Mental Health and Crime Flashcards
What are the readings?
Fazel et al (2016)
Jolliffe et al (2019)
Jolliffe et al (2017)
What are the prevalence, outcomes and interventions for MH? (Fazel et al)
Depression: 10-12% of male and 14% of female prisoners.
Psychotic disorders: 3-6%, much higher than in the general public.
Personality disorders: Antisocial personality disorder in 40-70% of prisoners.
Substance use disorders: Present in up to 50% of prisoners.
Increased suicide risk: Suicide rates are significantly higher than in the general population.
Higher mortality rates after release, especially from suicide and drug overdose.
Violence and victimization: Mental illness is linked to both violent behavior and victimization in prisons.
Reoffending: Poor mental health is associated with higher recidivism rates.
Screening and assessment: Many prisons lack adequate mental health screening upon entry.
Psychological interventions: CBT and structured programs show effectiveness.
Pharmacological treatments: Medications for depression, psychosis, and anxiety can be beneficial but are often underused.
Diversion programs: Some countries divert mentally ill offenders to mental health services instead of prison.
Aftercare and re-entry support: Continuity of care post-release is crucial to reducing negative outcomes.
What are the challenges with Fazel et al?
Overcrowding and resource limitations hinder effective mental health care.
Stigma and reluctance to seek help among prisoners.
Poor integration between criminal justice and health systems.
What is the background for Jolliffe et al 2017?
The study investigates factors that contribute to progression within the program, focusing on both individual and systemic influences.
What are the key factors associated with progression (Jolliffe et al 2017)
Mental Health Needs:
Youth with severe mental health problems (e.g., depression, psychosis) often struggle to engage fully in rehabilitation programs.
A strong predictor of poor progression, as substance misuse can hinder treatment engagement and exacerbate behavioural issues.
Motivation to Change:
Higher motivation correlates with better engagement and improved outcomes in the program.
Offenders with low motivation often drop out early or show limited improvement.
Family and Social Support:
Strong support networks help reinforce positive behavioral changes.
Family dysfunction or negative peer influence can undermine rehabilitation efforts.
History of Violence and Offending Severity:
Those with more severe criminal histories (e.g., violent offences) face greater challenges in completing the program.
Repeat offenders often show lower levels of engagement.
What are the institutional and systematic influences?
Staff-Prisoner Relationships:
* A positive relationship with staff increases the likelihood of program completion.
Program Structure and Delivery:
* Flexible, individualised interventions are more effective than rigid, one-size-fits-all programs.
What are the barriers to successful progression (Jolliffe et al 2017)?
Mental Health Stigma
Lack of Coordination Between Services: Poor communication between criminal justice, mental health, and social services leads to gaps in care.
Limited Resources and Overcrowding: Prison conditions, lack of funding, and staffing shortages negatively impact program effectiveness.
What implications did Jolliffe et al have?
Early Screening and Intervention:
* Identifying mental health issues at the start of the criminal justice process is crucial for better outcomes.
Integrated Mental Health and Rehabilitation Services:
* Greater collaboration between mental health professionals and correctional staff is needed.
Personalized Approaches:
* Programs should be tailored based on individual needs, including mental health history, substance use, and motivation levels.
Training for Staff:
* Prison and probation officers should receive specialized training in handling offenders with mental health needs.
What did Jolliffe et al (2019) do?
Used the Pittsburgh Youth Study
Depression, anxiety and offending measured every year from age 11-16
What are the Jolliffe et al find?
Little evidence that greater levels of depression and anxiety caused later offending
But offending seemed to cause later anxiety and depression.
What are the key points for MH and victimisation?
Those who experience child maltreatment have higher levels of later mental ill health
People with mental health issues tend to live in more disorganised neighbourhoods.
Who looked at personality disorders and men and women?
Dean et al 2024
What did Dean et al 2024 find?
Men and women with diagnoses of personality disorders, substance use disorders, and schizophrenia-spectrum disorders were at highest risk of victimisation and perpetration
How does crime relate to personality disorders?
People with personality disorders often have a hard time understanding emotions and tolerating distress. And they act impulsively
What are the symptoms ofg BPD?
