Criminal thinking in a community mental health sample: Effects on treatment engagement, psychiatric recovery, and criminality
Gross, Nicole R.
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People who engage in crime evidence thinking styles that support and reinforce antisocial behavior such as manipulativeness, impulsivity and irresponsibility (Yochelson & Samenow, 1976; Walters, 1990). Research with criminal justice (CJ) populations has found criminal thinking to be prevalent among persons with severe mental illness who are incarcerated and that their thinking styles are similar to those of incarcerated persons without serious mental illnesses (Morgan, Fisher, Duan, Mandracchia, & Murray, 2010; Wolff, Morgan, Shi, Fisher, & Huening, 2011). Additionally, a study by Gross & Morgan (2013) found that persons with mental illness admitted to a short-term psychiatric facility with a history of, but no current, CJ involvement evidenced criminal thinking similar to incarcerated persons with mental illness What remains unclear is whether criminal thinking styles are prevalent in community-based clinical samples and, if so, whether criminal thinking styles affect treatment engagement, psychiatric recovery and CJ outcomes. Current community-based interventions for CJ involved persons with serious mental illnesses, are efficacious in reducing mental health symptoms but not in preventing criminal recidivism (Morrisey, Meyer, Cuddeback, 2007; Calsyn, Yonker, Lemming, Morse, & Klinkenberg, 2005). The purpose of this study was to determine the prevalence of criminal thinking in community-based clinical samples, and understand the effects of criminal thinking on psychiatric (e.g., rehospitalization, treatment engagement) and CJ (e.g., reincarceration, arrest) outcomes. Participants (N = 225) were composed of male and female consumers enrolled in Assertive Community Treatment (ACT) and Forensic Assertive Community Treatment (FACT; or programs with a like model of service delivery) programs in four separate states. Results of the between subject Multivariate Analysis of Variance and univariate Analysis of Variance analyses revealed no differences in criminal thinking when comparing participants in ACT and FACT programs, and participants with and without a history of CJ involvement. Additionally, there were no significant differences in the number of PICTS-L-SF scale elevations for participants in ACT and FACT programs, and participants with and without a history of CJ involvement. Linear regression analyses indicated a significant relationship between general criminal thinking and mental health symptomatology. Specifically, both the overall level of symptom distress and the number of mental health symptoms experienced were positively associated with general criminal thinking. It is important to note that the results are limited in that there were substantially fewer participants in FACT programs as compared to ACT programs, and participants without a history of CJ involved as compared to those with a history of CJ involvement. Further, there was high number of community mental health programs that refused to participate in the study or that researchers were unable to contact regarding participation. Researchers were unable to assess for differences between participating and non-participating programs, and results may not generalize to or be representative of all persons enrolled in community mental health programs. The implications of the results will be discussed with reference to the treatment programming and future directions for research. Specifically, the importance of integrated treatment approaches that concurrently address mental health and criminogenic needs for persons with mental illness receiving community mental health services.