Environmental Factors' Influence on Criminal Justice Involvement for People with Serious Mental Illness

Background & Purpose: The over-representation of persons with serious mental illness (SMI) in the U.S. criminal justice system is a persistent problem with serious societal consequences. Efforts to assess risk for justice-involved individuals with SMI often rely on strategies aimed primarily at decreasing symptoms of mental illness. This study takes a different approach by seeking to examine person- as well as place-level risks that contribute to criminal justice involvement for persons with SMI in mental health treatment settings. Based on an analysis that highlights the role of environment, we offer findings that may lead to improved strategies for identifying criminal risk factors and responding to a wider range of needs for this population. 

Methods: As part of a larger study, we interviewed 31 people with SMI who were currently involved in mental health treatment and also had some history of criminal justice involvement, ranging from arrests to long-term incarceration. Interviews focused on participants’ perceptions on the variety of factors that contributed to and protected against their involvement in the criminal justice system over their life course. Members of the research team engaged in multiple rounds of comparative coding using a grounded dimensional analysis approach to identify themes related to the process of criminal justice involvement for people with SMI. 

Results: Our analysis reveals three environments – physical, social and treatment – that are critical to the context of risk for participants. Physical environment: Lack of local economic opportunity, neighborhood gang activity and ubiquitous drug use were often cited as having influenced participants to engage in criminalized behaviors. Relocation to neighborhoods with less prevalent or less visible drug and gang activity was cited as an aid in the process of avoiding trouble with the law. Social environment: Friends and acquaintances were often identified as an impetus for engagement in crime or as supporting actors in maintaining a crime-free life. Crimes discussed almost always occurred in a social environment and revolved around issues of substance use and addiction. Avoidance of peers who use substances surfaced as a leading way in which participants were able to exercise agency and minimize criminal risk. Treatment environment: Participants discussed how engaging in behavioral health services affected aspects of their environment in ways that were protective against criminal justice involvement. These environments include drop-in centers with supportive activities, recovery homes and other treatment centers that relocated participants to areas they perceived to be less risky, developing a social network of other individuals receiving treatment. 

Conclusions & Implications: The question of how criminal risk can be assessed in mental health treatment settings is a pressing and under-explored area of research. It is imperative that research in this area leads to capacity-building strategies for mental health treatment systems to mitigate criminal risk for individuals experiencing SMI. Our findings point to the influence that environments have for risk of and protection from criminal justice involvement. Supplementing and complicating contemporary approaches to risk assessment, our findings suggest that environmental factors require meaningful consideration by mental health treatment systems that serve individuals experiencing SMI.