Mental illnesses are the mental disorders that cause changes in a person’s thinking, emotion, and behaviour. The illnesses are likely to cause problems to a person’s social and work functioning (Parekh, 2015). There is inadequate knowledge and skills on how to deal with people with these disorders. The involvement of mentally ill people in the criminal justice system continues to increase, which raises concern for administrators, policy makers, and treatment providers in the justice system. This is one area that requires change and people to be more educated on the subject. I had a chance to work with mentally ill people during my internship in the criminal justice system. The following paper is a look at my experiences working with individuals and the things I learnt during my experience.
One of the things I realised in the beginning of my internship is the importance of necessary skills and treatment for the mentally ill people even when they are criminals. There is a rising concern that the number of mentally ill offenders in the criminal justice system are disproportionately represented. In addition, studies show that mentally ill offenders, when released, are twice as likely as healthy offenders to violate their parole or probation terms (Vanderloo & Butters, 2012). Also, there is an increased number of mentally ill patients who are criminalised due to the lack of adequate mental health settings. Being that these offenders span the boundaries of the criminal justice system to the mental health systems, there is a constant lack of clarity of the parties responsible for their criminal and financial needs. In most cases, there is a need to seek the collaboration of the two systems in order to ensure these individuals have access to basic and necessary care. Having identified such important factors, I was able to come up with goals for my work during my internship period. My goal was to provide assistance to the offenders and to ensure that I did my best to ensure they were treated fairly. I later realised there was not much I could do but I believe my actions made a difference to the peoples’ lives.
One of my responsibilities was referring treatment to the mentally ill offenders. In order to be effective, I had to find programs that were suitable to the individual in terms of location and the treatment offered. When searching for the treatment programs, I looked for those with a high efficacy rate in reducing recidivism of mentally ill offenders. Such interventions are usually difficult even for other offenders so this required a lot of research. Some treatment programs employ practices and interventions that improve the mental health outcomes of the offenders together with reducing the chances of recidivism. The research involved looking for programs that employ interventions like supported employment, integrated substance and mental health treatment, family psychoeducation and psychopharmacology (Vanderloo & Butters, 2012). My supervisor encouraged me to look at the programs employing the Assertive Community Treatment model. Such programs have treatment teams with professionals from different disciplines like psychiatrists, counsellors, and social workers. Such teams guaranteed the provision of services like crisis intervention, counselling, and advice on finances and careers. Such programs were said to have great practices in working with the mentally ill offenders. For those offenders with a history of substance abuse, I looked for programs that would pay attention to both mental illnesses and substance abuse. In some cases, it was difficult to find the ACT based programs in a nearby location for the offenders. In such cases, I was instructed to find treatment programs employing Forensic Assertive Community Treatment (FACT) Programs (Vanderloo & Butters, 2012). These programs mostly favoured African-American male offenders. As such, these preferences were kept in mind when referring the patients to the treatment programs. Other preferences included the mental conditions treated by the facility. For instance, some programs are geared towards catering for offenders with Schizophrenia, substance abuse, and antisocial personality disorder. Also, some programs prefer people with criminal offenses in the categories of sexual offenses, drug, property and violent offences (Peters, Wexler, & Lurigio, 2015).
Another responsibility was the assessment of the offenders. The importance of screening offenders is to identify the individuals with the highest risk of hurting themselves and other people. Additionally, it is important in determining if the offender can function in a prison if incarcerated and whether they can benefit from the treatment program in the prison. If not, the assessment determines if there is a need to transfer the offender to another facility and if that facility has a treatment program that could be beneficial to them. The American Psychiatric Association has guidelines on the assessment of offenders in prisons or jails (Kim, Becker-Cohen, & Serakos, 2015). The guidelines include the need to observe the offenders, to conduct structured interviews, conducting interviews during admissions and the screening of the mentally ill offenders by qualified professionals or correction staff with the necessary training. In some cases, there is a need for comprehensive assessment as indicated by the APA guidelines. Also, there are guidelines by the National Commission on Correctional Health Care on the mental health assessment of inmates (Vanderloo & Butters, 2012). Some of the guidelines require the screening of the offenders within two hours after their admission by a professional certified by the state and a mental evaluation by a qualified health professional within the first 14 days of admission. Other guidelines have required the correctional staff to be trained on identifying the symptoms of mental illness. The following guidelines were used in my assessment of the offenders. My supervisor required that I first read on the guidelines again before starting this role. It was easy to interpret these guidelines when in practice. The assessment process required the selection of an assessment tool. To do this, there was a framework I was instructed to use to determine the best assessment tool. The framework included understanding the tool’s purpose, the scoring techniques used in the tool, and understanding the tool’s point of view. Different tools require the perspective of a family member, clinician, or outside observer. The framework also includes the evaluation of the tool whether it is appropriate for the population being assessed. Other points include confirming the validity and reliability of the tool. Other considerations include the cost and ease of using the tool. Some of the assessment tools used are Brief Jail Mental Health Screen (BJMHS) and The Voice Diagnostic Interview Schedule for Children (V-DISC) (Vanderloo & Butters, 2012). The framework emphasizes the need to find a tool that will assess the level of severity and the mental health. In some cases, it was important to select tools that could provide a diagnostic clarity and an assessment of the psychotic symptoms. During the assessment, I had to determine the tool and also the level of case management and supervision needed. After assessing the offender, it was necessary to communicate the finding to their attorneys. The attorneys require this information to understand their clients and to prepare for their trials. Also, such information was sent to parole officers and probation officers since the information is useful to them as well. With the information, the officers can reduce the risk of recidivism for the offender. Studies show that characteristics of trust, fairness, and caring displayed by the probation and parole officers to the offenders are likely to reduce recidivism (Vanderloo & Butters, 2012).
