the CCSDM functions as an internally consistent, 2-factor scale useful for measuring attitudes toward SDM with people who have a SMI and are under community supervision. Professionals’ perceptions of the capabilities of supervisees with SMI to contribute to supervision plan development and, to a lesser extent, familiarity with recovery-oriented mental health services were positively associated with attitudes toward SDM with this population. An indicator of “otherness,” or social distance, also evidenced a strong relationship with CCSDM subscales.

Conclusions and Implications: Respondents were generally supportive of SDM. Given the benefits of SDM, assessment of these beliefs (perhaps using the CCSDM) is essential to inform implementation strategies aimed at establishing SDM policies and practices in community corrections settings. Additionally, training of community corrections professionals in mental health recovery principles and co-locating them with peer support services could raise awareness as to the capacities of people with SMI and reduce the social distance and stigma toward supervisees in a way that promotes SDM.