The research findings regarding the relationship between mental illness and crime vary considerably--often as a result of the definitions used and the populations studied. Not surprisingly, the associations between mental illness and crime tend to be more pronounced when studied among the general population than among the criminal justice population.
For example, according to one survey conducted in the early 1980s, people with serious mental illness (i.e., Axis I diagnoses) were more than five times as likely to report engaging in violent behaviors as those without serious mental illness (see Monahan, 1996). In contrast, an attempt to predict general and violent recidivism among parolees from a maximum-security inpatient psychiatric unit showed that psychotic parolees were less likely than nonpsychotic (but mentally ill) parolees to be rearrested for any offense and equally likely to be rearrested for a violent offense--approximately 70 percent at three years post-release (Villeneuve and Quinsey, 1995). Similarly, Hodgins and Cote (1993) found that the criminal careers of mentally disordered and nonmentally disordered offenders differed little. However, the combination of anti-social personality disorder and serious mental illness was associated with a significant increase in the frequency of nonviolent arrests.
Other researchers have suggested that the presumed association between mental illness and criminality is an artifact of the use of arrest records as a proxy for actual offenses. Mentally ill offenders may be more vulnerable to detection and arrest than nonmentally ill offenders. Therefore, they are more likely to be cycled through the criminal justice system for minor offenses (Teplin, 1984). A possible moderating variable in these studies is the effect of post-release mental health services. If in fact serious mental illness is associated with risk of recidivism, then the ongoing provision of needed psychiatric services to mentally ill parolees should result in improved functioning and fewer arrests. Indeed, several studies have supported this relationship. In one study of post-release mentally ill offenders, recidivism was directly related to the receipt of fewer services than the clients reported they needed (Solomon, Draine and Meyerson, 1994). More recently, Berecochea and Liu (1999) found that among mentally ill parolees in California, each additional visit to an outpatient psychiatric clinic was associated with an increase of 21 days on parole (i.e., reduced risk of recidivism).
In 1954, the California Department of Corrections and Rehabilitation established the parole outpatient clinic system to assist parolees with mental health problems and, as a consequence, reduce recidivism rates among this population. From the program's inception until Oct. 1, 2000, parole agents were primarily responsible for referring parolees to the parole outpatient clinics for services. Referrals were made if the parolee had a history of mental illness (usually indicated by the receipt of mental health services while in prison) or if the parole agent perceived that the parolee showed signs of mental instability. However, under this approach a substantial proportion of otherwise eligible parolees were either not identified or not provided appropriate services.
To enhance the department's ability to identify and treat mentally ill parolees, the Mental Health Services Continuum Program (MHSCP) was developed by the Parole and Community Services Division in July 2000. According to its design, MHSCP was to be applied to all eligible (mentally ill) inmates released on parole on or after Oct. 1, 2000.
Program Design and Description
The MHSCP was designed to reduce the symptoms of mental illness among parolees by providing timely, cost-effective mental health services that optimize their level of individual functioning in the community and …