During my internship, I also identified a set of principles that I used in my work. The first principle, Risk principle claims that it is possible to predict an offender’s risk in engaging in future criminal behaviours. To predict such risk, there is a need to employ actuarial risk measures that have been researched on by a number of scholars and understood to demonstrate their validity in such predictions (Vanderloo & Butters, 2012). Also, the principle explains the need for the treatments and interventions to match the level of the offender’s risk of recidivism. The principle was important in my research on intervention programs to refer the offenders. I did my best to find programs that were suitable to the individuals. To do so, I would spend a lot of time reading the offender’s medical file and criminal history and using the actuarial risk measures I would predict the likelihood of the criminals engaging in criminal activities again. In most cases, I sort assistance from other superior officers who had handled multiple cases. The knowledge also made it possible to select suitable intervention programs (Kim et al., 2015). For instance, an offender with a low risk of recidivism would be recommended a treatment program with minimal intervention practices but with good counselling and follow-up practices.
Also, I employed the principle of criminogenic need principle. The principle explains the need to identify problematic circumstances troubling a specific individual. In most cases, such circumstances can be unique to a person. In order to effectively reduce the risk of recidivism, it is important to address these issues. Some of the problematic circumstances include a history of antisocial behaviour, family circumstances, antisocial patterns, the types of work or school involved, substance abuse and the individual’s recreation activities. For instance, with regards to family circumstances, a person with a strong and nurturing background is likely to get the necessary monitoring and supervision. On the other hand, a person with poor-quality relationships lacks the moral support and may end up engaging in criminal activities. Furthermore, a person with alcohol and substance abuse problems is more susceptible to recidivism (Peters et al., 2015). For such a person, it is important to cater for their substance abuse problem and behaviour and equip them to tackle any problems of abuse.
I also utilised the principle of general responsivity in my work with the mentally ill offenders. The principle explains the need to have a program that matches the target audience (Vanderloo & Butters, 2012). The principle somewhat reinforces the risk principle. This principle was most useful in my allocation of treatment programs. I found that this was the most important part of my job, in my opinion. Putting an offender in the right treatment program would greatly influence their likelihood to stay out of prison and find a way to be productive in the society. Programs that would help an offender learn new skills depending on their mental condition and talents were very useful in accomplishing this. The principles were acquired from reading different researches on the subject. I learnt that one cannot know enough when taking such important responsibilities. There was a constant need to learn more, prepare for different cases, and most importantly learn the legal options when presented with a case.
In conclusion, an internship is meant to be an opportunity to learn on the field one intends to start their career. I found my internship as an educative process. The supervisors gave me a chance to take cases on my own after a period of probation, even though, I still had to report and seek guidance on unfamiliar issues. There are many misconceptions held about mentally ill people and hence the increased disproportional representation of these people in the criminal justice system. This was a chance to learn how these people can be handled and the need to have more trained people in the system to deal with them. Mentally ill people, like all other people, make mistakes and they are required to face the consequences of their mistakes. However, the criminal justice system should ensure that while doing this, these people receive the right and necessary care and treatment.
References
Kim, K., Becker-Cohen, M., & Serakos, M. (2015). The Processing and Treatment of Mentally Ill Persons in the Criminal Justice System. Urban Institute. Retrieved from http://www.urban.org/sites/default/files/alfresco/publication-pdfs/2000173-The-Processing-and-Treatment-of-Mentally-Ill-Persons-in-the-Criminal-Justice-System.pdf
Parekh, R. (2015). What is Mental Illness? American Psychiatric Association. Retrieved from https://www.psychiatry.org/patients-families/what-is-mental-illness
Peters, R. H., Wexler, H. K., & Lurigio, A. J. (2015). Co-Occurring Substance Use and Mental Disorders in the Criminal Justice System: A New Frontier of Clinical Practice and Research. Psychiatric Rehabilitation Journal, 38(1), 1-6. Retrieved from https://www.apa.org/pubs/journals/features/prj-0000135.pdf
Vanderloo, M. J., & Butters, R. P. (2012). Treating Offenders with Mental Illness: A Review of the Literature. Utah Criminal Justice Center, University of Utah. Retrieved from http://ucjc.utah.edu/wp-content/uploads/MIO-butters-6-30-12-FINAL.pdf
