Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-30T15:47:54.243Z Has data issue: false hasContentIssue false

Principles and practices of risk assessment in mental health jail diversion programs

Published online by Cambridge University Press:  25 November 2019

Sarah L. Desmarais*
Affiliation:
Department of Psychology, and Center for Family and Community Engagement, North Carolina State University, Raleigh, North Carolina, USA
Evan M. Lowder
Affiliation:
Department of Criminology, Law and Society, George Mason University, Fairfax, Virginia, USA
*
*Address correspondence to: Sarah L. Desmarais, PhD, Professor, Department of Psychology, Director, Center for Family and Community Engagement, North Carolina State University, Campus Box 7650, Poe Hall 714A, Raleigh, NC 27695, USA.(Email: [email protected])

Abstract

Eligibility criteria for participation in mental health jail diversion programs often specify that, to be diverted, a candidate must not pose a level of threat to public safety that cannot be managed in the community. Risk assessment tools were developed to increase consistency and accuracy in estimates of threat to public safety. Consequently, risk assessment tools are being used in many jurisdictions to inform decisions regarding an individual’s appropriateness and eligibility for mental health jail diversion and the strategies that may be successful in mitigating risk in this context. However, their use is not without controversy. Questions have been raised regarding the validity and equity of their estimates, as well as the impact of their use on criminal justice outcomes. The purpose of this review is to provide an overview of the science and practice of risk assessment to inform decisions and case planning in the context of mental health jail diversion programs. Our specific aims include: (1) to describe the process and components of risk assessment, including differentiating between different approaches to risk assessment, and (2) to consider the use of risk assessment tools in mental health jail diversion programs. We anchor this review in relevant theory and extant research, noting current controversies or debates and areas for future research. Overall, there is strong theoretical justification and empirical evidence from other criminal justice contexts; however, the body of research on the use of risk assessment tools in mental health jail diversion programs, although promising, is relatively nascent.

Type
Review
Copyright
© Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

References:

Munetz, MR, Griffin, PA Use of the Sequential Intercept Model as an approach to decriminalization of people with serious mental illness. Psychiatr Serv. 2006;57(4):544549.CrossRefGoogle ScholarPubMed
Case, B, Steadman, HJ, Dupuis, SA, Morris, LS Who succeeds in jail diversion programs for persons with mental illness? A multi-site study. Behav Sci Law. 2009;27(5):661674.CrossRefGoogle ScholarPubMed
Adult Mental Health Treatment Courts Database. SAMHSA’s GAINS Center. 2019. https://www.samhsa.gov/gains-center/mental-health-treatment-court-locator/adults. Accessed August 24, 2019.Google Scholar
Monahan, J, Skeem, JL. Risk assessment in criminal sentencing. Annu Rev Clin Psychol. 2016;12:489513.CrossRefGoogle ScholarPubMed
Casey, PM, Warren, RK, Elek, JK Using Offender Risk and Needs Assessment Information at Sentencing: Guidance for Courts from a National Working Group. Williamsburg, VA: National Center for State Courts; 2011.Google Scholar
Desmarais, SL, Lowder, EM Pretrial Risk Assessment Tools: A Primer for Judges, Prosecutors, and Defense Attorneys. Chicago, IL: the MacArthur Foundation; 2019.Google Scholar
