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Untangling the relationship (if any) between mental illness and crime

MinnPost photo by Sarah T. Williams
Jillian Peterson: "If there was something we could do to stop the revolving door, if there was something that could be changed in the people’s lives, what was it, and what type of program would actually be the most effective?"

After graduating from Grinnell College in 2003 with a degree in sociology, Jillian Peterson went right into the heart of the beast: She took a job as an investigator for the Capital Defender Office in New York City with the task of documenting the bio-psycho-social histories of men facing the death penalty.

The St. Paul native and Central High School alum said she was expecting “to meet Hannibal Lecter types, to be afraid, to feel threatened,” she said. “And I didn’t.”

Instead, she said, she began to see the humanity in these “very immature, very young” offenders who were “products of the lives they had led. And there was always mental illness, often a laundry list of diagnoses if you went way back.”

Peterson, who got her Ph.D. in psychology and social behavior at the University of California Irvine and now teaches at Normandale Community College in Bloomington, spent the next decade seeking to more deeply understand the relationship (if any) between mental illness and criminal behavior.

She knew already that people with serious mental illnesses were (and still are) overrepresented in the criminal justice system: In 2009, 1 million of the 7.3 million people under correctional supervision in the United States were diagnosed with schizophrenia, bipolar disorder or major depression. She also knew that the research consistently showed (and still does) that the vast majority of people who are diagnosed with mental illness are not more violent or dangerous than the general population and are far more likely to be victims than perpetrators of crime.

But she took the research a step further to ask the question: “How often and how consistently do symptoms directly precede criminal behavior among offenders with mental illness?”

The answer is not very often and not very consistently, Peterson and other researchers say in a study published in the current issue of the American Psychological Association’s Law and Human Behavior journal.

150 men and 429 crimes

Peterson and her team of eight conducted extensive interviews with and examined the records of 150 parolees of the Mental Health Court serving Hennepin County. (The specialty court, one of three in the state, operates much like the state’s drug courts, with a focus on reducing recidivism by linking nonviolent offenders to medical and social services.)

“A lot of these people had really long histories of criminal justice involvement,” Peterson said. “And it really was a revolving door. If there was something we could do to stop the revolving door, if there was something that could be changed in the people’s lives, what was it, and what type of program would actually be the most effective?”

The researchers identified and analyzed 429 crimes committed by the group’s members across the span of about 15 years, and found that only 7.5 percent were directly related to mental-health symptoms (including hallucinations, delusions, impulsivity, hopelessness and suicidality).

The team took care to establish rapport and build trust with their subjects, Peterson said. They used a “life-calendar” approach to identify and talk through major life events (births, deaths, breakups, traumas) before addressing the crimes.

When the team combined the categories of symptoms that were “directly related” or “mostly related” they found that 3 percent of the crimes were related to symptoms of major depression, 4 percent to symptoms of schizophrenia disorders and 10 percent to symptoms of bipolar disorder, for a total of about 18 percent.

The study found that those who committed crimes directly related to their symptoms also committed crimes that were independent of their symptoms. The real drivers at play, Peterson said, were not mental-health symptoms but substance-use disorders and social disadvantage (homelessness, unemployment etc.).

Out of the cycle

Peterson readily acknowledges some weaknesses in the study: the small sample size and the partial reliance on self-reporting and retrospection. But she said she hopes the results will change the approach to reducing recidivism.

“If you’re focusing on medication and mental-health treatment, you see symptom improvement, which is great,” she said. “But it doesn’t translate into the reduction of crime and violence in the way that you would think it would.”

An effective approach would include not only treatment for mental-health and substance-use disorders, but also attention to basic needs (chiefly housing and employment), she said. “It’s got to be comprehensive and it’s got to be individualized. Each person has such a different story that any one-size-fits-all program I don’t think is going to be very effective.”

Working with the Hennepin County offenders gave her a greater sense of possibility, Peterson said, a different experience entirely (needless to say) from the one on death row. The research subjects “really wanted to get their lives together, wanted to get a job, wanted to have a house, really had goals and dreams that were attainable, and really wanted to get out of the cycle they were stuck in. It felt less tragic. To me I felt a sense of hope.”

An interesting aside

Lest you worry that Peterson is at all dispirited by her field of study, you can watch her exuberant wedding dance entrance video, which has been viewed more than 84 million times on YouTube and has become a fund-raiser for the Sheila Wellstone Institute’s work against domestic violence.

Untangling the relationship (if any) between mental illness and crime
MinnPost photo by Sarah T. Williams
An autographed thank you from the cast of “The Office” hangs on Peterson’s office wall. The TV series borrowed from Peterson’s YouTube wedding video, “JK Wedding Dance Entrance,” which has been viewed more than 84 million times, and which now raises funds for the Sheila Wellstone Institute to help end violence against women and children.

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Comments (4)

  1. Submitted by Pat Thompson on 04/30/2014 - 09:52 am.

    Indirect effects

    “The study found that those who committed crimes directly related to their symptoms also committed crimes that were independent of their symptoms. The real drivers at play, Peterson said, were not mental-health symptoms but substance-use disorders and social disadvantage (homelessness, unemployment etc.).”

    And substance abuse (self-medicating) and social disadvantages like homelessness and unemployment could easily be related to the underlying mental illness, which I’m sure the researchers realize.

  2. Submitted by craig furguson on 04/30/2014 - 10:07 am.

    The State Risk Assessment

    The LSCMI, does not even list Mental Health as a criminogenic risk factor. Yet 25% of many jail populations screen positive for mental health issues (the two questions often screen people in to medical for continued services are “are you currently taking medication” or “have you ever been hospitalized”). I think that in many ways that we are using jails and prisons as proxy mental health institutions, because they are cheap and available if someone has a crime they can be sentenced on ($100/day vs $1000 at Anoka RTC or even more at a hospital psyc unit). You’ve got many people sitting in jails convicted for up to a year on trespassing and other livability crime – the only option if the client is uncooperative and civil commitment is unavailable. Clients even may get consecutive sentences. The clients get stabilized for jail management purposes (this may actually save their lives, such as they are) and then simply let out the door at the end of their sentences with no support, because there are still not enough community services or else the client refuses to participate. I have some hope that through the ACA (Obamacare) that we may see more resources developed because the law requires MH parity, there is a funding stream for treatment services and health care providers will be trying to figure out a way to manage chronic system users to contain costs. There is currently a lot of incentive to change the system, we just haven’t figured out who or how yet.

  3. Submitted by Peter Mikkalson on 04/30/2014 - 02:45 pm.

    It’s the same insider players as always…

    profiting from treating/streeting mental health patients via the ‘business of law enforcement’ in Minnesota. Consecutive sentences, outrageous charges centered around nothing more than poverty and a fee or fine payable to every agency that ‘touches’ them ensure that those snared in the system are never truly free-nor healed. Shame.

  4. Submitted by bea sinna on 05/01/2014 - 10:07 am.

    the chicken or the egg argument

    Pat, yes, of course there is a relationship between mental illness and homelessness, poverty, unemployment, substance abuse. Mental illness can be exacerbated by social disadvantages as well as be the cause of them.

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