Session: Embracing the Complexity: Exploring Ways to Optimize the Effectiveness of Interventions for Justice-Involved People with Serious Mental Illnesses (Society for Social Work and Research 25th Annual Conference - Social Work Science for Social Change)

There are over one million individuals with serious mental illnesses (SMI) in the U.S. criminal justice system. For the past several decades, efforts to curb rates of incarceration among this population have centered around interventions designed to facilitate access to mental health care. However, these interventions have produced mixed results for criminal and psychiatric recidivism. As a result, an emerging body of evidence has called for the need to expand the focus of services delivered to this population to include interventions that explicitly target the risk factors most closely associated with criminal recidivism (i.e. criminogenic risk factors). Although research has found that such interventions reduce recidivism by as much as fifty percent, they are not currently being used among justice-involved individuals with SMI. In order to promote their use, interventions targeting criminogenic risk factors must be delivered in a manner that addresses the treatment needs of this population.

Research has found that justice-involved people with SMI have complex, interlocking treatment needs. As the array of services for this population expands to include interventions that target criminogenic risk factors, it is critical to learn more regarding how the complex treatment needs of this population impact this intervention’s ability to effectively target criminogenic risk factors. This symposium will present results from a NIMH-funded study of the efficacy of a criminogenic intervention that was delivered using a Targeted Service Delivery Approach (TSDA). The TSDA is designed to optimize the intervention’s engagement with its intended treatment targets through service delivery strategies developed to address the learning and treatment needs of justice-involved individuals with SMI. This study involves two phases: an open trial phase (n = 34) focused on finalizing intervention materials, and an RCT phase (n = 68) that engaged a small scale efficacy trial of the new intervention. The present symposium will comprise four papers that use data from both study phases to examine preliminary outcomes for the intervention and explore how the complex treatment needs of the study population impact the intervention’s outcomes.

The first paper will examine the relationship between psychiatric symptoms and criminal thinking, a key treatment target for the intervention. The second paper will evaluate the relationship between adverse childhood events and criminogenic risk levels among justice-involved people with SMI. The third paper will examine gender differences in interpersonal problem-solving between justice-involved men and women and how these differences impact aggression, a key outcome for criminogenic interventions. Finally, the fourth paper will explore the impact of the study intervention’s impact on key treatment targets and outcomes. These papers advance knowledge regarding how the complex needs of people with SMI impact key treatment targets of criminogenic interventions, and how these interventions can most effectively engage the needs of people with SMI in order to optimize the effectiveness of interventions that focus on reducing criminal justice involvement. Collectively, findings from each paper will contribute to efforts to advance social change and promote both positive criminal justice and psychiatric outcomes among justice-involved people with SMI.