Emotional lability
Odd instability (fear of abandonment)
Suicidal outside of depressive periods.
Unstable and intense relationships.
Impulsivity.
Control of anger is lacking.
Identity disturbance.
Dissociative symptoms.
Emptiness.
What are the symptoms pf histrionic personality disorder?
Shallow, changeable emotions
Assumed intimacy with others
Hypersensitivity to criticism
Manipulative behaviour
Disproportionate emotional reactions
Sexually provocative behaviour
A compulsive desire for attention
Preoccupation with appearance
Suggestible and easily influenced
What are the symptoms of narcissistic personality disorder?
A grandiose sense of self-importance
A preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love
A belief that he or she is special and unique and can only be understood by, or should associate with, other special or high-status people or institutions
A need for excessive admiration
A sense of entitlement
Interpersonally exploitive behaviour
A lack of empathy
Envy of others or a belief that others are envious of him or her
A demonstration of arrogant and haughty behaviours or attitudes
What are the symptoms of ASPD?
Failure to conform to laws and social norms
Deceitfulness
Impulsivity
Irritability and aggressiveness
Reckless disregard for safety or self
Consistent irresponsibility
Lack of remorse
Who looked at the facets of psychopathy?
Cooke & Michie 2002
What are the 4 facets of psychopathy?
Interpersonal: arrogant and deceitful style
Affective: reduced capacity and use of emotions
Behavioural: impulsive and irresponsible behavioural style
Antisocial Behaviours
What are the symptoms of psychopathy?
Need for stimulation
Callousness
Promscious
Impulsitivty
Irresponsibility
Failure to accept responsibility
Superficial charm
Grandiose sense of self
Lack of remorse
Who looked at psychopathy and violence?
Roberts & Coid 2007
Hemphill et al 1998
What did Roberts & Coid find?
A minority of offenders have psychopathy, but they are responsible for a disproportionate amount of crime.
What did Hemphill et al find?
Individuals with psychopathy 3x more likely to re-offend in general and 4x more likely to commit further violent offences
What is the prevalence of MH in England?
1 in 4 people will experience a MH problem
1 in 6 report experience a common mental health problem in any given week
Who looked at the prevalence of mental disorders in prison?
Fazel et al 2016
What is the proportion of women with MD?
14.1
What is the proportion of men with MD?
10.2
What is the proportion of women with a psychotic illness?
3.9
What is the proportion of men with a psychotic illness?
3.6
What are the 4 explanations for why MH is high in prison?
People with MH commit more crime
Bias against people with MD
Getting convicted could cause MD
Prison conditions could cause MD
Explain: People with MH commit more crime
Could be symptoms (e.g., command hallucinations).
Could be tautological (e.g., substance misuse is both a mental health condition and a ‘crime’)
Could be another factor (e.g., poverty increases likelihood of both).
Explain: Bias against people with mental disorders
More likely to be:
Identified
Apprehended
Proceeded against
Found guilty
Sentenced to prison
Explain: Prison conditions could cause mental illness
Overcrowding, time behind door, noise, fear, grief, loss, smell
Importation v deprivation
What is the offender personality disorder pathway?
Between 50-70% of offenders in England and Wales may have a personality disorder
They commit more serious and violent offending.
Who looked at the OPD?
Jolliffe et al 2017
What does the OPD provide?
Reduce impact of personality disorder on their day-to-day life
Improve wellbeing
Reduce their risks to themselves and others
Who looked at personality disorders disproportionality?
Coid et al 2007
What did Coid et al (2007) find?
Despite evidence that offenders with personality disorder account for a disproportionate amount of serious and violent offending
What is the 4 criteria for risk assessment?
1) a specific sentence type (imprisonment for public protection; IPP or life sentence)
(2) index offence (sexual or violent)
(3) risk of harm rating of high or very high from the Offender Assessment tool
(4) risk of harm rating of medium with previous violent or sexual offences.
Who looked at sentence plan?
Hart et al 2011
What did Hart et al 2011 say?
Case consultation and formulation is a process of targeted specialist advice to consider the offender’s psychosocial and criminogenic needs relating to their personality disorder and to make decisions about the sentence plan