Barber-Rioja, V, Rotter, M, Schombs, F. Diversion evaluations: a specialized forensic examination. Behav Sci Law. 2017;35(5–6):418430.CrossRefGoogle ScholarPubMed
Talesh, S. Mental health court judges as dynamic risk managers: a new conceptualization of the role of judges. DePaul L Rev. 2007;57:93.Google Scholar
Ægisdóttir, S, White, MJ, Spengler, PM, et al. The meta-analysis of clinical judgment project: fifty-six years of accumulated research on clinical versus statistical prediction. Couns Psychol. 2006;34(3):341382.CrossRefGoogle Scholar
Grove, WM, Meehl, PE. Comparative efficiency of informal (subjective, impressionistic) and formal (mechanical, algorithmic) prediction procedures: the clinical–statistical controversy. Psychol Public Policy Law. 1996;2(2):293323.CrossRefGoogle Scholar
Grove, WM, Zald, DH, Lebow, BS, Snitz, BE, Nelson, C. Clinical versus mechanical prediction: a meta-analysis. Psychol Assess. 2000;12(1):19.CrossRefGoogle ScholarPubMed
Mamalian, CA State of the Science of Pretrial Risk Assessment. Washington, DC: U.S. Bureau of Justice Assistance; 2011.Google Scholar
Singh, JP, Desmarais, SL, Sellers, BG, Hylton, T, Tirotti, M, Van Dorn, RA From risk assessment to risk management: matching interventions to adolescent offenders’ strengths and vulnerabilities. Child Youth Serv Rev. 2014;47:19.CrossRefGoogle ScholarPubMed
Vieira, TA, Skilling, TA, Peterson-Badali, M. Matching court-ordered services with treatment needs: predicting treatment success with young offenders. Crim Justice Behav. 2009;36(4):385401.CrossRefGoogle Scholar
Vincent, GM, Paiva-Salisbury, ML, Cook, NE, Guy, LS, Perrault, RT Impact of risk/needs assessment on juvenile probation officers’ decision making: importance of implementation. Psychol Public Policy Law. 2012;18(4):549576.CrossRefGoogle Scholar
The Social-Ecological Model: A framework for prevention. National Center for Injury Prevention and Control, Division of Violence Prevention. https://www.cdc.gov/violenceprevention/publichealthissue/social-ecologicalmodel.html. Updated January 16, 2019. Accessed August 24, 2019.Google Scholar
Krug, EG, Mercy, JA, Dahlberg, LL, Zwi, AB. The world report on violence and health. Lancet. 2002;360(9339):10831088.CrossRefGoogle ScholarPubMed
Cartwright, JK, Desmarais, SL, Johnson, KL, Van Dorn, RA. Performance and clinical utility of a short violence risk screening tool in U.S. adults with mental illness. Psychol Serv. 2018;15(4):398408.CrossRefGoogle Scholar
Dolan, M, Doyle, M. Violence risk prediction: clinical and actuarial measures and the role of the psychopathy checklist. Br J Psychiatry. 2000;177:303311.CrossRefGoogle ScholarPubMed
Singh, JP, Desmarais, SL, Hurducas, C, et al. International perspectives on the practical application of violence risk assessment: a global survey of 44 countries. Int J Forensic Ment. 2014;13(3):193206.CrossRefGoogle Scholar
Viljoen, JL, McLachlan, K, Vincent, GM Assessing violence risk and psychopathy in juvenile and adult offenders: a survey of clinical practices. Assessment. 2010;17(3):377395.Google ScholarPubMed
Kraemer, HC, Kazdin, AE, Offord, DR, Kessler, RC, Jensen, PS, Kupfer, DJ Coming to terms with the terms of risk. Arch Gen Psychiatry. 1997;54(4):337343.Google ScholarPubMed
Klepfisz, G, Daffern, M, Day, A. Understanding protective factors for violent reoffending in adults. Aggress Violent Behav. 2017;32:8087.CrossRefGoogle Scholar
Webster, CD, Nicholls, TL, Martin, ML, Desmarais, SL, Brink, J. Short-Term Assessment of Risk and Treatability (START): the case for a new structured professional judgment scheme. Behav Sci Law. 2006;24(6):747766.CrossRefGoogle ScholarPubMed
Rogers, R. The uncritical acceptance of risk assessment in forensic practice. Law Hum Behav. 2000;24(5):595605.CrossRefGoogle ScholarPubMed
