Objectives

This study investigates the impact of behavioral health services and neighborhood disadvantage on recidivism among offenders with mental illness in mental health courts (MHCs) and in traditional courts. Although treatment is believed to lead to reduced recidivism for offenders with mental illness, little research has been conducted with MHC participants. Furthermore, neighborhood disadvantages are known to influence recidivism generally, but environmental factors have not been examined in the MHC context.

Methods

Data from the MacArthur MHC study were analyzed including 741 offenders with mental illness. Multilevel negative binomial regression was used to investigate individual and neighborhood level variances on recidivism and to control for the over-dispersion data. Neighborhood disadvantage data were obtained from the American Community Survey linked with residential data from participants.

Results

MHC participants received more behavioral health services of all types than the treatment as usual (TAU) group with the exception of substance abuse case management. However, MHC participants lived in the more disadvantaged neighborhoods compared to the TAU group. MHC participants receiving substance abuse therapy were more likely to be arrested compared to the MHC participants without this therapy. A significant effect of neighborhood disadvantage on arrests was found across all study models.

Conclusions

Professionals should recognize the importance of issues related to treatment-related variables and neighborhood disadvantages to develop, provide, and implement innovative interventions for offenders with mental illness. Understanding behavioral health services and neighborhood disadvantage associated with recidivism can help to more efficiently target research, practice, and policy for offenders with mental illness.

中文翻译：

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行为保健服务和邻里不利对累犯的影响：精神保健法院与传统法院参与者的比较

目标

这项研究调查了行为健康服务和邻里不利对精神疾病罪犯在精神健康法院（MHCs）和传统法院中再犯的影响。尽管据信治疗会减少患有精神疾病的罪犯的累犯率，但与MHC参与者进行的研究很少。此外，已知邻里劣势通常会影响累犯，但尚未在MHC中检查环境因素。

方法

麦克阿瑟MHC研究的数据进行了分析，包括741名患有精神疾病的罪犯。多级负二项式回归用于研究累犯的个体和邻域水平方差，并控制超分散数据。从美国社区调查获得的邻里不利数据与参与者的居住数据相联系。

结果

与MHC参与者相比，MHC参与者获得的所有类型的行为健康服务都多于常规治疗（TAU）组，但药物滥用案件管理除外。但是，与TAU组相比，MHC参与者生活在更为不利的社区。与没有这种疗法的MHC参与者相比，接受药物滥用疗法的MHC参与者更有可能被逮捕。在所有研究模型中均发现邻里不利对逮捕的重大影响。

结论

专业人士应认识到与治疗相关的变量和邻里不利相关的问题对于开发，提供和实施针对精神疾病罪犯的创新干预措施的重要性。了解行为健康服务和与累犯相关的邻里劣势可以帮助更有效地针对患有精神疾病的犯罪者进行研究，实践和制定政策。