Part I:
Current Responses to Individuals with Mental Health and Substance Use Disorders and Corrections Involvement People involved in the criminal justice system have wide-ranging needs, particularly those with behavioral health problems. Individuals under correctional control and supervision also pose various levels of risk to the community (risk of committing a new crime and the dangerousness of that crime). Before introducing the proposed framework for multisystem coordination, it is important to highlight some of the principles that guide the work of mental health, substance abuse, and corrections professionals. This context should help readers appreciate that there is no “one size fits all” approach for advancing the recovery of diverse groups of individuals under correctional supervision with substance abuse or mental health disorders—or both—or reducing their likelihood of reoffending. Treatment, support, and supervision must be tailored to individuals’ needs and risk levels.
Mental Health Treatment Mental illnesses are characterized by the diagnosis of a specific illness or disorder, the duration of symptoms, and the associated disability (the degree to which the person’s ability to perform activities of daily living is impaired). While diagnoses and duration are critical dimensions, it is the resultant disability, or functional impairment, that often determines both access to care within publicly funded programs and the types of needed interventions and supports. Some individuals may have disorders not associated with significant functional impairments, but which create challenges for corrections and program management, such as antisocial or borderline personality disorders in which relationships are destabilized by the individuals’ hostile, impulsive, or eccentric behavior.* Community-based treatment settings differ based on need. Individuals with low-level need for intervention and supports or who are otherwise stable are treated
*These disorders are listed on Axis II of the DSM-IV-TR multi-axial typology and are often referred to as “Axis II disorders.” Although historically these have been considered enduring disorders, newer cognitive interventions have been shown to be effective in reducing inappropriate behaviors.
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