Rutter, M. Psychosocial resilience and protective mechanisms. Am J Orthopsychiatry. 1987;57(3):316331.CrossRefGoogle ScholarPubMed
Desmarais, SL, Nicholls, TL, Wilson, CM, Brink, J. Using dynamic risk and protective factors to predict inpatient aggression: reliability and validity of START assessments. Psychol Assess. 2012;24(3):685700.CrossRefGoogle ScholarPubMed
Serin, RC, Chadwick, N, Lloyd, CD Dynamic risk and protective factors. Psychol Crime Law. 2016;22(1–2):151170.Google Scholar
Lowder, EM, Desmarais, SL, Rade, CB, Coffey, T, Van Dorn, RA Models of protection against recidivism in justice-involved adults with mental illnesses. Crim Justice Behav. 2017;44(7):893911.CrossRefGoogle Scholar
Lowder, EM, Desmarais, SL, Rade, CB, Johnson, KL, Van Dorn, RA Reliability and validity of START and LSI-R assessments in mental health jail diversion clients. Assessment. 2017;26(7):13471361. doi:10.1177/1073191117704505.Google ScholarPubMed
Webster, CD, Martin, M-L, Brink, J, Nicholls, TL, Desmarais, SL Manual for the Short-Term Assessment of Risk and Treatability (START). 1.1 ed. Coquitlam, Canada: British Columbia Mental Health & Addiction Services; 2009.Google Scholar
Yuan, Y, Capriotti, MR The impact of mental health court: a Sacramento case study. Behav Sci Law. 2019;37(4):452467.Google ScholarPubMed
Douglas, KS, Skeem, JL Violence risk assessment: getting specific about being dynamic. Psychol Public Policy Law. 2005;11(3):347383.CrossRefGoogle Scholar
Osher, F, Steadman, HJ, Barr, H. A best practice approach to community reentry from jails for inmates with co-occurring disorders: the APIC model. Crime Delinquency. 2003;49(1):7996.Google Scholar
Douglas, KS, Skeem, JL Violence risk assessment: getting specific about being dynamic. Psychol Public Policy Law. 2005;11(3):347.CrossRefGoogle Scholar
Johnson, KL, Desmarais, SL, Grimm, KJ, Tueller, SJ, Swartz, MS, Van Dorn, RA Proximal risk factors for short-term community violence among adults with mental illnesses. Psychiatr Serv. 2016;67(7):771778.CrossRefGoogle ScholarPubMed
Sadeh, N, Binder, RL, McNiel, DE Recent victimization increases risk for violence in justice-involved persons with mental illness. Law Hum Behav. 2014;38(2):119125.Google ScholarPubMed
Buchanan, A, Binder, R, Norko, M, Swartz, M. Psychiatric violence risk assessment. Am J Psychiatry. 2012;169(3):340.CrossRefGoogle ScholarPubMed
Andrews, DA, Bonta, J. Rehabilitating criminal justice policy and practice. Psychol Public Policy Law. 2010;16(1):3955.CrossRefGoogle Scholar
Van Dorn, RA, Grimm, KJ, Desmarais, SL, Tueller, SJ, Johnson, KL, Swartz, MS. Leading indicators of community-based violent events among adults with mental illness. Psychol Med. 2017;47(7):11791191.CrossRefGoogle ScholarPubMed
Van Dorn, RA, Andel, R, Boaz, TL, et al. Risk of arrest in persons with schizophrenia and bipolar disorder in a Florida Medicaid program: the role of atypical antipsychotics, conventional neuroleptics, and routine outpatient behavioral health services. J Clin Psychiatry. 2011;72(4):502508.CrossRefGoogle Scholar
Van Dorn, RA, Desmarais, SL, Petrila, J, Haynes, D, Singh, JP. Effects of outpatient treatment on risk of arrest of adults with serious mental illness and associated costs. Psychiatr Serv. 2013;64(9):856862.CrossRefGoogle ScholarPubMed
Skeem, JL, Winter, E, Kennealy, PJ, Louden, JE, Tatar, JR. Offenders with mental illness have criminogenic needs, too: toward recidivism reduction. Law Hum Behav. 2014;38(3):212224.CrossRefGoogle ScholarPubMed
Honegger, LN, Honegger, KS Criminogenic factors associated with noncompliance and rearrest of mental health court participants. Crim Justice Behav. 2019:46(9):0093854819862010.Google Scholar
