1. “Creating Opportunities for Safer Communities”
Recidivism and mental health: what is the connection and what are we doing about it in Iowa? MARCH 29, 2017
“Creating Opportunities for Safer Communities”
Iowa Department of Corrections

2. Scope of Reentry Challenge
Over 98% of individuals in jail/ prison return to the community, and:
68% of state prisoners are rearrested in 3 years
50% of state prisoners are reincarcerated in 3 years
So, to set the stage for our discussion this morning, what does reentry look like? The bad news…
High numbers of people are released from jails and prisons
Approximately 650,000 individuals are released from prisons each year.
Over 7 million different individuals are released from jails.
Most people released from jail and prison recidivate
Thirty-percent of individuals released from state prisons will be rearrested in the first six months following their release.
Within three years the percentage increases to two-thirds rearrested.
Within the same time frame, half (52%) will return to prison for either new crime or parole revocation.
Need to understand what your recidivism is—to be able to develop comprehensive approaches to transition, to determine what kinds of interventions/approaches will have the greatest impact on recidivism, and demonstrate effectiveness of these interventions
Source: Pew Center on the States (2012); Bureau of Justice Statistics (2014)
Iowa Department of Corrections

3. Reducing recidivism has emerged as a national priority
8/2/2013
Reducing recidivism has emerged as a national priority
1 in 33 adults is under correctional control.
Spending increased from $12 billion in 1988 to $53 billion in 2013.
While many states are seeing cuts to criminal justice components serving recidivism reduction functions.
Despite dropping crime rates across the country, recidivism rates remain stubbornly high.
1 in 33 adults is under some form of correctional control – probation, in prison, on parole…
Over the past 23 years, state spending across the country on corrections has skyrocketed—from $12 billion in 1988 to more than $53 billion in 2013.
As corrections spending has increased, many states are seeing cuts to law enforcement, community-based supervision, treatment, and other criminal justice components providing recidivism reduction functions.
Despite dropping crime rates across the country, recidivism rates remain stubbornly high.
Source: National Association of State Budget Officers, State Expenditure Report (1988 and 2014)
Iowa Department of Corrections

4. National statistics
Nearly 25% of both State prisoners and jail inmates who had a mental health problem, compared to a fifth of those without, had served 3 or more prior incarcerations.
About 74% of State prisoners who had a mental health problem met criteria for substance dependence or abuse.
Nearly 63% of State prisoners who had mental health problems had used drugs in the month before their arrest.
State prisoners who had mental health problem were twice as likely as those without to have been homeless in the year prior to their arrest.
Over 1 in 3 State prisoners who had a mental health problem had received treatment since admission to prison.
BJS Special Report, 2006
Iowa Department of Corrections

5. Iowa Department of Corrections

6. IOWA Prison Population
Iowa Department of Corrections

7. RETURN RATES TO PRISON WITHIN 3 YEARS
Iowa Department of Corrections

8. Statement of the problem
Persons with mental illness are grossly overrepresented in the criminal justice system
Criminal justice systems has become the de facto mental health system
Persons with mental illness are at double risk for failing supervision
…and more likely than their counterparts to fail because of technical violations
Jennifer Skeem, 2016
Iowa Department of Corrections

9. Additional Challenges Due to Stigma
5/2/2018
Additional Challenges Due to Stigma
Reduced Access:
Housing
Employment
Treatment
Other services
Bias
Distrust
Prejudice
Fear
Avoidance
Distress
Anger
Stereotyping
Perception of violence
In addition to the actual mental illnesses and CODs, these individuals face the challenge of how people perceive mental illness
In fact, these individuals are facing three layers of stereotypes: for mental illness, criminal justice involvement, and COD
Real effects on their abilities to interact in society and build the stability that will keep them safe
Derives in part from poor understanding of causes and treatment of mental health and substance use disorders
Many believe that mental illnesses and substance use disorders are signs of individual weakness and not health conditions
Can occur at all levels of society (affects attitudes of individuals with mental illnesses themselves, family members, court personnel, health providers, mental health providers, etc.)
Manifestations of stigma
Impact on access to community supports (e.g., housing, employment) and treatment
Reluctance to seek access to services and treatment
Reluctance to provide access to services and treatment (providers who are reluctant to serve “criminals”)
Inaccurate perception that individuals with mental illnesses are more violent than individuals without mental illnesses
Most people with mental illnesses are not violent, and most people who are violent do not have a mental illness
More likely to be victims than perpetrators
Two significant exceptions – substance abuse and medication adherence
Discrimination
Iowa Department of Corrections
Source: Surgeon General’s Report on Mental Health (1999)

10. The Behavioral Health – Criminal Justice Problem in Summary
5/2/2018
The Behavioral Health – Criminal Justice Problem in Summary
Arrested more often . . .
Incarceration exacerbates symptoms of mental illness. .
Incarcerated longer . . .
Difficulty accessing treatment in the community.. .
More likely to “fail” community supervision . .
What can you do to help support criminal justice and behavioral health staff, providers, and administrators address this problem?
Iowa Department of Corrections 10

11. What is the relationship between crime and mental illness?
Arrest rarely is a direct product of mental illness.
Mental illness is a modest risk for recidivism.
Leading risk factors ( e.g., criminal history, substance abuse, antisocial values & beliefs, antisocial peers, antisocial personality) are shared by those with and without mental illness.
Individuals with mental illness have various pathways into the criminal justice system.
Individuals with mental illness are at increased risk of developing substance abuse disorders and arrests have skyrocketed since 1980s.
Once involved, individuals tend to get caught up in a whirlpool fueled with managing illness and supervision conditions.
Iowa Department of Corrections
Jennifer Skeem, 2016

12. Improving outcomes Quality mental health treatment
Supervision-
Quality
Access/Dosage of correctional interventions
Improved Outcomes—Symptoms & functioning + Reduced risk
Iowa Department of Corrections

13. IDOC’s approach to improving Mental Health outcomes
Mental health training for staff
Core Correctional Practices
Recruiting and retaining mental health staff
Tele-psychiatry
Mental health information sharing program
NAMI P2P
Continuity of treatment
Community Connections Supporting Reentry (CCSR)
Iowa Department of Corrections

14. Criminal Justice Professionals Must Be Able to Rely on Their Partners in the Behavioral Health System
Conduct comprehensive assessments
Develop treatment plans
Provide necessary services
Continuous quality improvement
Improve Public Safety
Improve Public Health
Iowa Department of Corrections

15. Moving forward Balanced approach—supervision and treatment
Opportunities for diversion
Training
Collaboration
Information sharing
Reentry
Bipartisan support
National resources
Iowa Department of Corrections

16. Smarter use of taxpayer dollars:
Reentry Matters
8/2/2013
Public safety:
Helps reduce recidivism, resulting in fewer victims of crime and stops the revolving door of the criminal justice system
Stronger families:
Promotes family reunification and pro-social relationships
Improved community well-being:
Improves economic outcomes and yields healthier communities.
Smarter use of taxpayer dollars:
Reduces costly reincarceration, which diverts public resources away from other public priorities, such as education and social services
Can we tie recidivism reduction to fewer crimes?
Put a face – something for liberals. Families is an example. Reentry matters.
What’s next – how do we take all three categories to the next level – reentry matters, sca, and nrrc – looking ahead – more does the next 5 years hold. We don’t really lay out an agenda for what we’re doing in the future. Slide 3 – parallel that can bring us back to where we’re going.