Skeem, JL, Steadman, HJ, Manchak, SM Applicability of the Risk–Need–Responsivity model to persons with mental illness involved in the criminal justice system. Psychiatr Serv. 2015;66(9):916922.CrossRefGoogle ScholarPubMed
Hilton, NZ, Harris, GT, Rice, ME Sixty-six years of research on the clinical versus actuarial prediction of violence. Couns Psychol. 2006;34(3):400409.CrossRefGoogle Scholar
Guy, LS, Packer, IK, Warnken, W. Assessing risk of violence using structured professional judgment guidelines. J Forensic Psychol P. 2012;12(3):270283.CrossRefGoogle Scholar
Fazel, S, Sing, JP, Doll, H, Grann, M. Use of risk assessment instruments to predict violence and antisocial behaviour in 73 samples involving 24 827 people: systematic review and meta-analysis. Br Med J. 2012;345(7868):e4692.CrossRefGoogle ScholarPubMed
Guay, J-P, Parent, G. Broken legs, clinical overrides, and recidivism risk: an analysis of decisions to adjust risk levels with the LS/CMI. Crim Justice Behav. 2018;45(1):82100.CrossRefGoogle Scholar
Schmidt, F, Sinclair, SM, Thomasdóttir, S. Predictive validity of the youth level of service/case management inventory with youth who have committed sexual and non-sexual offenses: the utility of professional override. Crim Justice Behav. 2016;43(3):413430.CrossRefGoogle Scholar
Desmarais, SL, Johnson, KL, Singh, JP Performance of recidivism risk assessment instruments in U.S. correctional settings. Psychol Serv. 2016;13(3):206222.Google ScholarPubMed
Skeem, JL, Monahan, J. Current directions in violence risk assessment. Curr Dir Psychol Sci. 2011;20(1):3842.CrossRefGoogle Scholar
Broner, N, Mayrl, DW, Landsberg, G. Outcomes of mandated and nonmandated New York City jail diversion for offenders with alcohol, drug, and mental disorders. Prison J. 2005;85(1):1849.CrossRefGoogle Scholar
Webster, C, Douglas, K, Eaves, D, Hart, S. HCR-20: Assessing Risk for Violence (Version 2). Burnaby, Canada: Mental Health, Law, and Policy Institute at Simon Fraser University; 1997.Google Scholar
Barber-Rioja, V, Dewey, L, Kopelovich, S, Kucharski, LT The utility of the HCR-20 and PCL: SV in the prediction of diversion noncompliance and reincarceration in diversion programs. Crim Justice Behav. 2012;39(4):475-492.CrossRefGoogle Scholar
Andrews, DA, Bonta, J. Level of Service Inventory-Revised (LSI-R): User’s Manual. Toronto, Canada: Multi-Health Systems; 2001.Google Scholar
Bonfine, N, Ritter, C, Munetz, MR Exploring the relationship between criminogenic risk assessment and mental health court program completion. Int J Law Psychiatry. 2016;45:916.CrossRefGoogle ScholarPubMed
Vincent, GM, Guy, LS, Grisso, T. Risk Assessment in Juvenile Justice: A Guidebook for Implementation. Chicago, IL: John D. and Catherine T. MacArthur Foundation; 2012.Google Scholar
Desmarais, SL Commentary: risk assessment in the age of evidence-based practice and policy. Int J Forensic Ment. 2017;16(1):1822.CrossRefGoogle ScholarPubMed
Levin, SK, Nilsen, P, Bendtsen, P, Bulow, P. Structured risk assessment instruments: a systematic review of implementation determinants. Psychiat Psychol Law. 2016;23(4):602628.CrossRefGoogle Scholar
Desmarais, SL, Van Dorn, RA, Telford, RP, Petrila, J, Coffey, T. Characteristics of START assessments completed in mental health jail diversion programs. Behav Sci Law. 2012;30(4):448469.CrossRefGoogle ScholarPubMed
Proctor, E, Silmere, H, Raghavan, R, et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011;38(2):6576.CrossRefGoogle ScholarPubMed
Nonstad, K, Webster, CD How to fail in the implementation of a risk assessment scheme or any other new procedure in your organization. Am J Orthopsychiatry. 2011;81(1):9499.CrossRefGoogle ScholarPubMed
Hanley, D. Appropriate services: examining the case classification principle. J Offender Rehabil. 2006;42(4):122.CrossRefGoogle Scholar
Spring, B. Sound health care economics: provide the treatment needed (not less, not more). Health Psychol. 2019;38(8):701704.CrossRefGoogle Scholar
Andrews, DA, Dowden, C. Risk principle of case classification in correctional treatment: a meta-analytic investigation. Int J Offender Ther Comp Criminol. 2006;50(1):88100.Google ScholarPubMed
Lowenkamp, CT, Latessa, EJ, Holsinger, AM The risk principle in action: what have we learned from 13,676 offenders and 97 correctional programs? Crime Delinquency. 2006;52(1):7793.CrossRefGoogle Scholar
Hanson, KR, Bourgon, G, McGrath, RJ, et al. A Five-Level Risk and Needs System: Maximizing Assessment Results in Corrections Through the Development of a Common Language. New York, NY: Council of State Governments-Justice Center; 2017.Google Scholar
Andrews, DA, Bonta, J, Wormith, JS The recent past and near future of risk and/or need assessment. Crime Delinquency. 2006;52(1):727.CrossRefGoogle Scholar
Campbell, MA, Canales, DD, Wei, R, Totten, AE, Macaulay, WAC, Wershler, JL Multidimensional evaluation of a mental health court: adherence to the Risk–Need–Responsivity model. Law Hum Behav. 2015;39(5):489502.CrossRefGoogle ScholarPubMed
Andrews, DA, Bonta, J, Wormith, JS The Level of Service/Risk, Need, Responsivity (LS/RNR) manual. Toronto, Canada: Multi-Health Systems; 2008.Google Scholar
Nelson, RJ, Vincent, GM Matching services to criminogenic needs following comprehensive risk assessment implementation in juvenile probation. Crim Justice Behav. 2018;45(8):11361153.Google Scholar
Dowden, C, Andrews, DA The importance of staff practice in delivering effective correctional treatment: a meta-analytic review of core correctional practice. Int J Offender Ther Comp Criminol. 2004;48(2):203214.CrossRefGoogle ScholarPubMed
Vergara, AT, Kathuria, P, Woodmass, K, Janke, R, Wells, SJ Effectiveness of culturally appropriate adaptations to juvenile justice services. J Juvenile Justice. 2016;5(2):85.Google ScholarPubMed
Covington, SS, Bloom, BE Gender responsive treatment and services in correctional settings. Women Ther. 2007;29(3–4):933.CrossRefGoogle Scholar
Levenson, JS, Willis, GM Implementing trauma-informed care in correctional treatment and supervision. J Aggress Maltreat Trauma. 2019;28(4):481501.CrossRefGoogle Scholar
Heilbrun, K, Pietruszka, V, Thornewill, A, Phillips, S, Schiedel, R. Diversion at re-entry using criminogenic CBT: review and prototypical program development. Behav Sci Law. 2017;35(5–6):562572.Google ScholarPubMed
Van Dorn, RA, Desmarais, SL, Rade, CB, et al. Jail-to-community treatment continuum for adults with co-occurring substance use and mental disorders: study protocol for a pilot randomized controlled trial. Trials. 2017;18(1):365.Google ScholarPubMed
Skeem, JL, Manchak, S, Peterson, JK Correctional policy for offenders with mental illness: creating a new paradigm for recidivism reduction. Law Hum Behav. 2011;35(2):110126.CrossRefGoogle ScholarPubMed
Young, S, Chick, K, Gudjonsson, G. A preliminary evaluation of reasoning and rehabilitation 2 in mentally disordered offenders (RR2M) across two secure forensic settings in the United Kingdom. J Forens Psychiatry Psychol. 2010;21(3):336349.CrossRefGoogle Scholar
Wilson, CM, Desmarais, SL, Nicholls, TL, Hart, SD, Brink, J. Predictive validity of dynamic factors: assessing violence risk in forensic psychiatric inpatients. Law Hum Behav. 2013;37(6):377388.CrossRefGoogle ScholarPubMed
Sellers, BG, Desmarais, SL, Hanger, MW Measurement of change in dynamic factors using the START:AV. J Forensic Psychol Pract. 2017;17(3):198215.CrossRefGoogle ScholarPubMed